bluuebunny/crossref_metadata_2025 huggingface dataset:
As trajetórias assistenciais de usuários com obesidade na rede de atenção à saúde de Porto Alegre
Authors: Kessler Amanda Luisa , Nicolodi Francescato Ruiz Eliziane , Schuch Ilaine
Published: December 2023

Introdução:Partindo de toda a complexidade envolvida no enfrentamento da obesidade, o objetivo deste estudo foi analisar as trajetórias assistenciais de usuários com obesidade pela Rede de Atenção à Saúde do município de Porto Alegre-RS. Objetivo: analisar as trajetórias assistenciais de usuários com obesidade pela Rede de Atenção à Saúde do município de Porto Alegre-RS. Métodos:Estudo qualitativo e exploratório, com indivíduos que realizaram cirurgia bariátrica pela rede pública e profissionais de saúde, por meio de entrevista semiestruturada. Resultados: A partir da análise de conteúdo, foi possível traçar as trajetórias, destacando todos os pontos de atenção à saúde e profissionais acessados pelos usuários. Evidenciou-se que o cuidado àpessoa com obesidade se encontra fragilizado, ocorrendo em sua maioria em serviços especializados. A cirurgia bariátrica apareceu como uma opção central para o tratamento da obesidade, mesmo antes de se esgotarem outras tentativas de cuidado. Algumas das dificuldades apontadas foram a quase inexistência de equipe multiprofissional e a escassez de outras formas de cuidados. Como potencialidade,destacaram-se a facilidade de acessoe vínculos construídos na AB. Conclusão: Apesar dos avanços, o sistema de saúde brasileiro, em especial a Atenção Primária, ainda carece de melhorias, devendo ser vista não somente como primeiro local de acesso e encaminhamento, mas como ponto principal da rede, onde o usuário tenha suas necessidades reconhecidas.
The economic burden of stomas in the UK: a retrospective observational study of health records and hospital encounters
Authors: Mthombeni Fiona , Cawson Matthew , Chan Gerald , Boisen Esben Bo , Rethmeier Line O. , Pearson-Stuttard Jonathan
Published: December 2023

Background:

Stomas divert waste from the small intestine (ileostomy), large intestine (colostomy) or ureters (urostomy), and complications are common.

Aims:

This study evaluated healthcare resource utilisation (HCRU) and costs of stomas from a UK perspective.

Methods:

This was a retrospective observational study of adults with new stomas (New Stoma Group) or new/existing stomas and >6 months of follow-up (Established Stoma Group) using health records linked with hospital encounters (January 2009–December 2018). Age- and sex-matched controls were identified for each stoma case (1:50)

Findings:

Both the New (n=8533) and Established (n=9397) stoma groups had significantly higher HCRU (all P<0.0001) and associated costs (all P<0.01), driven by inpatient admissions. New Stoma Group: colostomy versus controls, £3227 versus £99 per person; ileostomy, £2576 versus £78 per person; and urostomy, £2850 versus £110 per person (all P<0.0001). Findings were similar in the Established Stoma Group.

Conclusion:

Stomas are associated with a substantial economic burden in the UK driven by hospital care. (Supplementary data tables can be obtained from the authors.)
Health check
Authors: Adebayo Shirley
Published: December 2023

Senior health visitor Shirley Adebayo, of North Middlesex University Hospital, sets out how early years settings can help tackle the epidemic of tooth decay among young children
All about …: small spaces
Authors: Rawstrone Annette
Published: December 2023

What is it that makes enclosed spaces so appealing to many children, and how can early years settings support them in this? Annette Rawstrone reports
HR guru: PATERNITY LEAVE
Authors: Edmunds Imogen
Published: December 2023

Imogen Edmunds, managing director of Redwing Solutions, which specialises in HR for early years settings, on paternity leave rights.
There is No Such Thing as a Quick Fix: Travel Times to Subsurface Drains
Authors: Kladivko Eileen , Bowling Laura
Published: December 2023

Highlights

Bromide tracer was applied at different distances from subsurface drains to assess travel times and preferential flow.

Some bromide arrived at the drain outlet with the first water flow after application, indicating preferential flow.

Total time for “cleanout” of bromide from the plots varied with drain spacing and relative distance from the drain.

When changing management practices, the full impact of the new system will not be reflected until several years later.

Abstract. Subsurface “tile” drains are an important water management practice for many productive agricultural soils, but drains also deliver nitrate-nitrogen and other soluble chemicals from the bottom of the rootzone to surface ditches and streams. Many studies have focused on determining different ways to reduce the delivery of nitrate and other chemicals to subsurface drains while still providing adequate drainage for crop production. One important consideration in such studies that is often overlooked is the response time of drainage outflow to changes in management at the soil surface. Drains integrate flow from distances immediately adjacent to the drain all the way to the midplane between parallel drains, which means changes in management will not be fully reflected in drainage waters for months to several years, depending on the drainage intensity, soil characteristics, and precipitation. This bromide tracer study was conducted at the Southeast Purdue Agricultural Center (SEPAC) in Indiana, USA. Bromide tracer was applied at the beginning of the drainage season (November) at different distances from the drains on multiple plots of different drain spacings. The bromide concentration in the drainflow was monitored over the next five years to determine breakthrough curves and the amount of time required to flush the bromide from the system. The initial breakthrough of bromide occurred during the first appearance of drainage after application, regardless of the location of the bromide strip, suggesting some preferential flow was occurring. This was further investigated with comparison to curves of theoretical travel time following Kirkham’s analytic solution for flow to a tile drain. The full transport of the bulk of the chemical took 2-3 years, but varied greatly among the different treatments, reflecting the longer travel times for locations further from the drain. Keywords: Keywords., Drainage, Preferential flow, Streamlines, Subsurface drainage, Travel times.
Polemic in Greek Art and Architecture
Authors: Scott Michael
Published: December 2023

ABSTRACT: This article argues for the existence of an artistic and architectural polemical discourse amongst the dedicatory monuments erected within the sanctuary of Delphi. With particular reference to monuments erected relating to the Persian wars of the fifth century bce, this article argues that the polemical discourse created between them focused not only on offering divergent views on the respective roles each dedicator played in the different battles, but also, more broadly and importantly, on offering conflicting understandings of how this conflict should be remembered as an event in Greek history, culture and identity.
Polemic in Polybius
Authors: Burton Paul
Published: December 2023

ABSTRACT: Polybius (c. 200–118 bc) is a notoriously combative historian, gleefully attacking his fellow historians for their moral failings and intellectual crimes, and their works for their misleading errors and grave distortions. But Polybius sometimes appears guilty himself of some of the same faults he finds in others. This paper aims to assess Polybius’ quality and reliability as a writer of history on his own terms, that is, according to the strict standards he sets for other historians, with the ultimate aim of determining whether his Histories marks a return to the high historiographical standards set by Polybius’ famous predecessor Thucydides, or perpetrates the same historiographical high crimes and misdemeanours he accuses his contemporary historical writers of committing.
Two polemics in want of a history: Sallust and Cicero
Authors: Wilson Marcus
Published: December 2023

ABSTRACT: Insight into the characteristics of Roman polemic can be revealed by contextualizing the two invectives transmitted among the works of Sallust alongside Cicero’s De optimo genere oratorum . The mutual attempts at character assassination of ‘Cicero’ and ‘Sallust’, usually considered of limited value by modern historians and biographers, show up the fault lines between genres (historiography and oratory), between education and entertainment, and between demolishing an opponent’s reputation and pairing oneself with him in perpetuity. These fictional defamatory attacks raise the participants to a level of fame analogous to, if not superior to, that of Aeschines and Demosthenes in the Greek rhetorical canon.
Theseus in the labyrinth
Authors: Futter Dylan
Published: December 2023

ABSTRACT: This article discusses the myth of Theseus and the Minotaur in light of the distinction between labyrinth and maze. According to the myth, Ariadne helped Theseus to escape from a labyrinth by giving him ball of string. But if a labyrinth is unlike a maze in presenting no choices to the wanderer, then why did Theseus need a clue? Though this question has not been systematically addressed in the scholarship, two lines of response can be identified. First, some scholars maintain that the 'labyrinth' in the myth must be a multicursal maze, for otherwise the story would make no sense. Secondly, others hold that they can make sense of the myth even if the labyrinth has but a single path. I argue against both positions in favour of an account that highlights the constructive use of contradiction in myth.
Anti-laser interference methods for compressive spectral imaging based on grayscale coded aperture
Authors: Zhang Hao , Ye Qing , Sun Ke , Li Yangliang , Wu Yunlong , Xu Haiping , Luo Haoqi
Published: December 2023

Coded aperture snapshot spectral imaging (CASSI) captures three-dimensional (3D) spectral images by one or several snapshots two-dimensional (2D) measurements. At present, in practical application of spectral imaging systems, artificial interference such as laser irradiation is wide-spread. When CASSI system is irradiated by intense laser, optoelectronic image sensor will inevitably be dazzled, leading to the loss of compressive sampling information, thereby reducing the reconstruction accuracy of spectral images. This paper establishes the imaging model of CASSI system under laser interference and proposes a grayscale coding design method. Through the design of a reasonable and feasible feedback model, the grayscale coded aperture is calculated according to the measurements of CASSI system in real time feedback. The intensity of the incident light of the system is modulated to reduce the power density on the sensor, thus avoiding sensor saturation, and improving the anti-laser interference threshold of the CASSI system. Simulation results show the improvement of reconstruction accuracy when grayscale coded apertures are employed.
Optical Parameter Extraction for Metamaterials via Robust Effective and Equivalent Medium Models
Authors: Thon Susanna , Ozaktas Ekin Gunes , Chintapalli Sreyas
Published: December 2023

Metamaterials are complex structured mixed-material systems with tailored physical properties that have found applications in a variety of optical and electronic technologies. New methods for homogenizing the optical properties of metamaterials are of increasing importance, both to study their exotic properties and because the simulation of these complex structures is computationally expensive. We propose a method to extract a homogeneous refractive index and wave impedance for inhomogeneous materials. We examine effective medium models, where inhomogeneities are subwavelength, and equivalent models where features are larger. Homogenization is only physically justified in the former; however, it is still useful in the latter if only the reflection, transmission, and absorption are of interest. We introduce a resolution of the branching problem in the Nicolson-Ross-Weir method that involves starting from the branch of the complex logarithm beginning with the minimum absolute mean derivative and then enforcing continuity, and also determine an effective thickness. We demonstrate the proposed method on patterned PbS colloidal quantum dot films in the form of disks and birefringent gratings. We conclude that effective models are Kramers-Kronig compliant, whereas equivalent models may not be. This work illuminates the difference between the two types of models, allowing for better analysis and interpretation of the optical properties of complex metamaterials.
Mycobacterium ulcerans-Bordetella trematum chronic tropical cutaneous ulcer: A four-case series, Côte d’Ivoire
Authors: Tchan Bi Goré Oscar , Kakou-Ngazoa Solange , Dizoe Sylveste , Hammoudi Nassim , Grine Ghiles , Ruimy Raymond , Drancourt Michel
Published: December 2023

Background

Chronic tropical cutaneous ulcers remain a neglected medical condition in West Africa, particularly Buruli ulcer, which is caused by mycolactone cytotoxin-secreting Mycobacterium ulcerans (M. ulcerans). Medical management of this highly debilitating and necrotising skin infection may be modified by colonisation and co-infection of the ulcer by opportunistic and pathogenic microorganisms, which considerably delays and increases the cost of treatment.

Methodology/principal finding

We diagnosed chronic tropical cutaneous ulcers in nine patients in Côte d’Ivoire using M. ulcerans-specific PCRs and culturomics. This revealed M. ulcerans in 7/9 ulcer swabs and 5/9 control swabs as well as an additional 122 bacterial species, 32 of which were specific to ulcers, 61 specifics to the controls, and 29 which were shared, adding 40 bacterial species to those previously reported. Whole genome sequencing of four Bordetella trematum (B. trematum) isolates in four Buruli ulcer swabs and no controls indicated cytolethal distending toxins, as confirmed by cytotoxic assay.

Conclusions/significance

In four cases of Buruli ulcer in Côte d’Ivoire, B. trematum was a co-pathogen which was resistant to rifampicin and clarithromycin, unmatching M. ulcerans antibiotic susceptibility profile and counteracting the current treatment of Buruli ulcer in West Africa and Australia. Thus, we report here chronic mixed M. ulcerans-B. trematum chronic tropical ulcer as a specific form of Buruli ulcer in West Africa.
Performance of modeling and balancing approach methods when using weights to estimate treatment effects in observational time-to-event settings
Authors: Barros Guilherme W. F. , Eriksson Marie , Häggström Jenny
Published: December 2023

In observational studies weighting techniques are often used to overcome bias due to confounding. Modeling approaches, such as inverse propensity score weighting, are popular, but often rely on the correct specification of a parametric model wherein neither balance nor stability are targeted. More recently, balancing approach methods that directly target covariate imbalances have been proposed, and these allow the researcher to explicitly set the desired balance constraints. In this study, we evaluate the finite sample properties of different modeling and balancing approach methods, when estimating the marginal hazard ratio, through Monte Carlo simulations. The use of the different methods is also illustrated by analyzing data from the Swedish stroke register to estimate the effect of prescribing oral anticoagulants on time to recurrent stroke or death in stroke patients with atrial fibrillation. In simulated scenarios with good overlap and low or no model misspecification the balancing approach methods performed similarly to the modeling approach methods. In scenarios with bad overlap and model misspecification, the modeling approach method incorporating variable selection performed better than the other methods. The results indicate that it is valuable to use methods that target covariate balance when estimating marginal hazard ratios, but this does not in itself guarantee good performance in situations with, e.g., poor overlap, high censoring, or misspecified models/balance constraints.
Analgesia and sedation strategies in neonates undergoing whole-body therapeutic hypothermia: A scoping review
Authors: Joshi Mahima , Muneer Javed , Mbuagbaw Lawrence , Goswami Ipsita
Published: December 2023

Background

Therapeutic hypothermia (TH) is a widely practiced neuroprotective strategy for neonates with hypoxic-ischemic encephalopathy. Induced hypothermia is associated with shivering, cold pain, agitation, and distress.

Objective

This scoping review determines the breadth of research undertaken for pain and stress management in neonates undergoing hypothermia therapy, the pharmacokinetics of analgesic and sedative medications during hypothermia and the effect of such medication on short- and long-term neurological outcomes.

Methods

We searched the following online databases namely, (i) MEDLINE, (ii) Web of Science, (iii) Cochrane Library, (iv) Scopus, (v) CINAHL, and (vi) EMBASE to identify published original articles between January 2005 and December 2022. We included only English full-text articles on neonates treated with TH and reported the sedation/analgesia strategy used. We excluded articles that reported TH on transport or extracorporeal membrane oxygenation, did not report the intervention strategies for sedation/analgesia, and reported hypoxic-ischemic encephalopathy in which hypothermia was not applied.

Results

The eligible publications (n = 97) included cohort studies (n = 72), non-randomized experimental studies (n = 2), pharmacokinetic studies (n = 4), dose escalation feasibility trial (n = 1), cross-sectional surveys (n = 5), and randomized control trials (n = 13). Neonatal Pain, Agitation, and Sedation Scale (NPASS) is the most frequently used pain assessment tool in this cohort. The most frequently used pharmacological agents are opioids (Morphine, Fentanyl), benzodiazepine (Midazolam) and Alpha2 agonists (Dexmedetomidine). The proportion of neonates receiving routine sedation-analgesia during TH is center-specific and varies from 40–100% worldwide. TH alters most drugs’ metabolic rate and clearance, except for Midazolam. Dexmedetomidine has additional benefits of thermal tolerance, neuroprotection, faster recovery, and less likelihood of seizures. There is a wide inter-individual variability in serum drug levels due to the impact of temperature, end-organ dysfunction, postnatal age, and body weight on drug metabolism.

Conclusions

No multidimensional pain scale has been tested for reliability and construct validity in hypothermic encephalopathic neonates. There is an increasing trend towards using routine sedation/analgesia during TH worldwide. Wide variability in the type of medication used, administration (bolus versus infusion), and dose ranges used emphasizes the urgent need for standardized practice recommendations and guidelines. There is insufficient data on the long-term neurological outcomes of exposure to these medications, adjusted for underlying brain injury and severity of encephalopathy. Future studies will need to develop framework tools to enable precise control of sedation/analgesia drug exposure customized to individual patient needs.
Developing an appropriate depression and anxiety screening tool for use with Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area of Australia: Protocol for a Delphi study
Authors: Meldrum Kathryn , Wallace Valda , Webb Torres , Ridgway Lynne , Quigley Rachel , Strivens Edward , Russell Sarah
Published: December 2023

Tools that screen for depression and anxiety developed using the Western biomedical paradigm are still used with First Nations peoples globally, despite calls for cross-cultural adaption. Recent work by the research team found that tools used to screen for depression and anxiety were not appropriate for use with Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area (NPA). of Australia. Consequently, the objective of this Delphi study is to gain consensus from an expert mental health panel to inform the development of an appropriate depression and anxiety screening tool(s). A Delphi study with Australian expert panellists will be used to reach consensus about whether an existing screening tool should be used or whether adaption or new tool development should take place. Three sequential rounds of anonymous online surveys will be used to reach consensus. The first round will seek consensus about the tool(s). Subsequent rounds will seek consensus on the development of the tool(s) identified in round one. Panellists will be identified using a combination of authorship of related publications, established national clinical or research profile in First Nations mental health, and/or by peer referral. Consensus will be reached when 75% of the panel agree. When agreement is not reached suggestions will be taken to the next round. If agreement is not achieved by the third round, the Steering Committee will make any outstanding decisions. Dissemination of the findings through continuing community engagement, conference presentations and publications will be led by Torres Strait Islander members of the research team.
Assessing environmental health impacts of coal mining exploitation in Iran: A Rapid Impact Assessment Matrix (RIAM) approach for environmental protection
Authors: Tianliang Wang , Aghalari Zahra , Mubanga Raphael , Sosa-Hernandez Juan Eduardo , Martínez-Ruiz Manuel , Parra-Saldívar Roberto
Published: December 2023

Environmental Impact Assessment is the process of evaluating the effects caused by a project on the environment. The outcomes generated by this assessment can lead to a reduction of the negative effects and an increase in the positive effects caused by mine projects. The present study was conducted to evaluate the environmental impact assessment of the Goliran Coal Mine in northern Iran. In the descriptive-analytical study, to achieve the objectives, observatory surveys were conducted around the coal mine using a checklist, which was about the positive and negative effects of a coal mine. Then the data were entered into the RIAM and the positive and negative effects were ranked and the most important effects were determined. In RIAM, one point is assigned to each component. 17 important activities for environmental impacts were identified using a checklist. Among the activities carried out at the coal mine site, the major ones included tunnel excavation, construction of the rail line collection and disposal of coal mine effluent, coal transportation, collection and disposal of mine tailings, and technical defects and leakage. The scores of each environmental factor were based on the four environmental components: physical/chemical, biological/ecological, social/cultural, and economic/operational. The results of the present study showed that the most negatively affected environmental components are the physical/chemical components derived from three activities; the construction of the underground tunnel; the construction of a coal transport rail line; and the actual transportation of coal extracts. The scores of each environmental factor based on the four components at the Goliran coal mine in northern Iran indicate that the highest negative score was -64, corresponding to the physical/chemical component, and was assigned to air pollution. On the other hand, the highest positive score corresponds to the economic/operational component with +54, assigned to the income that employees earn from the mine. Overall results showed that the coal mine in northern Iran had negative effects on the environment but the effects were not severe. It is suggested that for future research, corrective measures should be taken in the form of an environmental management plan to reduce the negative effects caused by coal mining, and then prospective research should be done to check the extent of reducing the negative effects.
The potential of piR-823 as a diagnostic biomarker in oncology: A systematic review
Authors: Sohn Eun Jung , Han Myoung-Eun , Park Young Mok , Kim Yun Hak , Oh Sae-Ock
Published: December 2023

Background

Emerging evidence has demonstrated that PIWI-interacting RNAs (piRNAs) play important roles in various physiological processes and contribute to cancer progression. Moreover, piRNAs and PIWI protein levels are associated with the prognosis and chemoresistance of various cancers. The limitations of biomarkers challenge early detection and monitoring of chemoresistance and cancer relapse.

Methods

To evaluate the potential of piRNA as a diagnostic biomarker in oncology, we systematically reviewed previous studies on the subject. PubMed, Embase, and Cochrane databases were searched to evaluate the diagnostic relevance of piRNAs in cancer. Eighteen studies (2,352 patients) were included. The quality of each study was evaluated with AMSTAR and QUADAS-2 tool.

Results & conclusions

The area under the curve (AUC) values of 26 piRNAs in patients with cancer ranged from 0.624 to 0.978, with piR-9491 showing the highest value (0.978). The sensitivity of the total of 21 piRNAs in cancer patients was between 42.86 and 100, with piR-9491 showing the highest sensitivity (100). The specificity of these 21 piRNAs ranged from 60.10 to 96.67 (with piR-018569 showing the highest specificity (96.67)). Their odds ratios were between 1.61 and 44.67, and piR-12488 showed the highest odds ratio (44.67). Generally, the piRNAs in this review showed better sensitivity and AUC values than current clinical diagnostic biomarkers, although current biomarkers appear to be more specific. Reviewed piRNAs showed better diagnostic performance than currently used clinical biomarkers. Notably, piR-823 showed a significant diagnostic performance in four types of cancer (colorectal, esophageal, gastric, and renal cell cancer). However, all 18 studies included in this review were a case-control study. So, further prospective studies are required for their validation.
Eating behaviour in Swiss preschool children–Validation of a German and a French version of the Children’s Eating Behaviour Questionnaire (CEBQ)
Authors: Leuba Anaëlle L. , Meyer Andrea H. , Kakebeeke Tanja H. , Stülb Kerstin , Arhab Amar , Zysset Annina E. , Leeger-Aschmann Claudia S. , Schmutz Einat A. , Kriemler Susi , Jenni Oskar G. , Puder Jardena J. , Munsch Simone , Messerli-Bürgy Nadine
Published: December 2023

Young children’s eating behavior is crucial for any further development of healthy eating. Early eating behavior are often assessed through parental report. The Children’s Eating Behaviour Questionnaire (CEBQ) is a widely used parental questionnaire that has been validated in families of different gender, age and cultural background. Research has shown that the 8-factor structure has some inconsistencies and sample characteristics such as age, gender, and culture can influence the results. To which extent such sample characteristics might influence results within a multi-lingual culture has not been investigated so far. Therefore, the aim of the study was to evaluate the factor structure of the CEBQ among 511 preschool children of the French and German parts of Switzerland, aged 2 to 6 years (Mean 3.85 years; SD 0.69). Confirmatory Factor Analysis showed a modified structure of the original questionnaire, with a 7-factor structure providing a reasonable fit to the data (TLI = 0.954, CFI = 0.952, RMSEA = 0.063 and SRMR = 0.067). The subscale ‘Desire to drink’ was removed, and a few items moved to other subscales as they loaded higher on a different subscale compared to the original model. Reliabilities based on the coefficient omega were acceptable to satisfying across the seven factors, ranging from 0.66 to 0.90. There were no significant gender or age differences, but French speaking children showed higher levels of ‘Satiety responsiveness’ and lower ‘Enjoyment of food’ than German speaking children. Yet, these effects were small. The German and French CEBQ are valid and reliable versions of the original CEBQ and can be used in a multicultural context.
Prevalence and risk factors of pre-hypertension and hypertension among adults in Southeastern Iran: Findings from the baseline survey of the Zahedan adult cohort study
Authors: Zare Mojtaba Gholami , Okati-Aliabad Hassan , Ansari-Moghaddam Alireza , Mohammadi Mahdi , Shahraki-Sanavi Fariba
Published: December 2023

Hypertension (HTN) stands as the leading modifiable risk factor for cardiovascular disease(CVD) and premature death globally. Understanding its prevalence and risk factors is essential for effective prevention and management of HTN. This study aimed to investigate the prevalence of Pre-hypertension (pre-HTN), HTN, and its risk factors in adults participating in the Zahedan adult cohort study (ZACS). This cross-sectional study used the baseline data of the ZACS. Ordinal logistic regression analysis was used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for potential risk factors. Among the 10,016 participants in this study, 60.89% were women, with an average age of 50.44 ± 9.18 years. The prevalence of pre-HTN and HTN was 42.03% (men 45.44%, women 39.84%) and 18.47% (men 21.09%, women 16.79%), respectively. Being male, older age, having higher socioeconomic status (SES), being overweight and obese, having a family history of HTN, comorbidities such as diabetes and CVD, as well as abnormal blood lipid levels (triglycerides and HDL cholesterol) were the most significant predictors of pre-HTN and HTN. These findings highlight that more than half of the participants in this study exhibit pre-HTN or HTN, placing them at risk for CVD and stroke. Implementing comprehensive preventive strategies tailored to these identified risk factors is imperative to alleviate the disease burden, enhance disease management, and improve HTN treatment and control.
Chinese sign language recognition based on surface electromyography and motion information
Authors: Li Wenyu , Luo Zhizeng , Li Wenguo , Xi Xugang
Published: December 2023

Sign language (SL) has strong structural features. Various gestures and the complex trajectories of hand movements bring challenges to sign language recognition (SLR). Based on the inherent correlation between gesture and trajectory of SL action, SLR is organically divided into gesture-based recognition and gesture-related movement trajectory recognition. One hundred and twenty commonly used Chinese SL words involving 9 gestures and 8 movement trajectories, are selected as research and test objects. The method based on the amplitude state of surface electromyography (sEMG) signal and acceleration signal is used for vocabulary segmentation. The multi-sensor decision fusion method of coupled hidden Markov model is used to complete the recognition of SL vocabulary, and the average recognition rate is 90.41%. Experiments show that the method of sEMG signal and motion information fusion has good practicability in SLR.
Productivity-adjusted life-years and correlates of uncontrolled hypertension at two health facilities in Zambia
Authors: Povia Joreen P. , Masenga Sepiso K. , Hamooya Benson M. , Gebremeskel Yordanos
Published: December 2023

Background

Hypertension has in the recent past surfaced as one of the conditions that has a significant impact on workforce productivity in emerging economies. Zambia is no different and has in the recent past recorded increasing cases. Despite the impact of hypertension being of great importance in regards to productivity, we have scarcity of data and studies on hypertension-related Productivity-Adjusted Life-Years (PALYs) in Zambia and Africa at large.

This study assessed the impact of hypertension on PALYs lost and socioeconomic factors associated with nonadherence to antihypertensive medication (NATAM).

Methods

This was a cross-sectional study of 198 participants from Livingstone University Teaching Hospital and Maramba Clinic situated in Livingstone, Zambia. Structured questionnaires were used to collect data. Productivity index multiplied by years lived was used to calculate PALYs and descriptive statistics were used to summarize sociodemographic, clinical and economic variables. Multivariable logistic regression was used to determine factors associated with NATAM.

Results

The participants had a median age (interquartile range (IQR)) of 49 years (41, 59) and 60.1% (n = 119) were females while 39.9% (n = 79) were male. Our estimated PALYs lost per person due to hypertension were 0.2 (IQR 0.0, 2.7). Cumulative PALYs value lost due to the burden of hypertension was estimated to be at $871,239.58 in gross domestic product (GDP). The prevalence of NATAM was 48% (n = 95). The factors that were significantly associated with NATAM were age (odds ratio (OR) 0.94; 95% confidence interval (CI) 0.90, 0.98), female sex (OR 2.52; 95%CI 1.18, 5.40), self-employment (OR 2.57; 95%CI 1.02, 6.45) and absenteeism from work (OR 3.60; 95%CI 1.16, 11.22).

Conclusions

Findings in our study highlight a high economic loss of PALYs due to hypertension with a potential to impact GDP negatively. We also found that NATAM reduced productivity and income among individuals of working age further impacting PALYs lost due to hypertension. The factors associated with NATAM were age, sex, employment status and absenteeism from work. This study underscores the need for interventions targeting young people, females, self-employed individuals, and absentees at work to improve adherence to antihypertensive drugs in order to reduce PALYs lost due to hypertension.
Cardiac response to water activities in children with Long QT syndrome type 1
Authors: Lundström Anna , Wiklund Urban , Winbo Annika , Eliasson Håkan , Karlsson Marcus , Rydberg Annika
Published: December 2023

Background

Swimming is a genotype-specific trigger in long QT syndrome type 1 (LQT1).

Objective

To examine the autonomic response to water activities in children and adolescents with LQT1.

Methods

In this cross-sectional study, LQT1 patients were age and sex matched to one healthy control subject. Electrocardiograms (ECGs) were recorded during face immersion (FI), swimming, diving, and whole-body submersion (WBS). Heart rate (HR) and heart rate variability (HRV) was measured. The high frequency (HF) component of HRV was interpreted to reflect parasympathetic activity, while the low frequency (LF) component was interpreted as reflecting the combined influence of sympathetic and parasympathetic activity on autonomic nervous modulation of the heart.

Results

Fifteen LQT1 patients (aged 7–19 years, all on beta-blocker therapy) and fifteen age and sex matched non-medicated controls were included. No significant ventricular arrhythmias were observed in the LQT1 population during the water activities. Out of these 15 matched pairs, 12 pairs managed to complete FI and WBS for more than 10 seconds and were subsequently included in HR and HRV analyses. In response to FI, the LQT1 group experienced a drop in HR of 48 bpm, compared to 67 bpm in the control group (p = 0.006). In response to WBS, HR decreased by 48 bpm in the LQT1 group and 70 bpm in the control group (p = 0.007). A significantly lower PTOT (p < 0.001) and HF (p = 0.011) component was observed before, during and after FI in LQT1 patients compared with the controls. Before, during and after WBS, a significantly lower total power (p < 0.001), LF (p = 0.002) and HF (p = 0.006) component was observed in the LQT1 patients.

Conclusion

A significantly lower HR decrease in response to water activities was observed in LQT1 subjects on beta-blocker therapy, compared to matched non-medicated controls. The data suggests an impaired parasympathetic response in LQT1 children and adolescents. An aberrant autonomic nervous system (ANS) response may cause an autonomic imbalance in this patient group.
Evaluation of immunogenicity-induced DNA vaccines against different SARS-CoV-2 variants
Authors: Kim Se Eun , Park So Hee , Park Woo-Jung , Kim Gayeong , Kim Seo Yeon , Won Hyeran , Hwang Yun-Ho , Lim Heeji , Kim Hyeon Guk , Kim You-Jin , Kim Dokeun , Lee Jung-Ah
Published: December 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in 2019 and caused the coronavirus disease 2019 (COVID-19) pandemic worldwide. As of September 2023, the number of confirmed coronavirus cases has reached over 770 million and caused nearly 7 million deaths. The World Health Organization assigned and informed the characterization of variants of concern (VOCs) to help control the COVID-19 pandemic through global monitoring of circulating viruses. Although many vaccines have been proposed, developing an effective vaccine against variants is still essential to reach the endemic stage of COVID-19. We designed five DNA vaccine candidates composed of the first isolated genotype and major SARS-CoV-2 strains from isolated Korean patients classified as VOCs, such as Alpha, Beta, Gamma, and Delta. To evaluate the immunogenicity of each genotype via homologous and heterologous vaccination, mice were immunized twice within a 3-week interval, and the blood and spleen were collected 1 week after the final vaccination to analyze the immune responses. The group vaccinated with DNA vaccine candidates based on the S genotype and the Alpha and Beta variants elicited both humoral and cellular immune responses, with higher total IgG levels and neutralizing antibody responses than the other groups. In particular, the vaccine candidate based on the Alpha variant induced a highly diverse cytokine response. Additionally, we found that the group subjected to homologous vaccination with the S genotype and heterologous vaccination with S/Alpha induced high total IgG levels and a neutralization antibody response. Homologous vaccination with the S genotype and heterologous vaccination with S/Alpha and S/Beta significantly induced IFN-γ immune responses. The immunogenicity after homologous vaccination with S and Alpha and heterologous vaccination with the S/Alpha candidate was better than that of the other groups, indicating the potential for developing novel DNA vaccines against different SARS-CoV-2 variants.
Field study examining the mucosal microbiome in equine glandular gastric disease
Authors: Paul Linda J. , Ericsson Aaron C. , Andrews Frank M. , McAdams Zachary , Keowen Michael L. , St Blanc Michael P. , Banse Heidi E.
Published: December 2023

Equine glandular gastric disease (EGGD) is a common disease among athletic horses that can negatively impact health and performance. The pathophysiology of this EGGD remains poorly understood. Previous studies using controlled populations of horses identified differences in the gastric glandular mucosal microbiome associated with disease. The objective of this study was to compare the gastric microbiome in horses with EGGD and those without across multiple barns and differing management practices. We hypothesized that alterations in the microbiome of the gastric glandular mucosa are associated with EGGD. A secondary objective was to perform a risk factor analysis for EGGD using the diet and management data collected. Microbial populations of biopsies from normal pyloric mucosa of horses without EGGD (control biopsies), normal pyloric mucosa of horses with EGGD (normal biopsies) and areas of glandular mucosal disruption in horses with EGGD (lesion biopsies) were compared. Lesion biopsies had a different microbial community structure than control biopsies. Control biopsies had a higher read count for the phylumActinomycetotacompared to lesion biopsies. Control biopsies also had an enrichment of the generaStaphylococcusandLawsonellaand the speciesStreptococcus salivarius. Lesion biopsies had an enrichment of the generaLactobacillusandActinobacillusand the speciesLactobacillus equigenerosi. These results demonstrate differences in the gastric glandular microbiome between sites of disrupted mucosa in horses with EGGD compared to pyloric mucosa of horses without EGGD. Risk factor analysis indicated that exercise duration per week was a risk factor for EGGD.
Automated, high-throughput quantification of EGFP-expressing neutrophils in zebrafish by machine learning and a highly-parallelized microscope
Authors: Efromson John , Ferrero Giuliano , Bègue Aurélien , Doman Thomas Jedidiah Jenks , Dugo Clay , Barker Andi , Saliu Veton , Reamey Paul , Kim Kanghyun , Harfouche Mark , Yoder Jeffrey A.
Published: December 2023

Normal development of the immune system is essential for overall health and disease resistance. Bony fish, such as the zebrafish (Danio rerio), possess all the major immune cell lineages as mammals and can be employed to model human host response to immune challenge. Zebrafish neutrophils, for example, are present in the transparent larvae as early as 48 hours post fertilization and have been examined in numerous infection and immunotoxicology reports. One significant advantage of the zebrafish model is the ability to affordably generate high numbers of individual larvae that can be arrayed in multi-well plates for high throughput genetic and chemical exposure screens. However, traditional workflows for imaging individual larvae have been limited to low-throughput studies using traditional microscopes and manual analyses. Using a newly developed, parallelized microscope, the Multi-Camera Array Microscope (MCAM™), we have optimized a rapid, high-resolution algorithmic method to count fluorescently labeled cells in zebrafish larvae in vivo. Using transgenic zebrafish larvae, in which neutrophils express EGFP, we captured 18 gigapixels of images across a full 96-well plate, in 75 seconds, and processed the resulting datastream, counting individual fluorescent neutrophils in all individual larvae in 5 minutes. This automation is facilitated by a machine learning segmentation algorithm that defines the most in-focus view of each larva in each well after which pixel intensity thresholding and blob detection are employed to locate and count fluorescent cells. We validated this method by comparing algorithmic neutrophil counts to manual counts in larvae subjected to changes in neutrophil numbers, demonstrating the utility of this approach for high-throughput genetic and chemical screens where a change in neutrophil number is an endpoint metric. Using the MCAM™ we have been able to, within minutes, acquire both enough data to create an automated algorithm and execute a biological experiment with statistical significance. Finally, we present this open-source software package which allows the user to train and evaluate a custom machine learning segmentation model and use it to localize zebrafish and analyze cell counts within the segmented region of interest. This software can be modified as needed for studies involving other zebrafish cell lineages using different transgenic reporter lines and can also be adapted for studies using other amenable model species.
IL-17RA promotes pathologic epithelial inflammation in a mouse model of upper respiratory influenza infection
Authors: Navaeiseddighi Zahrasadat , Tripathi Jitendra Kumar , Guo Kai , Wang Zhihan , Schmit Taylor , Brooks Delano R. , Allen Reese A. , Hur Junguk , Mathur Ramkumar , Jurivich Donald , Khan Nadeem
Published: December 2023

The upper respiratory tract (nasopharynx or NP) is the first site of influenza replication, allowing the virus to disseminate to the lower respiratory tract or promoting community transmission. The host response in the NP regulates an intricate balance between viral control and tissue pathology. The hyper-inflammatory responses promote epithelial injury, allowing for increased viral dissemination and susceptibility to secondary bacterial infections. However, the pathologic contributors to influenza upper respiratory tissue pathology are incompletely understood. In this study, we investigated the role of interleukin IL-17 recetor A (IL-17RA) as a modulator of influenza host response and inflammation in the upper respiratory tract. We used a combined experimental approach involving IL-17RA-/- mice and an air-liquid interface (ALI) epithelial culture model to investigate the role of IL-17 response in epithelial inflammation, barrier function, and tissue pathology. Our data show that IL-17RA-/- mice exhibited significantly reduced neutrophilia, epithelial injury, and viral load. The reduced NP inflammation and epithelial injury in IL-17RA-/- mice correlated with increased resistance against co-infection by Streptococcus pneumoniae (Spn). IL-17A treatment, while potentiating the apoptosis of IAV-infected epithelial cells, caused bystander cell death and disrupted the barrier function in ALI epithelial model, supporting the in vivo findings.
Microsporidian Nosema bombycis hijacks host vitellogenin and restructures ovariole cells for transovarial transmission
Authors: Wang Chunxia , Yu Bin , Meng Xianzhi , Xia Dan , Pei Boyan , Tang Xiangyou , Zhang Guizheng , Wei Junhong , Long Mengxian , Chen Jie , Bao Jialing , Li Chunfeng , Pan Guoqing , Zhou Zeyang , Li Tian
Published: December 2023

Microsporidia are a group of obligate intracellular parasites that infect almost all animals, causing serious human diseases and major economic losses to the farming industry. Nosema bombycis is a typical microsporidium that infects multiple lepidopteran insects via fecal-oral and transovarial transmission (TOT); however, the underlying TOT processes and mechanisms remain unknown. Here, we characterized the TOT process and identified key factors enabling N. bombycis to invade the ovariole and oocyte of silkworm Bombyx mori. We found that the parasites commenced with TOT at the early pupal stage when ovarioles penetrated the ovary wall and were exposed to the hemolymph. Subsequently, the parasites in hemolymph and hemolymph cells firstly infiltrated the ovariole sheath, from where they invaded the oocyte via two routes: (I) infecting follicular cells, thereby penetrating oocytes after proliferation, and (II) infecting nurse cells, thus entering oocytes following replication. In follicle and nurse cells, the parasites restructured and built large vacuoles to deliver themselves into the oocyte. In the whole process, the parasites were coated with B. mori vitellogenin (BmVg) on their surfaces. To investigate the BmVg effects on TOT, we suppressed its expression and found a dramatic decrease of pathogen load in both ovarioles and eggs, suggesting that BmVg plays a crucial role in the TOT. Thereby, we identified the BmVg domains and parasite spore wall proteins (SWPs) mediating the interaction, and demonstrated that the von Willebrand domain (VWD) interacted with SWP12, SWP26 and SWP30, and the unknown function domain (DUF1943) bound with the SWP30. When disrupting these interactions, we found significant reductions of the pathogen load in both ovarioles and eggs, suggesting that the interplays between BmVg and SWPs were vital for the TOT. In conclusion, our study has elucidated key aspects about the microsporidian TOT and revealed the key factors for understanding the molecular mechanisms underlying this transmission.