bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation status of the nationally harmonized competency-based, integrated, modular medical curriculum in Ethiopia: opportunities and challenges
Authors: Gebremickael Abinet , Mulu Abay
Published: July 2024

Background

Well-designed curriculums are crucial for quality education. This study aimed to assess the implementation status of a harmonized competency-based medical curriculum (CBMC) in Ethiopia, as well as identify the associated challenges and benefits.

Methods

A mixed-method approach was used. Data collection took place from September 1, 2023, to October 15, 2023. Eleven medical schools were randomly selected from a list of 28 public medical schools in Ethiopia. Participants were purposively chosen from selected medical schools using a controlled sampling method. A total of 121 participants took part in the survey. Interviews and focus group discussions were conducted with key informants to complement the quantitative findings. Descriptive statistics, such as frequencies and percentages, were used to summarize the quantitative survey responses. Thematic content analysis was used to analyze the qualitative data.

Results

The implementation of a CBMC in Ethiopian public universities faces various challenges and provides opportunities. Around 22% of respondents mentioned that the whole group session (WGS) had never been implemented in their school. Regarding community-based learning (CBL), 64.6% of respondents noted that it was intermittently implemented in their institution. Only 32% of respondents considered students’ clinical exposure during preclerkship years to be reasonable. Interestingly, approximately 73% of respondents stated that problem-based learning (PBL) activities were regularly conducted in their school. Around 68% of respondents believed that competency-based assessment methods were moderately utilized. While many participants perceive the curriculum as having positive content alignment and structure with intended learning outcomes, challenges related to practical sessions, resource limitations, and uneven access to training opportunities persist. Resource constraints are a prominent challenge. The opportunities identified include early clinical exposure and enhanced communication skills.

Conclusions

This survey highlights the need for ongoing curriculum evaluation and fine-tuning to ensure its success.
Process evaluation of comprehensive sexuality education programme in Zambia: a focus on contextual factors, mechanisms of impact, quality of development and implementation process
Authors: Mukanga Bright , Dlamini Siyabonga Blessing , Taylor Myra
Published: July 2024

Background

Comprehensive sexuality education (CSE) is critical in addressing negative sexual and reproductive health (SRH) outcomes among adolescents. Yet in many low- and middle-income countries (LMICs) including Zambia, little is known about the impact, realities of CSE implementation, the quality of teaching and the comprehensiveness of the content covered.

Methods

Our approach was informed by a process evaluation incorporating recommendations by the European Expert Group guidance on evaluating sexuality education programmes and the Medical Research Council (MRC) guidelines on process evaluation. The development process and quality of CSE implementation were assessed using eight and six quality criteria respectively. In-depth interviews (IDIs), focus group discussions (FGDs), document analysis and classroom observation were employed to assess contextual factors, implementation process and mechanisms of impact of CSE. In-depth interviews (50) and focus group discussions (2) with seven pupils in each group were conducted among 64 purposefully selected participants. The sample comprised pupils (35), parents (4) and teachers (17) from nine secondary schools (four peri-urban, four urban and one rural), policymakers (4), and religious leaders (4). We employed deductive content analysis to analyse the data.

Results

Contextual factors that influenced the implementation of CSE included: (1) piecemeal funding for the CSE programme; (2) lack of monitoring programmes in schools; (3) lack of community engagement; (4) religious and socio-cultural barriers; (5) lack of skills and competency to teach CSE; and (6) insufficient time allocation for CSE. The assessment of the quality of the development of CSE revealed: (1) a lack of sexual diversity; (2) no meaningful participation of pupils in programme implementation; (3) a lack of stakeholder engagement during programme implementation; (4)  lack of gender sensitivity; and (5) lack of human rights approach. Assessment of the quality of the implementation of CSE revealed: (1) no evidence of skill-based CSE teaching; (2) no linkage between CSE and SRH services in the communities; and (3) a lack of incorporation of multiple delivery methods during CSE teaching. The mechanisms of impact of CSE were related to the acceptability and positive changes in pupils’ SRH practices.

Conclusion

The complex influences of contextual factors during CSE implementation highlight the need for contextual analysis during the interventional design. Co-creation of the CSE programme through stakeholder participation could reduce social opposition and enable a culturally sensitive CSE. Comprehensive teacher training, a guiding curriculum as well as setting of appropriate monitoring tools and indicators are likely to enhance the quality of CSE implementation.
Bioremoval of tannins and heavy metals using immobilized tannase and biomass of Aspergillus glaucus
Authors: Saad Moataza Mahmoud , Saad Abdelnaby Mahmoud , Hassan Helmy Mohamed , Ibrahim Eman I. , Hassabo Amany A. , Ali Basant A.
Published: July 2024

Background

The presence of inorganic pollutants and heavy metals in industrial effluents has become a serious threat and environmental issues. Fungi have a remarkable ability to exclude heavy metals from wastewater through biosorption in eco-friendly way. Tannase plays an important role in bioconversion of tannin, a major constituent of tannery effluent, to gallic acid which has great pharmaceutical applications. Therefore, the aim of the current study was to exploit the potential of tannase from Aspergillus glaucus and fungal biomass waste for the bioremediation of heavy metals and tannin.

Results

Tannase from A. glaucus was partially purified 4.8-fold by ammonium sulfate precipitation (80%). The enzyme was optimally active at pH 5.0 and 40 °C and stable at this temperature for 1 h. Tannase showed high stability at different physiological conditions, displayed about 50% of its activity at 60 °C and pH range 5.0–6.0. Immobilization of tannase was carried out using methods such. as entrapment in Na-alginate and covalent binding to chitosan. The effects of Na-alginate concentrations on the beads formation and enzyme immobilization revealed that maximum immobilization efficiency (75%) was obtained with 3% Na-alginate. A potential reusability of the immobilized enzyme was showed through keeping 70% of its relative activity up to the fourth cycle. The best bioconversion efficiency of tannic acid to gallic acid by immobilized tannase was at 40 °C with tannic acid concentration up to 50 g/l. Moreover, bioremediation of heavy metal (Cr3+, Pb2+, Cu2+, Fe3+, and Mn2+) from aqueous solution using A. glaucus biomass waste was achieved with uptake percentage of (37.20, 60.30, 55.27, 79.03 and 21.13 respectively). The biomass was successfully used repeatedly for removing Cr3+ after using desorbing agent (0.1 N HCl) for three cycles.

Conclusion

These results shed the light on the potential use of tannase from locally isolated A. glaucus in the bioremediation of industrial tanneries contained heavy metals and tannin.
On the feasibility of ultrasound Doppler-based personalized hemodynamic modeling of the abdominal aorta
Authors: Fonken Judith , Gillissen Milan , van Engelen Eline , van Sambeek Marc , van de Vosse Frans , Lopata Richard
Published: July 2024

Background

Personalized modeling is a promising tool to improve abdominal aortic aneurysm (AAA) rupture risk assessment. Computed tomography (CT) and quantitative flow (Q-flow) magnetic resonance imaging (MRI) are widely regarded as the gold standard for acquiring patient-specific geometry and velocity profiles, respectively. However, their frequent utilization is hindered by various drawbacks. Ultrasound is used extensively in current clinical practice and offers a safe, rapid and cost-effective method to acquire patient-specific geometries and velocity profiles. This study aims to extract and validate patient-specific velocity profiles from Doppler ultrasound and to examine the impact of the velocity profiles on computed hemodynamics.

Methods

Pulsed-wave Doppler (PWD) and color Doppler (CD) data were successfully obtained for six volunteers and seven patients and employed to extract the flow pulse and velocity profile over the cross-section, respectively. The US flow pulses and velocity profiles as well as generic Womersley profiles were compared to the MRI velocities and flows. Additionally, CFD simulations were performed to examine the combined impact of the velocity profile and flow pulse.

Results

Large discrepancies were found between the US and MRI velocity profiles over the cross-sections, with differences for US in the same range as for the Womersley profile. Differences in flow pulses revealed that US generally performs best in terms of maximum flow, forward flow and ratios between forward and backward flow, whereas it often overestimates the backward flow. Both spatial patterns and magnitude of the computed hemodynamics were considerably affected by the prescribed velocity boundary conditions. Larger errors and smaller differences between the US and generic CFD cases were observed for patients compared to volunteers.

Conclusion

These results show that it is feasible to acquire the patient-specific flow pulse from PWD data, provided that the PWD acquisition could be performed proximal to the aneurysm region, and resulted in a triphasic flow pattern. However, obtaining the patient-specific velocity profile over the cross-section using CD data is not reliable. For the volunteers, utilizing the US flow profile instead of the generic flow profile generally resulted in improved performance, whereas this was the case in more than half of the cases for the patients.
Subspecialty physicians’ perspectives on barriers and facilitators of hepatitis C treatment: a qualitative study
Authors: Bredenberg Erin , Callister Catherine , Dafoe Ashley , Holliman Brooke Dorsey , Rowan Sarah E. , Calcaterra Susan L.
Published: July 2024

Introduction

The hepatitis C virus (HCV) causes chronic and curable disease with a substantial burden of morbidity and mortality across the globe. In the United States (US) and other developed countries, incidence of HCV is increasing and people who inject drugs are disproportionately affected. However, HCV treatment rates amongst patients with substance use disorders (SUD) are suboptimal. In this study, we aimed to understand the perspectives of subspecialist physicians who care for substantial numbers of patients with HCV, including addiction medicine, infectious diseases, and hepatology physicians, to better understand barriers and facilitators of HCV treatment.

Methods

We recruited subspecialty physicians via purposive and snowball sampling and conducted semi-structured interviews with 20 physicians at 12 institutions across the US. We used a mixed deductive and inductive approach to perform qualitative content analysis with a rapid matrix technique.

Results

Three major themes emerged: (1) Perceptions of patient complexity; (2) Systemic barriers to care, and (3) Importance of multidisciplinary teams. Within these themes, we elicited subthemes on the effects of patient-level factors, provider-level factors, and insurance-based requirements.

Conclusion

Our results suggest that additional strategies are needed to reach the “last mile” untreated patients for HCV care, including decentralization and leverage of telehealth-based interventions to integrate treatment within primary care clinics, SUD treatment facilities, and community harm reduction sites. Such programs are likely to be more successful when multidisciplinary teams including pharmacists and/or peer navigators are involved. However, burdensome regulatory requirements continue to hinder this expansion in care and should be eliminated.
Association of thyroid hormone with osteoarthritis: from mendelian randomization and RNA sequencing analysis
Authors: Li Chengxin , Tu Yucheng , Rong Rong , Zhang Ziji , Chen Weishen , Long Lingli , Zhang Yangchun , Wang Chao , Pan Baiqi , Wu Xiaoyu , Guan Mingqiang , Yang Bo , Zheng Linli , Sheng Puyi
Published: July 2024

Background

The relationship between thyroid hormone (TH) levels in vivo and osteoarthritis (OA) remains inconclusive. This study aims to investigate the association between TH levels and OA, analyze the effect of triiodothyronine on hypertrophic chondrocyte differentiation and OA progression, and identify potential target genes of triiodothyronine in OA to evaluate its diagnostic value.

Methods

Two-sample mendelian randomization method was used to probe the causal links between hyperthyroidism and OA. Differentially expressed genes (DEGs) from two RNA-sequencing data in Gene Expression Omnibus (GSE199847 and GSE114007) and enrichment analysis of DEGs (166 commonly upregulated genes and 71 commonly downregulated genes of GSE199847 and GSE114007) was performed to analyze the effect of triiodothyronine (T3) on hypertrophic chondrocyte differentiation and OA. C28/I2 cells treated with T3 and reverse transcription and quantitative real-time polymerase chain reaction were used to validate T3 targeted genes. The diagnostic performance of target genes was assessed by the receiver operating characteristic (ROC) curve and area under the curve (AUC).

Results

There was a positive causal association between hyperthyroidism and OA (IVW result, OR = 1.330, 95% CI 1.136–1.557,P = 0.0004). Weighted median and Weighted mode analysis also demonstrated that hyperthyroidism had a positive causal association with OA (p < 0.05, OR > 1). Bioinformatics analysis indicated T3 can partially induce the emergence of late hypertrophic chondrocyte and promote OA through extracellular matrix organization, blood vessel development, skeletal system development and ossification. Post-T3 treatment, MAFB, C1QTNF1, COL3A1 and ANGPTL2 were significantly elevated in C28/I2 cells. ROC curves in GSE114007 showed that AUC of all above genes were ≥ 0.7.

Conclusions

This study identified that hyperthyroidism has a positive causal association with OA by MR analysis. T3 induced hypertrophic chondrocytes promote OA progression by upregulating genes such as MAFB, C1QTNF1, COL3A1 and ANGPTL2, which can also serve as OA diagnosis.
Effect of protic surfactant ionic liquids based on ethanolamines on solubility of acetaminophen at several temperatures: measurement and thermodynamic correlation
Authors: Gondoghdi Parisa Akbarzadeh , Shekaari Hemayat , Mokhtarpour Masumeh , Sardroud Mirhesam Miraghazadeh , Afkari Ramin , Khorsandi Mohammad
Published: July 2024

Absolute qualifications with the application of protic ionic liquids (PILs) and a recognition of the numerous thermophysical features of these materials are required in various processes. Due to the wonderful applications of these compounds and their high potential in the chemical and pharmaceutical industries, there is a particular eagerness to utilize these PILs in drug solubility and delivery area. The aim of this investigation was to explore the solubility of the acetaminophen (ACP) in three PILs base on ethanolamine laurate [(2-hydroxyethylammonium laurate [MEA]La), (bis(2-hydroxyethyl)ammonium laurate [DEA]La), and ( tris(2-hydroxyethyl)ammonium laurate [TEA]La)]. The shake flask method has been employed in this study, and the conditions were set at T = (298.15–313.15) K and atmospheric pressure. Moreover, the experimental solubility data was correlated using a variety of empirical and thermodynamic models, encompassing e-NRTL and Wilson activity coefficient models and the empirical models such as Van’t Hoff-Jouyban-Acree and Modified Apelblat-Jouyban-Acree. Their performance for the system containing [MEA]La follow the trend for activity coefficient models and empirical respectively: the Wilson > e-NRTL and Modified Apelblat–Jouyban–Acree > Van’t Hoff–Jouyban–Acree. On the other hand, [DEA]La and [TEA]La PILs followed slightly different trend for activity coefficient models and empirical respectively: the Wilson > e-NRTL and Van’t Hoff–uyban–Acree > Modified Apelblat–Jouyban–Acree. The Van’t Hoff and Gibbs equations were used to determine the thermodynamic properties of dissolution in the studied systems.
Strong $\mathcal {F}$-convexity and concavity and refinements of some classical inequalities
Authors: Perić Jurica
Published: July 2024

The concept of strong ${\mathcal {F}}$
F
-convexity is a natural generalization of strong convexity. Although strongly concave functions are rarely mentioned and used, we show that in more effective and specific analysis this concept is very useful, and especially its generalization, namely strong ${\mathcal {F}}$
F
-concavity. Using this concept, refinements of the Young inequality are given as a model case. A general form of the self-improving property for Jensen type inequalities is presented. We show that a careful choice of control functions for convex or concave functions can give a control over these refinements and produce refinements of the power mean inequalities.
Processes of change in family therapies for anorexia nervosa: a systematic review and meta-synthesis of qualitative data
Authors: Cripps Sophie , Serpell Lucy , Pugh Matthew
Published: July 2024

Objective

To synthesise young person and family member perspectives on processes of change in family therapy for anorexia nervosa (AN), including systemic family therapy and manualised family-based treatments, to obtain an understanding of what helps and hinders positive change.

Method

A systematic search of the literature was conducted to identify qualitative studies focussing on experiences of therapeutic change within family therapies for AN from the perspectives of young people and their families. Fifteen studies met inclusion criteria and underwent quality appraisal following which they were synthesised using a meta-synthesis approach.

Results

Six overarching themes were generated: “A holistic focus on the young person’s overall development”; “The therapeutic relationship as a vehicle for change”; “The therapist’s confinement to a script and its impact on emotional attunement”; “A disempowering therapeutic context”; “Externalisation of the eating disorder (ED)”; and “The importance of family involvement”. Positive change was helped by understanding and support given to the young person’s overall development including their psychological, emotional, social and physical wellbeing, positive therapeutic relationships, relational containment within the family system and externalising conversations in which young people felt seen and heard. Positive change was hindered by inflexibility in the treatment approach, counter-effects of externalisation, negative experiences of the therapist, a narrow focus on food-intake and weight, as well as the neglect of family difficulties, emotional experiences, and psychological factors.

Conclusions

Positive change regarding the young person’s eating-related difficulties ensued in the context of positive relational changes between the young person, their family members, the therapist and treatment team, highlighting the significance of secure and trusting relationships. The findings of this review can be utilised by ED services to consider how they may adapt to the needs of young people and their families in order to improve treatment satisfaction, treatment outcomes, and in turn reduce risk for chronicity in AN.
Examining the interplay between physical activity, problematic internet use and the negative emotional state of depression, anxiety and stress: insights from a moderated mediation path model in university students
Authors: jelleli Hilmi , Ben Aissa Mohamed , Kaddech Nabil , Saidane Mouna , Guelmami Noomen , Bragazzi Nicola L. , Bonsaksen Tore , Fekih-Romdhane Feten , Dergaa Ismail
Published: July 2024

Background

The aim of this study was to investigate the relationship between Problematic Internet Use (PIU), emotional states of stress, anxiety and depression, and the practice of physical activity among Tunisian students.

Methods

Cross-sectional data were collected from 976 university students aged 20.76 ± 1.63 years (46.8% female). They filled out an online survey comprised of a socio-demographic questionnaire, the depression, anxiety and stress scale– 21 items (DASS-21), the international physical activity questionnaire (IPAQ) and the compulsive internet use scale (CIUS). Students were divided, based on their economic levels, into three groups: low (n = 256, 26.23%), medium (n = 523, 53.59%) and high (n = 197, 20.18%).

Results

Mediation analysis: Indirect effects of IPAQ and gender on DASS-21 were highlighted: β= -0.18 (p < 0.01) and β= -0.04,P < 0.01) respectively. In addition, a significant and negative effect of IPAQ on CIUS was demonstrated (β = -0.45,P < 0.01). In addition, the effect of CIUS on DASS-21 was significant (β = 0.39,P < 0.01). Also, the effect of gender on CIUS was significant (β=-0.10,P < 0.01) However, its effect on DASS-21 was not significant (β = 0.05,p = 0.078). The total effect of IPAQ on DASS21 was significant (β= -0.52,p < 0.01) but the effect of Gender on DASS-21 was not significant (β = 0.01,p = 0.817). Moderation analysis: the results showed a significant moderation effect of the interaction between IPAQ and Gender on CIUS (β = 0.07,p < 0.01). However, it was not significant between Gender and CIUS on DASS-21 (β = 0.09,p = 0.390) and between IPAQ and Gender on DASS21 (β = 0.01,p = 0.736) Also, the interaction between IPAQ and CIUS did not have a significant moderation effect on DASS-21 (β = 0.15,p = 0.115).

Conclusions

Findings suggest that relationships between PIU and negative emotional state of depression, anxiety and stress are mediated via physical exercise. These results underscore the importance of the physical activity factor in the studies analyzing longitudinal effects of PIU on mental health outcomes.
Estimation of kidney doses from [177Lu]Lu-DOTA-TATE PRRT using single time point post-treatment SPECT/CT
Authors: Spink Safia , Gillett Daniel , Heard Sarah , Harper Ines , Casey Ruth , Aloj Luigi
Published: July 2024

Background

Dosimetry after [177Lu]Lu-DOTA-TATE therapy can be demanding for both patients and the clinical service due to the need for imaging at several time points. In this work we compare three methods of single time point (STP) kidney dosimetry after [177Lu]Lu-DOTA-TATE therapy with a multiple time point (MTP) dosimetry method.

Method

Method 1 (MTP): Kidney doses were calculated from 31 patients including 107 therapy cycles. Post-therapy SPECT images were acquired on day 0, 4 and 7 along with a CT scan on day 4. A mono-exponential fit was used to calculate kidney doses using cycle specific data. Method 2 (Consistent effective half-life): The effective half-life $$\left({\text{T}}_{\text{e}\text{f}\text{f}}\right)$$ calculated in cycle 1 was assumed consistent for subsequent cycles of therapy and the activity scaled using a single day 3–5 SPECT/CT. Methods 3 and 4 (Hänscheid and Madsen approximations): The Hänscheid approximation and Madsen approximation were both evaluated using a single SPECT/CT acquired on day 0, 4 and 7. All STP methods were compared to the MTP method for accuracy.

Results

Using the MTP method, mean right and left kidney doses were calculated to be 2.9 ± 1.1 Gy and 2.8 ± 0.9 Gy respectively and the population $${\text{T}}_{\text{e}\text{f}\text{f}}$$ was 56 ± 13 h. For the consistent $${\text{T}}_{\text{e}\text{f}\text{f}}$$, Hänscheid and Madsen methods, the percentage of results within ± 20% of MTP method were 96% (n = 70), 95% (n = 80) and 94% (n = 80) respectively.

Conclusion

All three single time point methods had > 94% of results within ± 20% of the MTP method, however the consistent $${\text{T}}_{\text{e}\text{f}\text{f}}$$ method resulted in the highest alignment with the MTP method and is the only method which allows for calculation of the patient-specific $${\text{T}}_{\text{e}\text{f}\text{f}}$$. If only a single scan can be performed, day 4 is optimal for kidney dosimetry where the Hänscheid or Madsen approximation can be implemented with good accuracy.
Performance evaluation of the 3D-ring cadmium–zinc–telluride (CZT) StarGuide system according to the NEMA NU 1-2018 standard
Authors: Zorz Alessandra , Rossato Marco Andrea , Turco Paolo , Colombo Gomez Luca Maria , Bettinelli Andrea , De Monte Francesca , Paiusco Marta , Zucchetta Pietro , Cecchin Diego
Published: July 2024

Background

The application of semi-conductor detectors such as cadmium–zinc–telluride (CZT) in nuclear medicine improves extrinsic energy resolution and count sensitivity due to the direct conversion of gamma photons into electric signals. A 3D-ring pixelated CZT system named StarGuide was recently developed and implemented by GE HealthCare for SPECT acquisition. The system consists of 12 detector columns with seven modules of 16 × 16 CZT pixelated crystals, each with an integrated parallel-hole tungsten collimator. The axial coverage is 27.5 cm. The detector thickness is 7.25 mm, which allows acquisitions in the energy range [40–279] keV. Since there is currently no performance characterization specific to 3D-ring CZT SPECT systems, the National Electrical Manufacturers Association (NEMA) NU 1-2018 clinical standard can be tailored to these cameras. The aim of this study was to evaluate the performance of the SPECT/CT StarGuide system according to the NEMA NU 1-2018 clinical standard specifically adapted to characterize the new 3D-ring CZT.

Results

Due to the integrated collimator, the system geometry and the pixelated nature of the detector, some NEMA tests have been adapted to the features of the system. The extrinsic measured energy resolution was about 5–6% for the tested isotopes (99mTc, 123I and 57Co); the maximum count rate was 760 kcps and the observed count rate at 20% loss was 917 kcps. The system spatial resolution in air extrapolated at 10 cm with 99mTc was 7.2 mm, while the SPECT spatial resolutions with scatter were 4.2, 3.7 and 3.6 mm in a central, radial and tangential direction respectively. Single head sensitivity value for 99mTc was 97 cps/MBq; with 12 detector columns, the system volumetric sensitivity reached 520 kcps MBq−1 cc−1.

Conclusions

The performance tests of the StarGuide can be performed according to the NEMA NU 1-2018 standard with some adaptations. The system has shown promising results, particularly in terms of energy resolution, spatial resolution and volumetric sensitivity, potentially leading to higher quality clinical images.
Intuitive eating in the COVID-19 era: a study with university students in Brazil
Authors: Ruiz Ana Corrêa , de Lara Machado Wagner , D’avila Helen Freitas , Feoli Ana Maria Pandolfo
Published: July 2024

Background

The recurrence of weight gain is attributed to the homeostatic regulation of hunger and satiety signals, influenced by metabolic state, nutrient availability, and non-homeostatic mechanisms shaped by reinforced consequences from experiences. In response, Evelyn Tribole and Elyse Resch proposed Intuitive Eating (IE) in 1980, countering restrictive diets. IE, inversely correlated with Body Mass Index (BMI), binge eating, and anxiety/depression symptoms, fosters mind–body-food harmony by recognizing hunger and satiety cues. IE encourages meeting physiological, not emotional, needs, permitting unconditional eating, and relying on internal signals for food decisions. Amidst university students’ stress, exacerbated during the COVID-19 pandemic, understanding their eating behavior, particularly intuitive eating levels, becomes crucial.

Objective

This study aimed to assess the IE level of Brazilian students during the COVID-19 pandemic.

Methods

This cross-sectional study, the first to analyze the Intuitive Eating of students in Brazil during the pandemic, was conducted using an online questionnaire.

Results

The sample comprised 1335 students, most of whom were women (82.17%), with a mean age of 26.12 ± 7.9 years, and a healthy nutritional status (57.58%). The mean IE score was 3.2 ± 0.6. A significant association was found between the confinement situation, the type of housing unit, and the IE subscale-Unconditional Permission to Eat (p = 0.043). However, there was no association between the other subscales and the total IE scale. Regarding self-reported mental and eating disorders, the most frequent were anxiety (21.2%), depression (6.5%), and binge eating disorder (BED) (4.7%). IE was negatively associated with BED (B =  − 0.66; p < .001), bulimia nervosa (B =  − 0.58; p < .001), body mass index (BMI) (p < .001) and self-reported anxiety (B =  − .102; p = 0.16). The male sex showed a higher IE score compared with the female sex (p < .001).

Conclusion

While no significant association was found between IE and the confinement situation, a significant association was found between housing type and the Unconditional Permission to Eat subscale.
Impact of cerebral microbleeds on bleeding and outcome after stroke thrombolysis
Authors: Afifi Khaled , Al-Ahmer Ibrahim , El-Hiebary Amira , Hassanein Shaimaa , Elkholy Mona , Elkapany Rasha
Published: July 2024

Background

Cerebral microbleeds may be responsible for bleeding and poor functional outcome following thrombolysis of acute ischemic stroke. We tried to assess the association between cerebral microbleeds, hemorrhagic complication and functional outcome following intravenous thrombolysis in Egyptian acute ischemic stroke patients. We evaluated 66 acute ischemic stroke patients treated with intravenous thrombolysis for cerebral microbleeds using T2* weighted Magnetic Resonance Imaging Gradient echo. Distribution, number, and predictors of microbleeds were assessed. The effect of microbleeds presence and burden on development of hemorrhage after thrombolysis and 90 days functional outcome was evaluated.

Results

Out of 66 stroke patients treated with intravenous thrombolysis, 33 patients had microbleeds. Multivariate analysis shows that hypertension, diabetes mellitus, atrial fibrillation, smoking and leukoaraiosis were independently associated with microbleeds. Post-thrombolysis symptomatic intracerebral hemorrhage occurred in 12/66 (18.1%). Multivariate analysis shows that high burden microbleeds (≥ 10), leukoaraiosis, stroke severity, delayed thrombolysis were independently associated with intracerebral hemorrhage. Post-thrombolysis hemorrhage was statistically higher in microbleeds group (51.5%) than non-microbleeds group (9.1%) (p < 0.001). Parenchymal hemorrhage represents (58.8%) of hemorrhagic cases in microbleeds group in comparison to (33.3%) of non-microbleeds group (p = 0.62). Parenchymal hemorrhage represents (50%) of hemorrhagic cases with microbleeds < 10, while it represents (100%) of hemorrhagic cases with microbleeds ≥ 10. Favorable modified Rankin Scale (0–2) was more prevalent in non-microbleeds group (72.7%) than microbleeds group (45.5%) at 90 days (p = 0.024). Favorable outcome at discharge and at 90 days was statistically more prevalent in patients with microbleeds < 10 (p = 0.004).

Conclusion

High burden cerebral microbleeds should be considered a risk for parenchymal hemorrhage following intravenous thrombolysis. The presence and burden of microbleeds may affect prognosis 90 days after thrombolytic therapy.
GLDOC: detection of implicitly malicious MS-Office documents using graph convolutional networks
Authors: Wang Wenbo , Yi Peng , Kou Taotao , Han Weitao , Wang Chengyu
Published: July 2024

Nowadays, the malicious MS-Office document has already become one of the most effective attacking vectors in APT attacks. Though many protection mechanisms are provided, they have been proved easy to bypass, and the existed detection methods show poor performance when facing malicious documents with unknown vulnerabilities or with few malicious behaviors. In this paper, we first introduce the definition of im-documents, to describe those vulnerable documents which show implicitly malicious behaviors and escape most of public antivirus engines. Then we present GLDOC—a GCN based framework that is aimed at effectively detecting im-documents with dynamic analysis, and improving the possible blind spots of past detection methods. Besides the system call which is the only focus in most researches, we capture all dynamic behaviors in sandbox, take the process tree into consideration and reconstruct both of them into graphs. Using each line to learn each graph, GLDOC trains a 2-channel network as well as a classifier to formulate the malicious document detection problem into a graph learning and classification problem. Experiments show that GLDOC has a comprehensive balance of accuracy rate and false alarm rate − 95.33% and 4.33% respectively, outperforming other detection methods. When further testing in a simulated 5-day attacking scenario, our proposed framework still maintains a stable and high detection accuracy on the unknown vulnerabilities.
Clinical findings and laboratory parameters associated with CO-RADS classification in children with COVID-19
Authors: Elmeazawy Rehab , EL-Moazen Ahmed Mohammed Farid
Published: July 2024

Background

The aim of this study was to determine whether there are proven associations between CO-RADS categorizations and clinical and laboratory findings in children diagnosed with COVID-19 infection.

Methods

This is a retrospective observational study that includes the clinical and radiological data of pediatric patients who were admitted to both Minia University Hospital and Minia Insurance Hospital with a confirmed diagnosis of COVID-19, detected via reverse transcriptase PCR (RT-PCR) from nasopharyngeal swabs obtained between June 2022 and February 2023. Patients were divided into 5 groups based on the severity of involvement in chest CT.

Results

This study involved a total of 62 children who were confirmed to have COVID-19 infection. The most commonly observed symptoms in these children were fever (91.9%), shortness of breath (88.7%), and cough (87.1%). In addition, vomiting (24.2%), diarrhea (12.9%), impaired consciousness (11.2%), and convulsions (9.7%) were also reported. Significant differences were observed between CO-RADS classes in relation to patient gender, severity of respiratory distress, presence of cough, occurrence of diarrhea, elevated LDH levels, and prognosis.

Conclusion

The CO-RADS classification exhibited positive correlations with inflammatory biomarkers such as total leucocytic count, LDH, D-dimer, serum ferritin, and AST. Conversely, the CO-RADS classification showed negative correlations with ionized calcium levels, hemoglobin, and platelet count.
Bridging the gap: national virtual education programme for professionals caring for adults with intellectual and developmental disabilities at the time of COVID-19
Authors: Thakur Anupam , Bobbette Nicole , Bond Victoria , Gonzales Angela , Lake Johanna , Lefkowitz Gill , Mia Nadia , Niel Ullanda , Sockalingam Sanjeev , Streisslberger Erica , Thomson Kendra , Volpe Tiziana , Lunsky Yona
Published: July 2024

Background

The COVID-19 pandemic significantly impacted the mental health of adults with intellectual and developmental disabilities (IDD). During this period of uncertainty and need for up-to-date information, various virtual training programmes demonstrated the role of tele-mentoring programmes.

Aim

The aim of this paper is to describe the educational evaluation of the National Extension for Community Healthcare Outcomes – Adults with Intellectual and Developmental Disabilities (ECHO-AIDD), a programme for service providers working with adults with IDD during COVID-19.

Method

The programme consisted of six sessions, conducted weekly, over two cycles. Each session included didactic teaching by hub team members, COVID-19 news updates, wellness check-ins and a brief mindfulness activity, followed by a 30 to 45 min case-based discussion. The hub structure had an inter-professional approach to team expertise. Those with lived experience were an integral part of the content experts’ hub. Pre-, post- and follow-up evaluation data were collected.

Results

Care providers from health and social care sectors (n= 230) participated in the programme. High levels of engagement and satisfaction were reported. Self-efficacy ratings improved from pre- to post-, and were maintained at 8-week follow-up; improvement from pre- to post- was significant (P< 0.0001).

Conclusion

Exposure to National ECHO-AIDD educational intervention led to improvement in perceived competencies. This study also shows the valuable role of people with lived experience in fostering adaptive expertise in learners. The outreach and scalability support the feasibility of building a national virtual community of practice for IDD service providers. Future studies should focus on studying the impact of these programmes on the health outcomes of people with IDD.
Cystinosis-Associated Metabolic Bone Disease Across Ages and CKD Stages 1 to 5D/T
Authors: Lahring Johannes , Leifheit-Nestler Maren , Ewert Annika , Herzig Nadine , Köppl Christian , Pott Veronika , Oh Jun , Büscher Anja , Thumfart Julia , Weber Lutz T , Arbeiter Klaus , Acham-Roschitz Birgit , Tönshoff Burkhard , Zivicnjak Miroslav , Hohenfellner Katharina , Haffner Dieter
Published: July 2024

Context

The pathophysiology of cystinosis-associated metabolic bone disease is complex.

Objective

We hypothesized a disturbed interaction between osteoblasts and osteoclasts.

Methods

This binational cross-sectional multicenter study included 103 patients with cystinosis (61% children) with chronic kidney disease (CKD) stages 1 to 5D/T at hospital clinics. Ten key bone markers were evaluated.

Results

Skeletal complications occurred in two-thirds of the patients, with adults having a 5-fold increased risk compared with children. Patients with CKD stages 1 to 3 showed reduced z-scores for serum phosphate and calcium and suppressed fibroblast growth factor 23 (FGF23) and parathyroid hormone levels, in conjunction with elevated bone-specific alkaline phosphatase levels. Serum phosphate was associated with estimated glomerular filtration rate, combined phosphate and active vitamin D treatment, and native vitamin D supplementation, while serum calcium was associated with age and dosage of active vitamin D. Sclerostin was generally elevated in children, and associated with age, FGF23 levels, and treatment with active vitamin D and growth hormone. The osteoclast marker tartrate-resistant acid phosphatase 5b was increased, and associated with age and treatment with active vitamin D. The ratio of soluble ligand of receptor activator of nuclear factor-κB (sRANKL) and osteoprotegerin (OPG), a surrogate for the regulation of osteoclastogenesis by osteoblasts, was decreased and associated with phosphate and 1,25(OH)2D3 levels. These changes were only partly corrected after transplantation.

Conclusion

Bone health in cystinosis deteriorates with age, which is associated with increased osteoclast activity despite counter-regulation of osteoblasts via OPG/RANKL, which in conjunction with elevated sclerostin levels and persistent rickets/osteomalacia, may promote progressive bone loss.
Rising Incidence, Health Resource Utilization, and Costs of Polycystic Ovary Syndrome in the United Kingdom
Authors: Berni Thomas R , Morgan Christopher L , Rees D Aled
Published: July 2024

Context

Trends in incidence of polycystic ovary syndrome (PCOS) and effects on health resource utilization are unclear.

Objective

To describe trends in prevalence and incidence of PCOS in the United Kingdom. To establish healthcare resource use and associated costs.

Methods

Data were extracted from the Clinical Practice Research Datalink Aurum and Hospital Episode Statistics databases. Point prevalence and incidence were calculated (2004-2020). Patients with PCOS were matched to controls (1:1) by age, body mass index, and primary care practice. Primary care contacts were assigned an average cost and prescription items assigned a net ingredient cost. Inpatient admissions and outpatient consultations were processed into healthcare resource groups and costed to the national tariff.

Results

PCOS incidence increased from 1.22 per 1000 person years in 2004 to 1.77 (2012) and 2.20 (2019). Point prevalence increased from 1.02% (2004) to 2.2% (2012) and 3.5% (2020), and was highest in Asians. Mean contacts per person year (ppy) for patients with PCOS vs controls were 0.48 vs 0.29 for inpatients (P < .001), 3.81 vs 2.15 for outpatients (P < .001), and 6.43 vs 4.68 (P < .001) for primary care. Mean healthcare costs (ppy) were £837 vs £493 (P < .001) for inpatients, £444 vs £253 (P < .001) for outpatients, £157 vs £112 for primary care, and £109 vs £83 (P < .001) for primary care prescriptions. Total healthcare contacts ppy were 10.72 vs 7.11 (P < .001) and total associated costs £1546 vs £940 (P < .001).

Conclusion

The incidence of PCOS has risen significantly. Health resource utilization and costs of PCOS are significantly greater than controls.
The impact of sleep hygiene education and lavender essential oil inhalation on the sleep quality and overall well-being of athletes who undergo late-evening training: a randomized controlled trialâ¯â¯
Authors: Salem Atef , Trabelsi Khaled , Boujelbane Mohamed Ali , Belgacem Ahlem , Kerkeni Mohamed , kerkeni Manel , Boukhris Omar , Jahrami Haithem , Glenn Jordan , Ammar Achraf , Schöllhorn Wolfgang , Chtourou Hamdi
Published: July 2024

Background Sleep hygiene education (SHE) and lavender essential oil (LEO) inhalation are two effective strategies aimed at enhancing sleep quality and mood states. This study investigated the effects of a single SHE session combined with nightly LEO inhalation for 7 days of late-evening resistance training sessions on sleep quality and mood states in trained athletes. Methods Forty-two athletes were randomly assigned to four groups: a control group (CG), a SHE group (SHEG), a LEO group (LEOG), and a SHE + LEO group (CSLG). CG and LEOG maintained their sleep habits during the intervention, while SHEG and CSLG followed SHE recommendations. Additionally, LEOG and CSLG inhaled LEO nightly before sleep. Sleep patterns were recorded via actigraphy. The Brunel Mood Scale and the Hooper questionnaires were completed before and after the intervention. Results Sleep latency was lower in SHEG (p=0.001) and CSLG (p=0.012) compared to the CG. The subjective sleep score improved in SHEG, LEOG, and CSLG (p < 0.001), with greater improvement observed in SHEG (p = 0.002) and CSLG (p < 0.001) compared to CG at post-intervention. Additionally, significant improvements were observed in the Hooper index in the SHEG (p=0.048) and CSLG (p=0.027), with CSLG demonstrating higher scores compared to CG at the post-intervention assessment (p=0.026). Furthermore, the subjective fatigue score significantly decreased in the CSLG (p=0.009). Conclusions Combining SHE and LEO inhalation could be an effective strategy to enhance sleep latency, subjective sleep quality, and overall wellness, and reduce feelings of fatigue in trained athletes following late-evening resistance training sessions.
The Study of Geometry as the Most Important Way to Develop Heuristic Thinking
Authors: Sal'kov N.
Published: July 2024

Geometry by its nature is the most visual science of all that takes place in the life of mankind, and therefore the most visual for those who study at school or university – any book,

even the most non-technical, contains drawings, and drawings, in turn, are directly related to geometry in general and descriptive geometry in general in particular. After all, geometry studies points, lines and surfaces, but if you look closely, any drawing consists of points, lines and surfaces. It is not difficult to notice, so it is difficult to refute. The clarity of the drawings for beginners to learn something is the most important help for understanding the text. From the clarity of the school with its drawings in textbooks, the first step is taken to abstraction: the study of exclusively points and flat geometric shapes that are included in planimetry. After studying the names of geometric shapes, the student begins to study the laws of construction, to study various theorems, to prove them, to apply these proofs to other, more complex theorems. Here comes into play a phenomenon that can be called heuristic thinking based on logical constructions. The article also shows the use of Olympiads – urban and All-Russian – to further improve the development of heuristic thinking among students in order to replenish the departments of geometric profiles of universities as a result, as well as replenish our country with scientists in the direction 2.5.1 — "Descriptive geometry and computer graphics. Digital product lifecycle support." And in other areas, too.
Modernization of the state migration policy to ensure Russia's national
Authors: Shakurova N.
Published: July 2024

The purpose of the article is a comprehensive analysis of the problems of formation and modernization of the state legal regulation of migration policy in Russia as the most important resource for improving the internal and foreign policy of the state in terms of ensuring security at the present stage. Special attention is paid to the need to review migration quotas, strengthen control over the registration of migrants and vigilance of border checks, as well as the interaction of government agencies with representatives of national diasporas to prevent social tension and destabilization. The measures of control over the information space in order to counteract the radicalization of migrants and the spread of extremist sentiments among them are discussed. A proposal is made on the need to legalize labor migration and adjust migration policy as a response to the policies of neighboring states. It is proposed to maintain a visa-free regime with the CIS countries as a way to simplify intergovernmental dialogue and travel on a legal basis. The author of the article eventually comes to the conclusion that it is necessary to apply a balanced approach to the implementation of state migration policy, which will contribute to both security for Russia and the socio-economic integration of migrants, guaranteeing stability and social harmony in the country. The research used such methods as the analysis of documents (NPA regulating the migration process and national security in post-Soviet and modern Russia) and scientific literature on the subject under consideration, systemic, structural and functional, typological and comparative legal analysis, statistical and content analysis method of documents on the problems of formation and implementation of migration policy of the Russian Federation. Cluster analysis was used to assess the impact of migration on all spheres of society in the Russian Federation. The theoretical significance of the article lies in the development of conceptual foundations and methodological approaches to the modernization of migration policy in the context of national security. The practical significance of the article lies in the fact that its results can be used by government agencies and political organizations to develop and adjust regulatory legal acts regulating migration processes. The recommendations proposed by the author can contribute to improving the control of migration flows, increasing the effectiveness of interaction with national diasporas and preventing social tension and radicalization of migrants.