bluuebunny/crossref_metadata_2025 huggingface dataset:
Housing wealth appreciation and heterogeneous household consumption: Evidence from China
Authors: Qi Yingying , Yu Guohua , Liu Xiang , Ren Yuanming
Published: October 2023

In this paper, we develop a DSGE model including heterogeneous households, introduce the financial friction of credit constraint mechanism, and study the impact of house price shocks on the consumption of heterogeneous household. Based on this, the CHFS data in 2011, 2013, 2015, 2017, and 2019 were used to test the marginal propensity to consume for housing wealth appreciation under different credit constraints. Results show that: Firstly, the financial accelerator mechanism plays an important role in the transmission of housing price shocks to household consumption. The looser the degree of credit constraints, the more obvious the rise in housing prices will be to the consumption expenditure of borrowing household. Secondly, the impact of housing wealth appreciation on household consumption under different credit constraints is heterogeneous. Among them, housing wealth appreciation has a significant positive impact on household consumption expenditure with multiple houses, credit cards, non-loan restrictions, while the marginal effect on the consumption expenditure of households with only one house, loan limited, and no credit cards decreases. Thirdly, for every 1% increase in the housing wealth appreciation, household consumption will increase significantly by 0.10–0.14%.
Residents need competence not confidence: A retrospective evaluation of the new competency education program for Korean neurology residents
Authors: Choi Hojin , Oh Jeeyoung , Kim Chi Kyung , Ryu Hokyoung , Ryu Youngji
Published: October 2023

The objective of our study was to scrutinize the learning experiences of Korean neurology residents, with an emphasis on the implications of the novel competency-based curriculum implemented in 2021. We hypothesized that this revised curriculum could modulate residents’ cognitive conduct, primarily the manifestation of overconfidence, in distinctive ways across different stages of training. Our investigative framework was three-fold. Initially, we began with a qualitative inquiry involving in-depth interviews with a purposively selected cohort of eight residents from four training sites. This approach facilitated comprehensive insight into their perceptions of their competence and confidence across the continuum of a four-year residency program. Subsequently, we incorporated the K-NEPA13 assessment instrument, administered to the residents and their overseeing supervisors. This stage aimed to dissect potential cognitive biases, particularly overconfidence and consistency, within the resident population. The final study involved a comprehensive survey administered to a group of 97 Korean neurology residents, allowing us to consolidate and validate our preceding findings. Our findings revealed that junior residents portrayed heightened confidence in their clinical capabilities compared to their senior peers. Intriguingly, junior residents also displayed a stronger inclination towards reevaluating their clinical judgments, a behavior we hypothesize is stimulated by the recently introduced competency-based curriculum. We identified cognitive divergence between junior and senior residents, with the latter group favoring more consistent and linear cause-and-effect reasoning, while the former demonstrated receptiveness to introspection and reconsideration. We speculate this adaptability might be engendered by the supervisor assignment protocol intrinsic to the new curriculum. Our study highlights the essentiality of incorporating cognitive behaviors when devising medical education strategies. Acknowledging and addressing these diverse cognitive biases, and instilling a spirit of adaptability, can nurture a culture that persists in continuous learning and self-reflection among trainee doctors.
Communicating COVID-19 exposure risk with an interactive website counteracts risk misestimation
Authors: Sinclair Alyssa H. , Taylor Morgan K. , Brandel-Tanis Freyja , Davidson Audra , Chande Aroon T. , Rishishwar Lavanya , Andris Clio , Adcock R. Alison , Weitz Joshua S. , Samanez-Larkin Gregory R. , Beckett Stephen J.
Published: October 2023

During the COVID-19 pandemic, individuals depended on risk information to make decisions about everyday behaviors and public policy. Here, we assessed whether an interactive website influenced individuals’ risk tolerance to support public health goals. We collected data from 11,169 unique users who engaged with the online COVID-19 Event Risk Tool (https://covid19risk.biosci.gatech.edu/) between 9/22/21 and 1/22/22. The website featured interactive elements, including a dynamic risk map, survey questions, and a risk quiz with accuracy feedback. After learning about the risk of COVID-19 exposure, participants reported being less willing to participate in events that could spread COVID-19, especially for high-risk large events. We also uncovered a bias in risk estimation: Participants tended to overestimate the risk of small events but underestimate the risk of large events. Importantly, even participants who voluntarily sought information about COVID risks tended to misestimate exposure risk, demonstrating the need for intervention. Participants from liberal-leaning counties were more likely to use the website tools and more responsive to feedback about risk misestimation, indicating that political partisanship influences how individuals seek and engage with COVID-19 information. Lastly, we explored temporal dynamics and found that user engagement and risk estimation fluctuated over the course of the Omicron variant outbreak. Overall, we report an effective large-scale method for communicating viral exposure risk; our findings are relevant to broader research on risk communication, epidemiological modeling, and risky decision-making.
Impact of velocity- and acceleration-compensated encodings on signal dropout and black-blood state in diffusion-weighted magnetic resonance liver imaging at clinical TEs
Authors: Führes Tobit , Saake Marc , Szczepankiewicz Filip , Bickelhaupt Sebastian , Uder Michael , Laun Frederik Bernd
Published: October 2023

Purpose

The study aims to develop easy-to-implement concomitant field-compensated gradient waveforms with varying velocity-weighting (M1) and acceleration-weighting (M2) levels and to evaluate their efficacy in correcting signal dropouts and preserving the black-blood state in liver diffusion-weighted imaging. Additionally, we seek to determine an optimal degree of compensation that minimizes signal dropouts while maintaining blood signal suppression.

Methods

Numerically optimized gradient waveforms were adapted using a novel method that allows for the simultaneous tuning of M1- and M2-weighting by changing only one timing variable. Seven healthy volunteers underwent diffusion-weighted magnetic resonance imaging (DWI) with five diffusion encoding schemes (monopolar, velocity-compensated (M1 = 0), acceleration-compensated (M1 = M2 = 0), 84%-M1–M2-compensated, 67%-M1–M2-compensated) at b-values of 50 and 800 s/mm2 at a constant echo time of 70 ms. Signal dropout correction and apparent diffusion coefficients (ADCs) were quantified using regions of interest in the left and right liver lobe. The blood appearance was evaluated using two five-point Likert scales.

Results

Signal dropout was more pronounced in the left lobe (19%-42% less signal than in the right lobe with monopolar scheme) and best corrected by acceleration-compensation (8%-10% less signal than in the right lobe). The black-blood state was best with monopolar encodings and decreased significantly (p < 0.001) with velocity- and/or acceleration-compensation. The partially M1–M2-compensated encoding schemes could restore the black-blood state again. Strongest ADC bias occurred for monopolar encodings (difference between left/right lobe of 0.41 μm2/ms for monopolar vs. < 0.12 μm2/ms for the other encodings).

Conclusion

All of the diffusion encodings used in this study demonstrated suitability for routine DWI application. The results indicate that a perfect value for the level of M1–M2-compensation does not exist. However, among the examined encodings, the 84%-M1–M2-compensated encodings provided a suitable tradeoff.
Foveal feedback in perceptual processing: Contamination of neural representations and task difficulty effects
Authors: Contemori Giulio , Oletto Carolina Maria , Battaglini Luca , Motterle Elena , Bertamini Marco
Published: October 2023

Visual object recognition was traditionally believed to rely on a hierarchical feedforward process. However, recent evidence challenges this notion by demonstrating the crucial role of foveal retinotopic cortex and feedback signals from higher-level visual areas in processing peripheral visual information. The nature of the information conveyed through foveal feedback remains a topic of debate. To address this, we conducted a study employing a foveal mask paradigm with varying stimulus-mask onset asynchronies in a peripheral same/different task, where peripheral objects exhibited different degrees of similarity. Our hypothesis posited that simultaneous arrival of feedback and mask information in the foveal cortex would lead to neural contamination, biasing perception. Notably, when the two peripheral objects were identical, we observed a significant increase in the number of "different" responses, peaking at approximately 100 ms. Similar effect was found when the objects were dissimilar, but with an overall later timing (around 150 ms). No significant difference was found when comparing easy (dissimilar objects) and difficult trials (similar objects). The findings challenge the hypothesis that foveation planning alone accounts for the observed effects. Instead, these and previous observations support the notion that the foveal cortex serves as a visual sketchpad for maintaining and manipulating task-relevant information.
Determinants of the food insecurity at household level in Pakistan: A multilevel model approach
Authors: Mahmood Tahir , Kumar Ramesh , Ali Tariq Mehmood , Naeem Nawal , Pongpanich Sathirakorn
Published: October 2023

Food insecurity is a major concern for the developing world and around 37% of the population of Pakistan is food insecure. This paper utilizes the Food Insecurity Experience Scale (FIES) to assess the population prevalence of food insecurity and to identify their risk factors and determinants at the household level in Pakistan. This study employs a multi-level random coefficient model, using the Pakistan Panel Household Survey (PPHS-2010) dataset; representative data from 4,130 households. Factors like; income of the household, gender, education, household size, land ownership, and shocks of food insecurity allow the incidence of idiosyncratic shocks (injuries and/or casualties) at the community level, which affects the food insecurity situation of the community, rather differently were included. The study confirms a statistically significant inverse relationship between household income, household size, and household head education with food insecurity and a positive association of shocks and inflation with food insecurity at the household level. Specifically, with increasing per capita income of the household, food insecurity declines (coefficient: -0.083, statistically significant at 1%) and food insecurity increases with shocks (coefficient: 0.058, statistically significant at 1% significance level). The study also reveals a significant heterogeneity at a one percent significance level in the determinants of food insecurity at the district, community, and household levels. The income of the household, household head gender and education level, household size, household assets, shocks, injuries, and inflationary pressure are important determinants of food insecurity in Pakistan.
Key transcriptional effectors of the pancreatic acinar phenotype and oncogenic transformation
Authors: Azevedo-Pouly Ana , Hale Michael A. , Swift Galvin H. , Hoang Chinh Q. , Deering Tye G. , Xue Jumin , Wilkie Thomas M. , Murtaugh L. Charles , MacDonald Raymond J.
Published: October 2023

Proper maintenance of mature cellular phenotypes is essential for stable physiology, suppression of disease states, and resistance to oncogenic transformation. We describe the transcriptional regulatory roles of four key DNA-binding transcription factors (Ptf1a, Nr5a2, Foxa2 and Gata4) that sit at the top of a regulatory hierarchy controlling all aspects of a highly differentiated cell-type–the mature pancreatic acinar cell (PAC). Selective inactivation of Ptf1a, Nr5a2, Foxa2 and Gata4 individually in mouse adult PACs rapidly altered the transcriptome and differentiation status of PACs. The changes most emphatically included transcription of the genes for the secretory digestive enzymes (which conscript more than 90% of acinar cell protein synthesis), a potent anabolic metabolism that provides the energy and materials for protein synthesis, suppressed and properly balanced cellular replication, and susceptibility to transformation by oncogenic KrasG12D. The simultaneous inactivation of Foxa2 and Gata4 caused a greater-than-additive disruption of gene expression and uncovered their collaboration to maintain Ptf1a expression and control PAC replication. A measure of PAC dedifferentiation ranked the effects of the conditional knockouts as Foxa2+Gata4 > Ptf1a > Nr5a2 > Foxa2 > Gata4. Whereas the loss of Ptf1a or Nr5a2 greatly accelerated Kras-mediated transformation of mature acinar cells in vivo, the absence of Foxa2, Gata4, or Foxa2+Gata4 together blocked transformation completely, despite extensive dedifferentiation. A lack of correlation between PAC dedifferentiation and sensitivity to oncogenic KrasG12D negates the simple proposition that the level of differentiation determines acinar cell resistance to transformation.
Quality of life among patients with atrial fibrillation: A theoretically-guided cross-sectional study
Authors: Rush Kathy L. , Seaton Cherisse L. , Burton Lindsay , Loewen Peter , O’Connor Brian P. , Moroz Lana , Corman Kendra , Smith Mindy A. , Andrade Jason G.
Published: October 2023

Background

Patients with atrial fibrillation (AF) have significantly lower health-related quality of life (HRQoL) compared to the general population and patients with other heart diseases. The research emphasis on the influence of AF symptoms on HRQoL overshadows the role of individual characteristics. To address this gap, this study’s purpose was to test an incremental predictive model for AF-related HRQoL following an adapted HRQoL conceptual model that incorporates both symptoms and individual characteristics.

Methods

Patients attending an AF specialty clinic were invited to complete an online survey. Hierarchical regression analyses were conducted to examine whether individual characteristics (overall mental health, perceived stress, sex, age, AF knowledge, household and recreational physical activity) incremented prediction of HRQoL and AF treatment satisfaction beyond AF symptom recency and overall health.

Results

Of 196 participants (mean age 65.3 years), 63% were male and 90% were Caucasian. Most reported ‘excellent’ or ‘good’ overall and mental health, had high overall AF knowledge scores, had low perceived stress scores, and had high household and recreation physical activity. The mean overall AF Effect On Quality-Of-Life Questionnaire (AFEQT) and AF treatment satisfaction scores were 70.62 and 73.84, respectively. Recency of AF symptoms and overall health accounted for 29.6% of the variance in overall HRQoL and 20.2% of the variance in AF treatment satisfaction. Individual characteristics explained an additional 13.6% of the variance in overall HRQoL and 7.6% of the variance in AF treatment satisfaction. Perceived stress and household physical activity were the largest contributors to overall HRQoL, whereas age and AF knowledge made significant contributions to AF treatment satisfaction.

Conclusions

Along with AF symptoms and overall health, individual characteristics are important predictors of HRQoL and AF treatment satisfaction in AF patients. In particular, perceived stress and household physical activity could further be targeted as potential areas to improve HRQoL.
A new method for in vivo assessment of corneal transparency using spectral-domain OCT
Authors: Vilbert Maëlle , Bocheux Romain , Georgeon Cristina , Borderie Vincent , Pernot Pascal , Irsch Kristina , Plamann Karsten
Published: October 2023

Corneal transparency is essential to provide a clear view into and out of the eye, yet clinical means to assess such transparency are extremely limited and usually involve a subjective grading of visible opacities by means of slit-lamp biomicroscopy. Here, we describe an automated algorithm allowing extraction of quantitative corneal transparency parameters with standard clinical spectral-domain optical coherence tomography (SD-OCT). Our algorithm employs a novel pre-processing procedure to standardize SD-OCT image analysis and to numerically correct common instrumental artifacts before extracting mean intensity stromal-depth (z) profiles over a 6-mm-wide corneal area. The z-profiles are analyzed using our previously developed objective method that derives quantitative transparency parameters directly related to the physics of light propagation in tissues. Tissular heterogeneity is quantified by the Birge ratio Br and the photon mean-free path (ls) is determined for homogeneous tissues (i.e., Br~1). SD-OCT images of 83 normal corneas (ages 22–50 years) from a standard SD-OCT device (RTVue-XR Avanti, Optovue Inc.) were processed to establish a normative dataset of transparency values. After confirming stromal homogeneity (Br <10), we measured a median ls of 570 μm (interdecile range: 270–2400 μm). By also considering corneal thicknesses, this may be translated into a median fraction of transmitted (coherent) light Tcoh(stroma) of 51% (interdecile range: 22–83%). Excluding images with central saturation artifact raised our median Tcoh(stroma) to 73% (interdecile range: 34–84%). These transparency values are slightly lower than those previously reported, which we attribute to the detection configuration of SD-OCT with a relatively small and selective acceptance angle. No statistically significant correlation between transparency and age or thickness was found. In conclusion, our algorithm provides robust and quantitative measurements of corneal transparency from standard SD-OCT images with sufficient quality (such as ‘Line’ and ‘CrossLine’ B-scan modes without central saturation artifact) and addresses the demand for such an objective means in the clinical setting.
Examining the hedge performance of US dollar, VIX, and gold during the coronavirus pandemic: Is US dollar a better hedge asset?
Authors: Yun Seok-Jun , Choi Sun-Yong , Kim Young Sung
Published: October 2023

This study utilizes the hedging potential of the U.S. Dollar Index (USDX) during the COVID-19 period, specifically comparing its positive effects on optimal portfolio weights and hedging ratios with those of traditional hedging assets, such as the VIX and gold. The scalar BEKK GARCH model is employed to forecast volatility and calculate hedging indicators. The results show that USDX exhibits strong hedging abilities against S&P 500 index volatility. These findings highlight the advantageous role of the USDX as a hedging instrument, particularly during periods of heightened market uncertainty, such as during the COVID-19 crisis. Despite the increased market volatility during the COVID-19 pandemic, the value of the optimal portfolio weights is stable and the volatility of the weights is significantly reduced, demonstrating the strength of the USDX’s low risk and volatility in hedging against market fluctuations. Moreover, the increase in the hedge ratio indicates that more capital is allocated to hedging, reflecting the increased correlation between the USDX and S&P 500 index. These results emphasize the beneficial role of the USDX as a hedging instrument during times of elevated market uncertainty, such as during the COVID-19 crisis. Ultimately, USDX can provide valuable insights for market participants seeking effective hedging strategies.
Advanced photon counting CT imaging pipeline for cardiac phenotyping of apolipoprotein E mouse models
Authors: Allphin Alex J. , Mahzarnia Ali , Clark Darin P. , Qi Yi , Han Zay Y. , Bhandari Prajwal , Ghaghada Ketan B. , Badea Alexandra , Badea Cristian T.
Published: October 2023

Background

Cardiovascular disease (CVD) is associated with the apolipoprotein E (APOE) gene and lipid metabolism. This study aimed to develop an imaging-based pipeline to comprehensively assess cardiac structure and function in mouse models expressing different APOE genotypes using photon-counting computed tomography (PCCT).

Methods

123 mice grouped based on APOE genotype (APOE2, APOE3, APOE4, APOE knockout (KO)), gender, human NOS2 factor, and diet (control or high fat) were used in this study. The pipeline included PCCT imaging on a custom-built system with contrast-enhanced in vivo imaging and intrinsic cardiac gating, spectral and temporal iterative reconstruction, spectral decomposition, and deep learning cardiac segmentation. Statistical analysis evaluated genotype, diet, sex, and body weight effects on cardiac measurements.

Results

Our results showed that PCCT offered high quality imaging with reduced noise. Material decomposition enabled separation of calcified plaques from iodine enhanced blood in APOE KO mice. Deep learning-based segmentation showed good performance with Dice scores of 0.91 for CT-based segmentation and 0.89 for iodine map-based segmentation. Genotype-specific differences were observed in left ventricular volumes, heart rate, stroke volume, ejection fraction, and cardiac index. Statistically significant differences were found between control and high fat diets for APOE2 and APOE4 genotypes in heart rate and stroke volume. Sex and weight were also significant predictors of cardiac measurements. The inclusion of the human NOS2 gene modulated these effects.

Conclusions

This study demonstrates the potential of PCCT in assessing cardiac structure and function in mouse models of CVD which can help in understanding the interplay between genetic factors, diet, and cardiovascular health.
Examining antecedents of organizational citizenship behavior: An empirical study in Indonesian police context
Authors: Sridadi Ahmad Rizki , Eliyana Anis , Priyandini Fika Arista , Pratama Andika Setia , Ajija Shochrul Rohmatul , Mohd Kamil Nurul Liyana
Published: October 2023

Police reform in the Mobile Brigade Corps unit in Indonesia, which seeks to break away from militaristic elements, has not been fully implemented optimally. This is reflected in the lack of implementation of human values in serving the community. The extra effort of officers in encouraging community service based on human values can be realized through Organizational Citizenship Behavior which is not only directed at fellow officers, but also towards organizations in the context of community service. Based on Social Exchange Theory, this study aims to investigate the mechanism of strengthening Organizational Citizenship Behavior in the context of the Police Mobile Brigade Corps with the support of Empowering Leadership, Psychological Empowerment, and Job Satisfaction. Using a quantitative approach, this study distributed online questionnaires to 395 Mobile Brigade Corps officers. Furthermore, this study analyzes the data using Partial Least Squares–Structural Equation Modeling. The test results show that Empowering Leadership can strengthen Organizational Citizenship Behavior. In addition, this study reveals the mediating role of Psychological Empowerment and Job Satisfaction in the influence of Empowering Leadership on Organizational Citizenship Behavior. With these findings, the Police Mobile Brigade Corps needs to improve the competence of officers through training and development efforts so that officers feel psychologically empowered and have job satisfaction. On the other hand, Mobile Brigade Corps needs to encourage leaders to provide opportunities for officers to participate in decision making and recognize their contributions to work.
The intensity of a resistance exercise session can be quantified by the work rate of exercise
Authors: Scott Brendan R. , Marston Kieran J. , Teo Shaun Y. M. , Forrest Mitchell R. L. , Jonson Andrew , Walden Thomas P. , Galna Brook , Peiffer Jeremiah J.
Published: October 2023

Purpose

Athletes regularly perform resistance training, yet it is unknown how best to monitor its intensity. This study compared different resistance exercise intensity metrics to determine their sensitivity to manipulating work rate (via altering inter-set rest and load).

Methods

Following baseline testing for 10- and 3-repetition maximum (RM; squat and bench press), fourteen trained participants completed four volume-matched protocols in a randomised order: 3x10 with 85% 10RM, 60 s rest (3x1060s); 3x10 with 85% 10RM, 180 s (3x10180s); 8x3 with 85% 3RM, 120 s (8x3120s); 8x3 with 85% 3RM, 300 s (8x3300s). Internal intensity was quantified via rate of oxygen consumption (V˙O2), heart rate, blood lactate concentration, and rating of perceived exertion (RPE). External intensity was assessed via previously developed “Training-Intensity” (TI) and “Intensity-Index” (II) metrics, and from exercise work rate (expressed as kg∙min-1 and joules∙min-1).

Results

Internal intensity and work-rate metrics were highest for 3x1060s, followed by 3x10180s, 8x3120s and 8x3300s (p≤0.027). TI and II were higher for 8x3 than 3x10 protocols (p<0.001), but not different within these configurations. Internal intensity measures were more strongly correlated with work rate (r = 0.37–0.96) than TI and II (r = -0.42–0.33) metrics.

Conclusions

Work rate corroborated objective internal intensity metrics during resistance exercise, with the highest work rate session (3x1060s) also eliciting greater RPE scores than other protocols. In contrast, the TI and II did not agree with other intensity measures, likely because they do not consider rest periods. Practitioners can plan for the physiological and perceptual demands of resistance training by estimating work rate.
Effect of external therapies of traditional Chinese medicine on constipation in patients with CRF: A meta-analysis
Authors: Wu Yu , Ying Qisu , He Yajing , Xie Xiangcheng , Yuan Xiao , Wang Ming , Fei Xiao , Yang Xiu
Published: October 2023

Objective

The purpose of this study was to evaluate the curative effect of external therapies of traditional Chinese medicine on constipation in patients with chronic renal failure and to provide scientific theoretical basis for clinical practice.

Method

We searched the English database of PubMed, EMBASE, the Cochrane Library and the Web of Science and Chinese database of CNKI, Wan fang database, VIP Database and China Biomedical Literature Database up to December 2022. Randomized controlled trials (RCTs) involving constipation in patients with CRF that compared external therapies of traditional Chinese medicine and routine treatment to routine treatment were eligible for the analysis. A meta-analysis of the outcome indicators including total efficiency, weekly defecation times, defecation time, defecation difficulty score, patient-assessment of constipation quality of life and adverse events of treatment were performed. The analysis was performed by using Review Manager version 5.3.

Result

A total of 23 studies were included, with 1764 patients. Meta-analysis results showed that compared with the control group, the test group could significantly increase weekly defecation times(MD = 0.94, 95%CI(0.70, 1.18), Z = 7.74, P < 0.00001), reduce defecation time(MD = -2.92, 95%CI(-3.69, -2.16), Z = 7.49, P < 0.00001), reduce defecation difficulty score(MD = -1.92, 95%CI(-2.45, -1.39), Z = 7.11, P < 0.00001), improve the quality of life in patients with constipation(MD = -7.57, 95%CI(-10.23, -4.91), Z = 5.58, P < 0.00001) and obtain a higher total effective rate of treatment(OR = 4.53, 95%CI(3.27, 6.29), Z = 9.07, P < 0.00001). In terms of safety, there was no statistical significance in the incidence of adverse events between two groups(OR = 0.35, 95%CI(0.04, 2.95), Z = 0.96, P = 0.34).

Conclusion

The combination of external therapies of traditional Chinese medicine and routine treatment could achieve an excellent curative effect, and there was no specific adverse event. However because of the limited level of current evidence, more high-quality trials are needed in the future.5
Factors to determine the adoption of online teaching in Tanzania’s Universities during the COVID-19 pandemic
Authors: Anasel Mackfallen G. , Swai Idda L.
Published: October 2023

Background

Face to face mode of delivery has been a standard method of teaching courses in the majority of African Universities Tanzania included. The COVID-19 pandemic has caused the closure of all schools and universities worldwide; therefore, face-to-face teaching is no longer the only appropriate and feasible teaching method. This requires changes in the teaching method with the remarkable rise of e-learning, whereby teaching must be undertaken remotely and on digital platforms.

Objective

The main objective of this study is to determine the perceived factors that hinder the adoption of online teaching in Tanzanian universities.

Method

A mixed method dominated by a quantitative approach was used to answer the research questions. A total of 173 academic and ICT staff from nineteen universities in Tanzania participated in this study. Descriptive statistics (univariate analysis) and binary logistic regression were applied to analyse the frequency and compare the mean to describe the characteristics of respondents and determine the factors influencing the academic staff to have an online course. This was followed by content analysis to analyse the academic staff’s proposed adaptation to online classes.

Results

The findings indicated that the main hindrances to online teaching are lack of capacity; knowledge on how to conduct online courses; knowledge and technological factors; environmental factors; staff attitudes towards delivering online courses, and years spent using eLearning. The academic staff proposed improving ICT infrastructure and strengthening the capacity of academic staff to provide online courses.

Conclusion

The study concludes that most academic staff are willing to adopt online teaching while suggesting improving the organisational and individual factors to enhance online education. The paper recommends that the university use freely available online teaching tools and platforms while simultaneously focusing on addressing the corporate and individual factors identified in this paper to enhance online teaching, which is mandatory in response to lockdown measures.
Coarse-grained molecular dynamics-guided immunoinformatics to explain the binder and non-binder classification of Cytotoxic T-cell epitope for SARS-CoV-2 peptide-based vaccine discovery
Authors: Yusuf Muhammad , Destiarani Wanda , Widayat Wahyu , Yosua Yosua , Gumilar Gilang , Tanudireja Angelica Shalfani , Rohmatulloh Fauzian Giansyah , Maulana Farhan Azhwin , Baroroh Umi , Hardianto Ari , Maharani Rani , Nurainy Neni , Wijayadikusumah Acep Riza , Ristandi Ryan B. , Atmosukarto Ines Irene Caterina , Subroto Toto
Published: October 2023

Epitope-based peptide vaccine can elicit T-cell immunity against SARS-CoV-2 to clear the infection. However, finding the best epitope from the whole antigen is challenging. A peptide screening using immunoinformatics usually starts from MHC-binding peptide, immunogenicity, cross-reactivity with the human proteome, to toxicity analysis. This pipeline classified the peptides into three categories, i.e., strong-, weak-, and non-binder, without incorporating the structural aspect. For this reason, the molecular detail that discriminates the binders from non-binder is interesting to be investigated. In this study, five CTL epitopes against HLA-A*02:01 were identified from the coarse-grained molecular dynamics-guided immunoinformatics screening. The strong binder showed distinctive activities from the non-binder in terms of structural and energetic properties. Furthermore, the second residue from the nonameric peptide was most important in the interaction with HLA-A*02:01. By understanding the nature of MHC-peptide interaction, we hoped to improve the chance of finding the best epitope for a peptide vaccine candidate.
Prevalence of HIV testing uptake among the never-married young men (15–24) in sub-Saharan Africa: An analysis of demographic and health survey data (2015–2020)
Authors: Musonda Emmanuel , Phiri Million , Shasha Liness , Bwalya Chiti , Musemangezhi Shuko , Ishimwe Sage Marie Consolatrice , Kalinda Chester
Published: October 2023

Background

In sub-Saharan Africa, HIV and AIDS remain a major public health concern among adolescents and young men. HIV testing is the first critical step for linking infected individuals to HIV treatment and prevention. However, HIV-testing uptake among sexually active young men remains low in the region. This study was conducted to assess the HIV testing rates among unmarried young men in sub-Saharan Africa.

Methods

Using data from the most recent country Demographic and Health Surveys (DHS) conducted between January 1, 2015, and December 31, 2020, in 18 sub-Saharan African countries, an Inverse Heterogeneity model (IVhet) using MetaXL software was used to estimate country, regional and sub-regional pooled estimates of HIV testing uptake among sexually active unmarried young men in sub-Saharan Africa. Furthermore, multivariable binary logistic regression was conducted to examine the factors associated with HIV testing uptake among unmarried young men.

Results

The overall pooled prevalence estimate of HIV testing uptake among sexually active unmarried young men in sub-Saharan Africa was 33.0% (95% CI: 21–45, I2 = 99%, p <0.001). There was variation in the prevalence across countries ranging from 7% (95% CI: 5–9) in Guinea to 77% (95% CI: 74–80) in Cameroon. Central Africa had the highest prevalence of HIV testing among unmarried young men, at 47% (95% CI:0–100) while West Africa had the lowest prevalence at 11% (95% CI:2–23). Results further show that young men aged 15–19 (aOR = 0.59, 95% CI 0.52–0.66) were less likely to test for HIV. Young men who spent 8 to 12 years in school (aOR = 3.26 95% CI 2.21–4.79) or 13 years and above (aOR = 3.56 95% CI 2.35–5.37) had increased odds of undertaking an HIV test.

Conclusion

The prevalence of HIV testing among sexually active unmarried young men remains low in sub-Saharan Africa. Therefore, the results suggest that health policymakers should consider re-evaluating the current HIV prevention policies and programmes with the view of redesigning the present HIV testing campaigns to enhance the uptake among young people.
The association between maternal infection and intellectual disability in children: A systematic review and meta-analysis
Authors: Rezaeinejad Mahroo , Riahi Seyed Mohammad , Moghadam Kimia Behzad , Tadi Mehrdad Jafari , Geraili Zahra , Parsa Hamid , Marhoommirzabak Elika , Nourollahpour Shiadeh Malihe , Khatir Ali Alizadeh
Published: October 2023

Background

There is arguing evidence regarding the association between maternal infections during pregnancy and the risk of intellectual disability (ID) in children. This systematic review and meta-analysis are essential to determine and address inconsistent findings between maternal infections during pregnancy and the risk of ID in children.

Methods

The MOOSE and PRISMA guidelines were followed to perform and report on this study. The Medline/PubMed, Web of Science, Embase, and Scopus databases were searched from inception up to March 15, 2023, to identify potentially eligible studies. Inclusion and exclusion criteria were applied, as well as the Newcastle-Ottawa Scale was used to assess the methodological quality of studies included. The included studies were divided into two types based on the participants: (1) ID-based studies, which involved children with ID as cases and healthy children as controls and evaluated maternal infection in these participants; (2) infection-based studies, which assessed the prevalence or incidence of ID in the follow-up of children with or without exposure to maternal infection. We used Random-effects models (REM) to estimate the overall pooled odds ratio (OR) and 95% confidence intervals (CIs). The between-studies heterogeneity was assessed with the χ2-based Q-test and I2 statistic. Subgroup and sensitivity analyses were applied to explore the source of heterogeneity and results consistency.

Results

A total of eight studies including 1,375,662 participants (60,479 cases and 1,315,183 controls) met the eligibility criteria. The REM found that maternal infection significantly increased the risk of ID in children (OR, 1.33; 95% CI, 1.21–1.46; I2 = 64.6). Subgroup analysis showed a significant association for both infection-based (OR, 1.27; 95%CI, 1.15–1.40; I2 = 51.2) and ID-based (OR, 1.44; 95%CI, 1.19–1.74; I2 = 77.1) studies. Furthermore, subgroup analysis based on diagnostic criteria revealed a significant association when maternal infection or ID were diagnosed using ICD codes (OR, 1.33; 95% CI, 1.20–1.48; I2 = 75.8).

Conclusion

Our study suggests that maternal infection during pregnancy could be associated with an increased risk of ID in children. This finding is consistent across different types of studies and diagnostic criteria. However, due to the heterogeneity and limitations of the included studies, we recommend further longitudinal studies to confirm the causal relationship and the underlying mechanisms.
A non-randomized pilot study protocol of a novel social support intervention for individuals in early recovery from hazardous alcohol use
Authors: McCurdy Li Yan , Kong Grace , Krishnan-Sarin Suchitra , Kiluk Brian D. , Potenza Marc N.
Published: October 2023

Introduction

Connecting individuals to recovery support services such as recovery community centers and mutual help organizations can be crucial for sustaining recovery from addiction. However, there may be barriers to engagement with recovery support services on individual (e.g., limited motivation) and structural (e.g., limited information on recovery resources) levels. This pilot study will determine the feasibility and acceptability of a novel online social support intervention (Let’s Do Addiction Recovery Together!, abbreviated as LDART) that uses pre-recorded videos created by members from several recovery support services to help individuals in early recovery from hazardous alcohol use sustain motivation during recovery and introduce them to freely available recovery support services in the community.

Methods and analysis

This will be a non-randomized mixed-method pilot study. We will recruit 30 adults who engaged in past-year hazardous alcohol use and have some desire to cut down or quit to use LDART every night for a month. A subset of these participants will be invited to participate in a semi-structured qualitative interview after completing the study. Primary outcomes will be feasibility parameters such as recruitment and retention rates, and acceptability measures such as frequency of intervention use. Secondary outcomes will include self-reported changes in alcohol use, engagement in recovery support services, and quality of life at one-month post-intervention relative to baseline.

Discussion

Results of this pilot study will inform a randomized controlled trial to examine efficacy of this intervention, with the goal of creating an accessible and scalable intervention that has direct benefits on individuals who want to cut down or quit problematic alcohol use.

Trial registration

ClinicalTrials.gov ID: NCT06022107.
Calcium supplementation in pregnancy: An analysis of potential determinants in an under-resourced setting
Authors: Ajong Atem Bethel , Kenfack Bruno , Ali Innocent Mbulli , Yakum Martin Ndinakie , Ukaogo Prince Onydinma , Mangala Fulbert Nkwele , Aljerf Loai , Telefo Phelix Bruno
Published: October 2023

Introduction

Despite the evidence that calcium supplementation in pregnancy improves maternofoetal outcomes, many women still do not take calcium supplements during pregnancy in Cameroon. This study identifies factors that influence calcium supplementation during pregnancy in a low resource setting.

Methods

We conducted a cross-sectional hospital-based study (from November 2020 to September 2021) targeting 1074 healthy women in late pregnancy at the maternities of four major health facilities in the Nkongsamba Health District, Cameroon. Data were collected using an interview-administered semi-structured questionnaire and analysed using Epi Info version 7.2.4.0, and the statistical threshold for significance set at p-value = 0.05.

Results

The mean age of the participants was 28.20±6.08 years, with a range of 15–47 years. The proportion of women who reported taking any calcium supplements in pregnancy was 72.62 [69.85–75.22]%. Only 12% of calcium-supplemented women took calcium supplements throughout pregnancy, while a majority (50%) took calcium supplements just for 4–5 months. Women believe that taking calcium supplements is more for foetal growth and development (37.12%) and prevention of cramps (38.86%), than for the prevention of hypertensive diseases in pregnancy (2.84%). About all pregnant women (97.65%) took iron and folic acid supplements during pregnancy, and 99.24% took these supplements at least once every two days. Upon control for multiple confounders, the onset of antenatal care before 4 months of pregnancy (AOR = 2.64 [1.84–3.78], p-value = 0.000), having had more than 3 antenatal care visits (AOR = 6.01 [3.84–9.34], p-value = 0.000) and support/reminder from a partner on the necessity to take supplements in pregnancy (AOR = 2.00 [1.34–2.99], p-value = 0.001) were significantly associated with higher odds of taking any calcium supplements in pregnancy.

Conclusion

Calcium supplementation practices in pregnancy remain poor in this population and far from WHO recommendations. Early initiation of antenatal care, a high number of antenatal visits and reminders or support from the partner on supplement intake significantly increase the odds of taking any calcium supplements in pregnancy. In line with WHO recommendations, women of childbearing age should be sensitised to initiate antenatal care earlier and attain as many visits as possible. Male involvement in prenatal care might also boost the likelihood of these women taking calcium supplements.
Ranking versus rating in peer review of research grant applications
Authors: Tamblyn Robyn , Girard Nadyne , Hanley James , Habib Bettina , Mota Adrian , Khan Karim M. , Ardern Clare L.
Published: October 2023

The allocation of public funds for research has been predominantly based on peer review where reviewers are asked to rate an application on some form of ordinal scale from poor to excellent. Poor reliability and bias of peer review rating has led funding agencies to experiment with different approaches to assess applications. In this study, we compared the reliability and potential sources of bias associated with application rating with those of application ranking in 3,156 applications to the Canadian Institutes of Health Research. Ranking was more reliable than rating and less susceptible to the characteristics of the review panel, such as level of expertise and experience, for both reliability and potential sources of bias. However, both rating and ranking penalized early career investigators and favoured older applicants. Sex bias was only evident for rating and only when the applicant’s H-index was at the lower end of the H-index distribution. We conclude that when compared to rating, ranking provides a more reliable assessment of the quality of research applications, is not as influenced by reviewer expertise or experience, and is associated with fewer sources of bias. Research funding agencies should consider adopting ranking methods to improve the quality of funding decisions in health research.
An interpretable machine learning model of cross-sectional U.S. county-level obesity prevalence using explainable artificial intelligence
Authors: Allen Ben
Published: October 2023

Background

There is considerable geographic heterogeneity in obesity prevalence across counties in the United States. Machine learning algorithms accurately predict geographic variation in obesity prevalence, but the models are often uninterpretable and viewed as a black-box.

Objective

The goal of this study is to extract knowledge from machine learning models for county-level variation in obesity prevalence.

Methods

This study shows the application of explainable artificial intelligence methods to machine learning models of cross-sectional obesity prevalence data collected from 3,142 counties in the United States. County-level features from 7 broad categories: health outcomes, health behaviors, clinical care, social and economic factors, physical environment, demographics, and severe housing conditions. Explainable methods applied to random forest prediction models include feature importance, accumulated local effects, global surrogate decision tree, and local interpretable model-agnostic explanations.

Results

The results show that machine learning models explained 79% of the variance in obesity prevalence, with physical inactivity, diabetes, and smoking prevalence being the most important factors in predicting obesity prevalence.

Conclusions

Interpretable machine learning models of health behaviors and outcomes provide substantial insight into obesity prevalence variation across counties in the United States.
First 72-hours after birth: Newborn feeding practices and neonatal mortality in India
Authors: Mal Piyasa , Ram Usha
Published: October 2023

Background

The reductions in mortality levels among children under five years are observed in most populations, including populations that were lagging the progress in the past. However, the reduction is not uniform across ages during childhood. The mortality declines within the first month have shown relatively slow progress. Early initiation of breastfeeding and discarding pre-lacteal feed protects the newborn from acquiring infection and, thereby, reduces mortality. This paper assesses the change in the prevalence of early initiation of breastfeeding and pre-lacteal feed along with their associated factors, and their association with neonatal mortality in India.

Methods

We used data from the three rounds of National Family Health Surveys conducted during 2005–06, 2015–16 and 2019–21 in India. We used bivariate and multivariate analyses to examine prevalence rates, risk factors, and relationships between breastfeeding practices, including early initiation of breastfeeding and pre-lacteal feed, and neonatal mortality.

Results

Early initiation of breastfeeding within one hour after birth increased rapidly from 25% in 2005–06 to 42% in 2019–21, and the pre-lacteal feeding practice declined from 57% in 2005–06 to 15% in 2019–21. Pre-lacteal feed is lower in states/districts where early breastfeeding initiation is predominant and vice versa. The role of health professionals during pregnancy and the first two days after delivery significantly improved breastfeeding practice. Further, the findings suggest that an early breastfeeding initiation is associated with lower neonatal mortality, whereas pre-lacteal feed is not harmful compared to late breastfeeding initiation.

Conclusion

Prevalence of pre-lacteal feed reduced, and initiation of early breastfeeding increased considerably after the launch of the National Rural Health Mission in India. However, after 2015–16, early breastfeeding initiation has stagnated, and the decline in pre-lacteal feed has slowed down. The future program needs special attention to emphasize the availability and accessibility of breastfeeding advisers and observers in health facilities to help mitigate adverse neonatal outcomes.