bluuebunny/crossref_metadata_2025 huggingface dataset:
Proportion of Non-severe Ischemic Stroke Patients Returning to Work
Authors:   Department of Community Medicine, Family Medicine, and Occupational Medicine, Wipahut Krittin , Chaiear Naesinee ,   Department of Community Medicine, Family Medicine, and Occupational Medicine, Boonjaraspinyo Sirintip ,   Department of Community Medicine, Family Medicine, and Occupational Medicine, Kongbunkiat Kannikar ,   Division of Neurology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, Tiamkao Somsak ,   Division of Neurology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, Soonthornvinit Warisa ,   Department of Community Medicine, Family Medicine, and Occupational Medicine
Published: June 2023

OBJECTIVE To explore the proportion of non-severe ischemic stroke patients returning to work (RTW) and to examine the association of demographic, clinical, and evaluative information with RTW outcomes. METHODS This observational study included non-severe ischemic stroke patients at the stroke ward, Srinagarind Hospital, Khon Kaen, Thailand between September 2021 and November 2022. Patients included were over 18-year-old, had NIHSS scores not exceeding 14, were currently employed and wanted to RTW. Patients were assessed at the discharged time, 2-week-follow-up, and 3-month-follow-up. Bivariate analysis was conducted using either Chi-square or Fisher’s exact test. RESULTS Sixty-four patients were recruited of whom 4 dropped out, leaving a total of 60. The cumulative proportions of successful RTW patients at the discharged time, 2-week-follow-up, 1-month-follow-up, and 3-month-follow-up were 26.7%, 51.7%, 70%, and 76.7% (95%CI 16.8-38.8, 39.2-64.0, 57.7-80.5, 64.9-86.0), respectively. Most patients could RTW in the first month, then the number plateaued at 3 months. More successful RTW patients included those in cognitive demand occupations, evaluated as normal to minor neurological severity, motor power graded 4-5 at discharge, passed MoCA or MMSE test, and who were rated as independent by either the mRS or the BI. Bivariate analysis revealed statistically significant association between RTW proportion and occupation type, neurological severity, motor power, and ADL disability. CONCLUSIONS Most non-severe ischemic stroke patients could RTW within 3 months after discharge. Occupational type, neurological severi-ty, motor power, and ADL associated with the proportion of RTW (3-month-follow-up). RTW evaluation of non-severe stroke patients should be assessed at short intervals for 3 months after discharge. KEYWORDS return to work, ischemic stroke, occupation, cognition, activities of daily living
Identifi cation of the Postharvest Pink Mold Rot Fungus (Trichothecium roseum) on Grapes in China
Authors:   Department of Entomology and Plant Pathology, Faculty of Agriculture, Chiang Mai University, Chiang Mai 50200, Thailand, Harishchandra Dulanjalee Lakmali ,   Beijing Key Laboratory of Environment-Friendly Management on Fruit Diseases and Pests in North China, Institute of Plant Protection, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100097, People’s Republic of China, Zhang Wei ,   Beijing Key Laboratory of Environment-Friendly Management on Fruit Diseases and Pests in North China, Institute of Plant Protection, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100097, People’s Republic of China, Wedaralalage Thilini Chethana Kandawatte ,   Centre of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai 57100, Thailand,   School of Science, Mae Fah Luang University, Chiang Rai 57100, Thailand, Li Xinghong ,   Beijing Key Laboratory of Environment-Friendly Management on Fruit Diseases and Pests in North China, Institute of Plant Protection, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100097, People’s Republic of China, Cheewangkoon Ratchadawan ,   Department of Entomology and Plant Pathology, Faculty of Agriculture, Chiang Mai University, Chiang Mai 50200, Thailand
Published: June 2023

Grape is an important crop due to its consumption as fresh fruit as well as the secondary products developed from the berries such as wines, jams, juice, jellies, and vinegar. Postharvest losses in grapes can adversely affect their market value and the quality of the secondary products developed from grapes. These losses can be due to pathogenic infections and other damage due to improper handling and storage practices. During a brief survey of the cold storage facilities of the Beijing Academy of Forestry and Pomology Sciences, grape berries showing postharvest rot symptoms were collected. Further onsite observations suggested that the disease was postharvest pink mold rot caused by Trichothecium roseum. Trichothecium roseum is an asexually reproducing soil-borne fungus with an unknown sexual morph. This fungus is known to cause postharvest diseases in many fruits and vegetables around the world. Our objective in this study was to report the fi rst occurrence of pink rot on grapes caused by T. roseum with molecular phylogeny, morphological studies, and pathogenicity tests. Also, this is the fi rst report of T. roseum from grapes in China.
Fiber-chip link via mode division multiplexing
Authors: Gordillo Oscar Jimenez , Novick Asher , Wang Oliver , Rizzo Anthony , Dave Utsav , Bergman Keren , Lipson Michal
Published: June 2023

Applying mode division multiplexing techniques to a fiber-chip link would greatly increase its communication bandwidth. However, its implementation is very difficult due to the huge higher-order mode mismatch between multimode integrated waveguides and optical fibers (FMF). Here, we present an integrated coupler between the higher order modes of a silicon waveguide and those of a FMF. Our device is capable of terabit-per-second bandwidth based on the multiplexing of 4 spatial modes. It relies on a multi-stage silicon taper combined with a 3D polymer waveguide, which convert and shape the modes for one-to-one mode coupling to the FMF. We demonstrate an average crosstalk of -7 dB to the closest mode and capability for 1.92 Tb/sec data transmission in the L-band via mode and wavelength division multiplexing.
Simultaneous measurement of temperature and salinity based on hole-assisted dual-core fiber
Authors: Guan Chunying , Liu Yu , Yang Jing , Xue Yuxiao , Gao Shan , tian peixuan , Ye Peng , Duan Zhenyu , Shi Jin-hui , Yang Jun , Yuan Libo
Published: June 2023

A dual-parameter optical fiber sensor based on a hole-assisted dual-core fiber (HADCF) has been proposed and experimentally demonstrated. The dual-mode interferometer generated by the LP01 mode and LP11 mode in the suspended core is combined with the directional coupler formed by the suspended core and the center core in a 16 mm long HADCF. Simultaneous measurements of NaCl salinity and temperature have been achieved by monitoring the interference dip and resonance dip. The measured salinity sensitivity of NaCl and temperature sensitivity are 190.7 pm/‰ and -387.4 pm/℃, respectively. The proposed sensor has the advantages of simple fabrication, high integration and dual parameter measurement, which make it potential applications for marine environment measurement.
Adaptive dynamics of memory-one strategies in the repeated donation game
Authors: LaPorte Philip , Hilbe Christian , Nowak Martin A.
Published: June 2023

Human interactions can take the form of social dilemmas: collectively, people fare best if all cooperate but each individual is tempted to free ride. Social dilemmas can be resolved when individuals interact repeatedly. Repetition allows them to adopt reciprocal strategies which incentivize cooperation. The most basic model for direct reciprocity is the repeated donation game, a variant of the prisoner’s dilemma. Two players interact over many rounds; in each round they decide whether to cooperate or to defect. Strategies take into account the history of the play. Memory-one strategies depend only on the previous round. Even though they are among the most elementary strategies of direct reciprocity, their evolutionary dynamics has been difficult to study analytically. As a result, much previous work has relied on simulations. Here, we derive and analyze their adaptive dynamics. We show that the four-dimensional space of memory-one strategies has an invariant three-dimensional subspace, generated by the memory-one counting strategies. Counting strategies record how many players cooperated in the previous round, without considering who cooperated. We give a partial characterization of adaptive dynamics for memory-one strategies and a full characterization for memory-one counting strategies.
The CERV protein of Cer1, a C. elegans LTR retrotransposon, is required for nuclear export of viral genomic RNA and can form giant nuclear rods
Authors: Sun Bing , Kim Haram , Mello Craig C. , Priess James R.
Published: June 2023

Retroviruses and closely related LTR retrotransposons export full-length, unspliced genomic RNA (gRNA) for packaging into virions and to serve as the mRNA encoding GAG and POL polyproteins. Because gRNA often includes splice acceptor and donor sequences used to splice viral mRNAs, retroelements must overcome host mechanisms that retain intron-containing RNAs in the nucleus. Here we examine gRNA expression in Cer1, an LTR retrotransposon inC.eleganswhich somehow avoids silencing and is highly expressed in germ cells. Newly exported Cer1 gRNA associates rapidly with the Cer1 GAG protein, which has structural similarity with retroviral GAG proteins. gRNA export requires CERV (C.elegansregulator ofviral expression), a novel protein encoded by a spliced Cer1 mRNA. CERV phosphorylation at S214 is essential for gRNA export, and phosphorylated CERV colocalizes with nuclear gRNA at presumptive sites of transcription. By electron microscopy, tagged CERV proteins surround clusters of distinct, linear fibrils that likely represent gRNA molecules. Single fibrils, or groups of aligned fibrils, also localize near nuclear pores. During theC.elegansself-fertile period, when hermaphrodites fertilize oocytes with their own sperm, CERV concentrates in two nuclear foci that are coincident with gRNA. However, as hermaphrodites cease self-fertilization, and can only produce cross-progeny, CERV undergoes a remarkable transition to form giant nuclear rods or cylinders that can be up to 5 microns in length. We propose a novel mechanism of rod formation, in which stage-specific changes in the nucleolus induce CERV to localize to the nucleolar periphery in flattened streaks of protein and gRNA; these streaks then roll up into cylinders. The rods are a widespread feature of Cer1 in wild strains ofC.elegans, but their function is not known and might be limited to cross-progeny. We speculate that the adaptive strategy Cer1 uses for the identical self-progeny of a host hermaphrodite might differ for heterozygous cross-progeny sired by males. For example, mating introduces male chromosomes which can have different, or no, Cer1 elements.
Incentivisation practices and their influence on physicians’ prescriptions: A qualitative analysis of practice and policy in Pakistan
Authors: Khan Mishal , Rahman-Shepherd Afifah , Noor Muhammad Naveed , Sharif Sabeen , Hamid Meherunissa , Aftab Wafa , Isani Afshan Khurshid , Khan Robyna Irshad , Hasan Rumina , Shakoor Sadia , Siddiqi Sameen
Published: June 2023

Focus on profit-generating enterprise in healthcare can create conflicts of interest that adversely impact prescribing and pricing of medicines. Although a global challenge, addressing the impacts on quality of care is particularly difficult in countries where the pharmaceutical industry and physician lobby is strong relative to regulatory institutions. Our study characterises the range of incentives exchanged between the pharmaceutical industry and physicians, and investigates the differences between incentivisation practices and policies in Pakistan. In this mixed methods study, we first thematically analysed semi-structured interviews with 28 purposively selected for-profit primary-care physicians and 13 medical sales representatives from pharmaceutical companies working across Pakistan’s largest city, Karachi. We then conducted a content analysis of policies on ethical practice issued by two regulatory bodies responsible in Pakistan, and the World Health Organization. This enabled a systematic comparison of incentivisation practices with what is considered ‘prohibitive’ or ‘permissive’ in policy. Our findings demonstrate that incentivisation of physicians to meet pharmaceutical sales targets is the norm, and that both parties play in the symbiotic physician-pharma incentivisation dynamics. Further, we were able to categorise the types of incentive exchanged into one of five categories: financial, material, professional or educational, social or recreational, and familial. Our comparison of incentivisation practices with policies revealed three reasons for such widespread incentivisation linked to sales targets: first, some clear policies were being ignored by physicians; second, there are ambiguous or contradictory policies with respect to specific incentive types; and third, numerous incentive types are unaddressed by existing policies, such as pharmaceutical companies paying for private clinic renovations. There is a need for policies to be clarified and updated, and to build buy-in for policy enforcement from pharmaceutical companies and physicians, such that transgressions on target-driven prescribing are seen to be unethical.
Discovery of a novel bat lyssavirus in a Long-fingered bat (Myotis capaccinii) from Slovenia
Authors: Černe Danijela , Hostnik Peter , Toplak Ivan , Presetnik Primož , Maurer-Wernig Jedrt , Kuhar Urška
Published: June 2023

Lyssaviruses are the causative agents of rabies, a zoonotic, fatal disease that is thought to be ancestral to bats. In the last decade, the detection of bat associated lyssaviruses is increasing also in Europe. Within a retrospective bat associated lyssavirus surveillance study a total of 225 dead bats of 21 bat species were collected in Slovenia between 2012 and 2019 and tested by specific real-time RT-PCR method. The first lyssavirus positive sample in bats in Slovenia was detected using the real-time RT-PCR, the fluorescent antibody test, and next generation sequencing, while the rabies tissue culture inoculation test was unsuccessful due to sample degradation and storage conditions. The nearly complete genome of Divača bat lyssavirus from Slovenia consists of 11,871 nucleotides and reflects the characteristic gene organization known for lyssaviruses, encoding the five viral proteins. Phylogenetic analysis of Divača bat lyssavirus revealed that it belongs to phylogroup I lyssaviruses and is most closely related to Kotalahti bat lyssavirus (KBLV) with 87.20% nucleotide and 99.22% amino acid identity. Together with KBLV, Khujand virus, European bat lyssavirus 2, Bakeloh bat lyssavirus, and Aravan virus, Divača bat lyssavirus was detected in the genus Myotis suggesting its key role in the transmission and maintenance of certain lyssaviruses.
Delving in folate metabolism in the parasite Leishmania major through a chemogenomic screen and methotrexate selection
Authors: Bigot Sophia , Leprohon Philippe , Ouellette Marc
Published: June 2023

Most of our understanding of folate metabolism in the parasiteLeishmaniais derived from studies of resistance to the antifolate methotrexate (MTX). A chemical mutagenesis screen ofL.majorFriedlin and selection for resistance to MTX led to twenty mutants with a 2- to 400-fold decrease in MTX susceptibility in comparison to wild-type cells. The genome sequence of the twenty mutants highlighted recurrent mutations (SNPs, gene deletion) in genes known to be involved in folate metabolism but also in novel genes. The most frequent events occurred at the level of the locus coding for the folate transporter FT1 and included gene deletion and gene conversion events, as well as single nucleotide changes. The role of some of theseFT1point mutations in MTX resistance was validated by gene editing. The geneDHFR-TScoding for the dihydrofolate reductase-thymidylate synthase was the second locus with the most mutations and gene editing confirmed a role in resistance for some of these. The pteridine reductase genePTR1was mutated in two mutants. The episomal overexpression of the mutated versions of this gene, but also ofDHFR-TS, led to parasites several fold more resistant to MTX than those overexpressing the wild-type versions. Genes with no known link with folate metabolism and coding for a L-galactolactone oxidase or for a methyltransferase were mutated in specific mutants. Overexpression of the wild-type versions of these genes in the appropriate mutants reverted their resistance. Our Mut-seq approach provided a holistic view and a long list of candidate genes potentially involved in folate and antifolate metabolism inLeishmania.
The diverse genetic genotypes of Bartonella species circulating in rodents from Inner Mongolia, Northern China
Authors: Li Jianyun , Zhang Chenxi , Lu Miao , Wang Yu , Wang Wen , Liu Fang , Wu Shaoqing , Liu Yang , Fan Mengguang , Li Kun
Published: June 2023

Bartonella are generally recognized as zoonotic pathogens of mammals, including many rodent species. However, data on the genetic diversity of Bartonella in some regions are still absent in China. In this study, we collected rodent samples (Meriones unguiculatus, Spermophilus dauricus, Eolagurus luteus, and Cricetulus barabensis) from Inner Mongolia located in Northern China. The Bartonella were detected and identified by sequencing the gltA, ftsZ, ITS, and groEL genes in them. An overall 47.27% (52/110) positive rate was observed. This may be the first report that M. unguiculatus and E. luteus harbor Bartonella. Phylogenetic and genetic analysis on gltA, ftsZ, ITS, and groEL genes indicated that the strains were divided into seven distinct clades, suggesting the diverse genetic genotypes of Bartonella species in this area. Of those, Clade 5 meets the criteria for identification as a novel species based on gene sequence dissimilarity to known Bartonella species and herein we name it “Candidatus Bartonella mongolica”.
The COVID-19 pandemic and its impacts on diet quality and food prices in sub-Saharan Africa
Authors: Ismail Abbas , Madzorera Isabel , Apraku Edward A. , Tinkasimile Amani , Dasmane Dielbeogo , Zabre Pascal , Ourohire Millogo , Assefa Nega , Chukwu Angela , Workneh Firehiwot , Mapendo Frank , Lankoande Bruno , Hemler Elena , Wang Dongqing , Abubakari Sulemana W. , Asante Kwaku P. , Baernighausen Till , Killewo Japhet , Oduola Ayoade , Sie Ali , Soura Abdramane , Vuai Said , Smith Emily , Berhane Yemane , Fawzi Wafaie W.
Published: June 2023

Background

Sub-Saharan Africa faces prolonged COVID-19 related impacts on economic activity, livelihoods and nutrition, with recovery slowed down by lagging vaccination progress.

Objective

This study investigated the economic impacts of COVID-19 on food prices, consumption and dietary quality in Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania.

Methods

We conducted a repeated cross-sectional study using a mobile platform to collect data from July-December, 2021 (round 2). We assessed participants’ dietary intake of 20 food groups over the previous seven days and computed the primary outcome, the Prime Diet Quality Score (PDQS), and Dietary Diversity Score (DDS), with higher scores indicating better quality diets. We used generalized estimating equation (GEE) linear regression models to assess factors associated with diet quality during COVID-19.

Results

Most of the respondents were male and the mean age was 42.4 (±12.5) years. Mean PDQS (±SD) was low at 19.4(±3.8), out of a maximum score of 40 in this study. Respondents (80%) reported higher than expected prices for all food groups. Secondary education or higher (estimate: 0.73, 95% CI: 0.32, 1.15), medium wealth status (estimate: 0.48, 95% CI: 0.14, 0.81), and older age were associated with higher PDQS. Farmers and casual laborers (estimate: -0.60, 95% CI: -1.11, -0.09), lower crop production (estimate: -0.87, 95% CI: -1.28, -0.46) and not engaged in farming (estimate: -1.38, 95% CI: -1.74, -1.02) were associated with lower PDQS.

Conclusion

Higher food prices and lower diet quality persisted during the COVID-19 pandemic. Economic and social vulnerability and reliance on markets (and lower agriculture production) were negatively associated with diet quality. Although recovery was evident, consumption of healthy diets remained low. Systematic efforts to address the underlying causes of poor diet quality through transforming food system value chains, and mitigation measures, including social protection programs and national policies are critical.
Variability in phenylalanine side chain conformations facilitates broad substrate tolerance of fatty acid binding in cockroach milk proteins
Authors: Santhakumari Partha Radhakrishnan , Dhanabalan KanagaVijayan , Virani Saniya , Hopf-Jannasch Amber S. , Benoit Joshua B. , Chopra Gaurav , Subramanian Ramaswamy
Published: June 2023

Diploptera punctata, also known as the Pacific beetle cockroach, is a viviparous cockroach that gives birth to live offspring and secretes a highly concentrated mixture of glycosylated proteins as a source of nourishment for developing embryos. These proteins are lipocalins that bind to lipids and crystallize in the gut of the embryo. A structure of milk crystals harvested from the embryos showed that the milk-derived crystals were heterogeneous and made of three proteins (called Lili-Mips). We hypothesized that the isoforms of Lili-Mip would display different affinities for fatty acids due to the ability of the pocket to bind multiple acyl chain lengths. We previously reported the structures of Lili-Mip from crystals grownin vivoand recombinantly expressed Lili-Mip2. These structures are similar, and both bind to several fatty acids. This study explores the specificity and affinity of fatty acid binding to recombinantly expressed Lili-Mip 1, 2 & 3. We show that all isoforms can bind to different fatty acids with similar affinities. We also report the thermostability of Lili-Mip is pH dependent, where stability is highest at acidic pH and declines as the pH increases to physiological levels near 7.0. We show that thermostability is an inherent property of the protein, and glycosylation and ligand binding do not change it significantly. Measuring the pH in the embryo’s gut lumen and gut cells suggests that the pH in the gut is acidic and the pH inside the gut cells is closer to neutral pH. In various crystal structures (reported here and previously by us), Phe-98 and Phe-100 occupy multiple conformations in the binding pocket. In our earlier work, we had shown that the loops at the entrance could adapt various conformations to change the size of the binding pocket. Here we show Phe-98 and Phe-100 can reorient to stabilize interactions at the bottom of the cavity–and change the volume of the cavity from 510 Å3to 337 Å3. Together they facilitate the binding of fatty acids of different acyl chain lengths.
180 years of marine animal diversity as perceived by public media in southern Brazil
Authors: Herbst Dannieli Firme , Rampon Jara , Baleeiro Bruna , Silva Luiz Geraldo , Fossile Thiago , Colonese André Carlo
Published: June 2023

Commoditization of marine resources has dramatically increased anthropogenic footprints on coastal and ocean systems, but the scale of these impacts remain unclear due to a pervasive lack of historical baselines. Through the analysis of historical newspapers, this paper explores changes in marine animals (vertebrates and invertebrates) targeted by historical fisheries in southern Brazil since the late 19th century. The investigation of historical newspaper archives revealed unprecedented information on catch composition, and perceived social and economic importance of key species over decades, predating official national-level landing records. We show that several economically and culturally important species have been under persistent fishing pressure at least since the first national-scale subsidies were introduced for commercial fisheries in Brazil in the late 19th and early 20th centuries. Our work expands the current knowledge on historical fish catch compositions in the southwestern Atlantic Ocean, while advocating for the integration of historical data in ocean sustainability initiatives.
Pharmacists’ communication skills with deaf and hard of hearing patients: A needs assessment
Authors: Al Aloola Noha , Alanazi Maram , Alotaibi Norah , Alwhaibi Monira
Published: June 2023

Objectives

Assess the Saudi pharmacists’ perceptions of their responsibilities toward deaf and hard-of-hearing (DHH) patients, their current practices, and their need for communication skills training.

Study design

A prospective cross-sectional study.

Methods

Pharmacist and deaf communication questionnaire (PDCQ), a newly structured, validated, pilot-tested, and self-administered online questionnaire, was used to collect data. A total of 303 pharmacists working in the Saudi community and outpatient pharmacies participated in the study. Data were analyzed using SPSS and descriptive statistics were used to describe the study findings. These included Mean ± standard deviation (SD), frequency, and Chi-square tests.

Results

Most pharmacists perceived that DHH patients had difficulty correctly understanding their medication instructions. Writing was the most common method used for communication, whereas the unavailability of interpreters and the low reading levels of these patients were the highest barriers to communication. Moreover, most pharmacists believed that they should be skilled at communicating with DHH patients. However, many pharmacists felt that they are not well prepared to communicate with these patients.

Conclusion

This research highlights the poor skills, low confidence and low knowledge Saudi pharmacists have about their legal obligations towards DHH patients. In addition, there is paucity of sufficient resources to help pharmacists improve their communication with such patients.
Systemic pro- and anti-inflammatory profiles in acute non-specific low back pain: An exploratory longitudinal study of the relationship to six-month outcome
Authors: Chang Wei-Ju , Jenkins Luke C. , Humburg Peter , Wasinger Valerie , Walton David M. , Schabrun Siobhan M.
Published: June 2023

Objectives

Pro-inflammatory molecules are thought to underpin the development of chronic low back pain (LBP). Although research has begun to explore the association between pro-inflammatory molecules in acute LBP and long-term outcome, no study has explored the role of anti-inflammatory molecules. We aimed to explore whether levels of systemic pro- and anti-inflammatory molecules 1) changed over a period of six months from the onset of acute LBP; 2) differed between people who were recovered (N = 11) and unrecovered (N = 24) from their episode of LBP at six months; 3) baseline psychological factors were related to inflammatory molecule serum concentrations at baseline, three and six months.

Methods

We retrospectively included participants with acute LBP included from a larger prospective trial and examined blood samples for the measurement of pro- and anti-inflammatory molecules and measures of pain, disability, and psychological factors at baseline, three and six months.

Results

The serum concentrations of pro- and anti-inflammatory molecules did not differ over time when compared between participants who recovered and those who did not recover at six-month follow-up. At three months, the unrecovered group had higher interleukin (IL)-8 and IL-10 serum concentrations than the recovered group. Baseline psychological factors were not related to inflammatory molecules at any time point.

Discussion

This exploratory study showed that levels of systemic inflammatory molecules did not change over the course of LBP, irrespective of whether people were recovered or unrecovered at six months. There was no relationship between acute-stage psychological factors and systemic inflammatory molecules. Further investigation is needed to elucidate the contribution of pro- and anti-inflammatory molecules to long-term LBP outcome.
Minimum acceptable dietary intake among children aged 6–23 months in Ethiopia: A systematic review and meta-analysis
Authors: Kassie Gizachew Ambaw , Gebrekidan Amanuel Yosef , Enaro Eskinder Yilma , Asgedom Yordanos Sisay
Published: June 2023

Background

In the absence of minimum acceptable diet, children aged 6–23 months are vulnerable to malnutrition. Not feeding at least the minimum acceptable diet is a major global problem, particularly in developing countries. Even though many studies have been conducted in Ethiopia there are inconsistencies. Therefore, this review aimed to estimate the pooled prevalence of a minimum acceptable diet in Ethiopia.

Methods

Published articles from various electronic databases, such as PubMed/MEDLINE, EMBASE, Google Scholar, and Science Direct were systematically searched. All cross-sectional studies conducted on the minimum acceptable diet of children aged 6–24 months and published up to October 30/2021 were included in this review. Data were extracted using an Excel spreadsheet and analyzed using STATA version 14.1. The random-effects model was used to estimate the pooled prevalence, and a subgroup analysis was performed to identify the possible source of heterogeneity. Begg’s and Egger’s tests were used to identify possible publication bias.

Results

Nine cross-sectional studies involving 4,223 participants were included. Significant heterogeneity was observed across the studies (I2 = 99.4%). The pooled prevalence of minimum acceptable diet in Ethiopia was found to be 25.69% (95% CI: 11.96, 39.41)

Conclusion

This review revealed that the minimum acceptable dietary intake among children aged 6–23 months in Ethiopia was relatively low; only 1 in 4 of children met the minimum acceptable diet. This indicates that the government should promote child feeding practices according to guidelines to increase the proportion of children with a minimum acceptable diet.
The effectiveness of lifestyle interventions on ecological literacy: A contribution to the underlying mechanism in linguistic ecology
Authors: Ha Changchen , Chen Yang , Zhang Jiaen , Dong Shumin
Published: June 2023

In today’s society, citizens’ ecological literacy (ecoliteracy) is critical for their understanding of sustainable development. This study used a questionnaire designed to quantitatively assess ecoliteracy from a linguistic ecology perspective. First, an underlying mechanism model for ecoliteracy was designed based on the results of previous studies. Then, the ecoliteracy level assessment scores of Guiyang inhabitants were combined with the respondents’ corresponding lifestyle characteristics to explore the effectiveness of interventions in affecting the participants’ ecoliteracy levels. The results showed that the formation and development of ecoliteracy is a dynamic and circular process that revolves around variables of independent, dependent, mediating, moderating and control. The various factors in the model interact and operate evenly along a particular path. As for the level of lifestyle characteristics, participants’ ecoliteracy levels had a statistically significant relationship with their attitudes regarding the importance of nature, participating in outdoor activities, and improving their ecoliteracy levels; as well as the frequencies regarding daily outdoor activity, the main activities in ecological areas, participation in volunteer activities, and use of ecological knowledge. The respondents with the highest levels of ecoliteracy had the most positive attitudes and engaged in ecological actions with the highest frequency. The lifestyle intervention features here are of great significance to the harmonious coexistence between humans and the natural environment and are also helpful for improving human health.
A deep attention LSTM embedded aggregation network for multiple histopathological images
Authors: Kim Sunghun , Lee Eunjee
Published: June 2023

Recent advancements in computer vision and neural networks have facilitated the medical imaging survival analysis for various medical applications. However, challenges arise when patients have multiple images from multiple lesions, as current deep learning methods provide multiple survival predictions for each patient, complicating result interpretation. To address this issue, we developed a deep learning survival model that can provide accurate predictions at the patient level. We propose a deep attention long short-term memory embedded aggregation network (DALAN) for histopathology images, designed to simultaneously perform feature extraction and aggregation of lesion images. This design enables the model to efficiently learn imaging features from lesions and aggregate lesion-level information to the patient level. DALAN comprises a weight-shared CNN, attention layers, and LSTM layers. The attention layer calculates the significance of each lesion image, while the LSTM layer combines the weighted information to produce an all-encompassing representation of the patient’s lesion data. Our proposed method performed better on both simulated and real data than other competing methods in terms of prediction accuracy. We evaluated DALAN against several naive aggregation methods on simulated and real datasets. Our results showed that DALAN outperformed the competing methods in terms of c-index on the MNIST and Cancer dataset simulations. On the real TCGA dataset, DALAN also achieved a higher c-index of 0.803±0.006 compared to the naive methods and the competing models. Our DALAN effectively aggregates multiple histopathology images, demonstrating a comprehensive survival model using attention and LSTM mechanisms.
Measuring implementation outcomes in the context of scaling up possible serious bacterial infection guidelines: Implications for measurement and programs
Authors: Abuya Timothy , Odwe George , Ndwiga Charity , Okondo Chantalle , Liambila Wilson , Mungai Samuel , Mwaura Peter , K’Oduol Kezia , Natecho Alice , Gitaka Jesse , Warren Charlotte E.
Published: June 2023

Background

Reducing the burden of neonatal sepsis requires timely identification and initiation of suitable antibiotic treatment in primary health care (PHC) settings. Countries are encouraged to adopt simplified antibiotic regimens at the PHC level for treating sick young infants (SYI) with signs of possible serious bacterial infection (PSBI). As countries implement PSBI guidelines, more lessons on effective implementation strategies and outcome measurements are needed. We document pragmatic approaches used to design, measure and report implementation strategies and outcomes while adopting PSBI guidelines in Kenya.

Methods

We designed implementation research using longitudinal mixed methods embedded in a continuous regular systematic learning and adoption of evidence in the PHC context. We synthesized formative data to co-create with stakeholders, implementation strategies to incorporate PSBI guidelines into routine service delivery for SYIs. This was followed by quarterly monitoring for learning and feedback on the effect of implementation strategies, documented lessons learned and tracked implementation outcomes. We collected endline data to measure the overall effect on service level outcomes.

Results

Our findings show that characterizing implementation strategies and linking them with implementation outcomes, helps illustrate the pathway between the implementation process and outcomes. Although we have demonstrated that it is feasible to implement PSBI in PHC, effective investment in continuous capacity strengthening of providers through blended approaches, efficient use of available human resources, and improving the efficiency of service areas for managing SYIs optimizes timely identification and management of SYI. Sustained provision of commodities for management of SYI facilitates increased uptake of services. Strengthening facility-community linkages supports adherence to scheduled visits. Enhancing the caregiver’s preparedness during postnatal contacts in the community or facility will facilitate the effective completion of treatment.

Conclusion

Careful design, and definition of terms related to the measurement of implementation outcomes and strategies enable ease of interpretation of findings. Using the taxonomy of implementation outcomes help frame the measurement process and provides empirical evidence in a structured way to demonstrate causal relationships between implementation strategies and outcomes. Using this approach, we have illustrated that the implementation of simplified antibiotic regimens for treating SYIs with PSBI in PHC settings is feasible in Kenya.
Computer simulation approach to the identification of visfatin-derived angiogenic peptides
Authors: Choi Ji Myung , Vuppala Srimai , Park Min Jung , Kim Jaeyoung , Jegal Myeong-Eun , Han Yu-Seon , Kim Yung-Jin , Jang Joonkyung , Jeong Min-Ho , Joo Bo Sun
Published: June 2023

Angiogenesis plays an essential role in various normal physiological processes, such as embryogenesis, tissue repair, and skin regeneration. Visfatin is a 52 kDa adipokine secreted by various tissues including adipocytes. It stimulates the expression of vascular endothelial growth factor (VEGF) and promotes angiogenesis. However, there are several issues in developing full-length visfatin as a therapeutic drug due to its high molecular weight. Therefore, the purpose of this study was to develop peptides, based on the active site of visfatin, with similar or superior angiogenic activity using computer simulation techniques.Initially, the active site domain (residues 181∼390) of visfatin was first truncated into small peptides using the overlapping technique. Subsequently, the 114 truncated small peptides were then subjected to molecular docking analysis using two docking programs (HADDOCK and GalaxyPepDock) to generate small peptides with the highest affinity for visfatin. Furthermore, molecular dynamics simulations (MD) were conducted to investigate the stability of the protein-ligand complexes by computing root mean square deviation (RSMD) and root mean square fluctuation(RMSF) plots for the visfatin-peptide complexes. Finally, peptides with the highest affinity were examined for angiogenic activities, such as cell migration, invasion, and tubule formation in human umbilical vein endothelial cells (HUVECs). Through the docking analysis of the 114 truncated peptides, we screened nine peptides with a high affinity for visfatin. Of these, we discovered two peptides (peptide-1: LEYKLHDFGY and peptide-2: EYKLHDFGYRGV) with the highest affinity for visfatin. In an in vitrostudy, these two peptides showed superior angiogenic activity compared to visfatin itself and stimulated mRNA expressions of visfatin and VEGF-A. These results show that the peptides generated by the protein-peptide docking simulation have a more efficient angiogenic activity than the original visfatin.
Feasibility of a patient-oriented navigation programme for patients with lung cancer or stroke in Germany: Protocol of the CoreNAVI study
Authors: Gödde Kathrin , Fügemann Hella , Goerling Ute , Grittner Ulrike , Kohl Raphael , Meisel Andreas , Reinhold Thomas , Schnitzer Susanne , Deckert P. Markus , Frost Nikolaj , Schreiber Stephan J. , Rieckmann Nina , Holmberg Christine
Published: June 2023

Background

Patient navigation programmes were introduced in the United States and recently gained interest in Germany, where the health care system is fragmented. Navigation programmes aim to decrease barriers to care for patients with age-associated diseases and complex care paths. Here we describe a feasibility study to evaluate a patient-oriented navigation model that was developed in a first project phase by integrating data about barriers to care, vulnerable patient populations and existing support services.

Methods

We designed a mixed-methods feasibility study that consists of two two-arm randomized controlled trials aligned with observational cohorts. The intervention group of the RCTs gets support by personal navigators for 12 months. The control group receives a brochure with regional support offers for patients and caregivers. The feasibility of the patient-oriented navigation model for two prototypic age-associated diseases, lung cancer and stroke, is evaluated with regard to its acceptance, demand, practicality and efficacy. This investigation includes process evaluation measures with detailed documentation of the screening and recruitment process, questionnaires about satisfaction with navigation, observant participation and qualitative interviews. Estimates of efficacy for patient-reported outcomes are obtained at three follow-up time points including satisfaction with care and health-related quality of life. Furthermore, we analyze health insurance data from patients of the RCT insured at a large German health insurance (AOK Nordost) to investigate heath care utilization, costs and cost effectiveness.

Trial registration

The study is registered at the German Clinical Trial Register (DRKS-ID: DRKS00025476).
NAUNEHAL; Integrated immunization and MNCH interventions: A quasi-experimental study–Protocol
Authors: Ataullahjan Anushka , Khan Amira , Islam Muhammad , Tahir Rehman , Anwar Saeed , Ahmed Imran , Nauman Ahmed , Bhutta Zulfiqar A.
Published: June 2023

Introduction

Great improvements in the health of newborns, children, and women in Pakistan are needed. A large body of literature has demonstrated that the majority of maternal, newborn, and child deaths are preventable with essential health strategies including immunization, nutrition interventions, and child health interventions. Despite the importance of these interventions for the health of women and children, access to services continues to be a barrier. Furthermore, demand for services also contributes to low coverage of essential health interventions. Given the emerging threat of COVID-19 coupled with already weak maternal and child health, delivering effective and feasible nutrition and immunization services to communities, and increasing demand and uptake of services is a pressing and important need.

Methods and analysis

This quasi-experimental study aims to improve health service delivery and increase uptake. The study included four main intervention strategies including community mobilization, mobile health teams offering MNCH and immunization services, engagement of the private sector, and testing of a comprehensive health, nutrition, growth, and immunization app, Sehat Nishani, for a period of 12 months. The target group of the project were women of reproductive age (15–49 years) and children under-five. The project was implemented in three union councils (UCs) in Pakistan including Kharotabad-1(Quetta District, Balochistan), Bhana Mari (Peshawar District, Khyber Pakhtunkhwa) and Bakhmal Ahmedzai (Lakki Marwat district, Khyber Pakhtunkhwa). Propensity score matching based on size, location, health facilities, and key health indicators of UC was conducted to identify three matched UCs. A household baseline, midline, endline and close-out assessment will be conducted for evaluating coverage of interventions as well as the knowledge, attitude, and practices of the community in the MNCH and COVID-19 context. Descriptive and inferential statistics will be used to test hypotheses. As well, a detailed cost-effectiveness analysis will be conducted to generate costing data for these interventions to effectively inform policymakers and stakeholder on feasibility of the model.

Trial registration: NCT05135637.
Using deep LSD to build operators in GANs latent space with meaning in real space
Authors: Toledo-Marín J. Quetzalcóatl , Glazier James A.
Published: June 2023

Generative models rely on the idea that data can be represented in terms of latent variables which are uncorrelated by definition. Lack of correlation among the latent variable support is important because it suggests that the latent-space manifold is simpler to understand and manipulate than the real-space representation. Many types of generative model are used in deep learning, e.g., variational autoencoders (VAEs) and generative adversarial networks (GANs). Based on the idea that the latent space behaves like a vector space Radford et al. (2015), we ask whether we can expand the latent space representation of our data elements in terms of an orthonormal basis set. Here we propose a method to build a set of linearly independent vectors in the latent space of a trained GAN, which we call quasi-eigenvectors. These quasi-eigenvectors have two key properties: i) They span the latent space, ii) A set of these quasi-eigenvectors map to each of the labeled features one-to-one. We show that in the case of the MNIST image data set, while the number of dimensions in latent space is large by design, 98% of the data in real space map to a sub-domain of latent space of dimensionality equal to the number of labels. We then show how the quasi-eigenvectors can be used for Latent Spectral Decomposition (LSD). We apply LSD to denoise MNIST images. Finally, using the quasi-eigenvectors, we construct rotation matrices in latent space which map to feature transformations in real space. Overall, from quasi-eigenvectors we gain insight regarding the latent space topology.
‘I’m not the mother I wanted to be’: Understanding the increased responsibility, decreased control, and double level of intentionality, experienced by abused mothers
Authors: Dekel Bianca , Abrahams Naeemah
Published: June 2023

A paucity of research has been conducted within South Africa on abused women’s experiences of motherhood, even though abused women tend to be at increased risk of negative physical and mental health difficulties, which can interfere with their ability to take care of themselves and their children. The aim of this qualitative study was to explore women’s experiences of mothering in the context of an abusive relationship. Data was collected via individual, telephonic, semi-structured, in-depth interviews with 16 mothers from three South African provinces, and analyzed according to the principles of grounded theory. Our findings highlight the mothers’ experiences of: a simultaneous increased sense of responsibility with regards to their children and a loss of control over their mothering; as well as experiencing abuse aimed at either the mother or the child, which is simultaneously meant to affect the other; and lastly, mothers’ assessing themselves negatively through normative paradigms of ‘good mothering’, regardless that they often mother in the best way they know how to, given challenging circumstances. Therefore, this study highlights that the motherhood institution continues to create ‘good mothering’ benchmarks against which women themselves evaluate their mothering, often leading to feelings of inadequacy. Our findings also emphasize that the environment created by men’s abuse is in conflict with the great expectations placed upon mothers in abusive relationships. Thus, mothers may experience huge pressure, which may lead to feelings of failure, self-blame, and guilt. This study has demonstrated that the abuse mothers’ encounter adversely impacted on their mothering. We therefore emphasize the need to better understand how mothering is influenced by and responsive to violence. This is important as understanding abused women’s experiences can assist us to further develop appropriate support mechanisms needed to ensure minimal impact on both women and their children.