bluuebunny/crossref_metadata_2025 huggingface dataset:
Interaction Between Hepatitis B, Hepatitis C and Alcohol in the Development of Hepatocellular Carcinoma: A Systematic Review and Meta‐Analysis
Authors: Poorolajal Jalal , Shadi Yahya , Heshmati Bahram
Published: December 2024

The objective of this report is to provide clarification on the interaction among hepatitis B virus (HBV), hepatitis C virus (HCV) and alcohol in the development of hepatocellular carcinoma (HCC). A systematic search was performed in PubMed, Web of Science and Scopus databases up to July 18, 2023. The inclusion criteria involved observational studies that examined the relationship between HBV, HCV, alcohol use and the development of HCC. To assess between‐study heterogeneity, the I2 statistics were employed. Publication bias was evaluated using the Begg and Egger tests. The effect sizes were estimated as odds ratios (ORs) with 95% confidence intervals (CIs) utilising a random‐effects model. Among the initial pool of 31,021 studies identified, 28 studies involving 42,406 participants met the inclusion criteria. Through our meta‐analysis, we found that the combined effect of HBV and alcohol was associated with an OR of 14.56 (95% CI: 9.80, 21.65). The combined impact of HCV and alcohol showed an OR of 42.44 (95% CI: 20.11, 89.56). Coinfection with both HBV and HCV was associated with an OR of 32.58 (95% CI: 20.57, 51.60). These results emphasising the importance of reducing alcohol consumption and implementing effective viral hepatitis prevention and treatment.
Writing worlds: Exploring mentorship approaches supporting adolescents' authentic writing across a Canadian youth centre's programmes
Authors: Mannard Emily
Published: December 2024

In its diverse forms, authentic writing carries the potential to connect literacy practice to an author's ‘real world’. While contemporary approaches to authentic writing instruction—advocating writer‐centred, intertextual and culturally relevant productions—are most often explored in formal learning contexts like classrooms, this paper seeks to amplify the mentorship strategies employed within an informal youth centre learning space in Montreal, Canada. The following research questions have guided this work: (1) How do adult mentors leverage authentic writing principles to support adolescents' participation within two writing‐based programmes developed in a youth centre context? (2) How do the interests, perspectives and backgrounds of adult mentors shape the mentorship strategies they choose to employ? Data collected and analysed through participant‐focused ethnographic approaches assist the author in revealing how adult writing mentors draw from their own cultural, linguistic and embodied experiences to foster interest‐driven, culturally sustaining and community‐based writing opportunities for adolescents. The four key mentorship themes emerging through this research—centring the essential role of writing journeys, identities and communities while acknowledging several barriers to authentic writing—advocate drawing from the rich literacy practices thriving within informal contexts to inform contemporary writing curricula.
Random Mating in a Hybrid Zone Between Two Putative Climate‐Adapted Bird Lineages With Predicted Mitonuclear Incompatibilities
Authors: Austin Lana M. , Amos J. Nevil , Robledo‐Ruiz Diana A. , Zhou Jessica W. , Clarke Rohan H. , Pavlova Alexandra , Sunnucks Paul
Published: December 2024

Biochemical and evolutionary interactions between mitochondrial and nuclear genomes (‘mitonuclear interactions’) are proposed to underpin fundamental aspects of biology including evolution of sexual reproduction, adaptation and speciation. We investigated the role of pre‐mating isolation in maintaining functional mitonuclear interactions in wild populations bearing diverged, putatively co‐adapted mitonuclear genotypes. Two lineages of eastern yellow robin Eopsaltria australis—putatively climate‐adapted to ‘inland’ and ‘coastal’ climates—differ by ~7% of mitogenome nucleotides, whereas nuclear genome differences are concentrated into a sex‐linked region enriched with mitochondrial functions. Female‐specific selection and male‐mediated gene flow across the hybrid zone where the lineages coexist and interbreed can explain this pattern. It remains unknown whether lineage divergence is driven by intrinsic incompatibilities (particularly in females; Haldane's rule), extrinsic selection, both, or other drivers. We tested whether lineage divergence could be facilitated by non‐random mate‐pairing with respect to partners' mitolineage and/or mitonuclear genes encoded by the Z sex‐chromosome, which differ between the lineages. We used field‐, Z‐linked‐ and mitolineage data from two locations where lineages hybridise to test whether females mate disproportionately with (1) males of their own mitolineage and/or bearing similar Z‐linked variation, as might be expected if hybrids experience intrinsic incompatibilities, or (2) putatively locally‐adapted males, as might be expected under environmental selection. Comparing field observations with simulations provided no evidence of non‐random mating, thus drivers of observed population genetic patterns are consistent with reduced female gene flow likely acting post‐mating. Future tests of female‐biased mortality at different life stages and habitat selection may clarify mechanisms of selection.
Schenker against the Pack: Controversial Hypermetres in Bach's Prelude No. 1 in C major, The Well‐Tempered Clavier Book I
Authors: WAGNER NAPHTALI , REUVEN RAM
Published: December 2024

Is musical analysis meant to guide performance – or to be based on it? Can a Schenkerian analysis of a piece be corroborated by a performance or an arrangement? This article addresses these questions through a well‐known test case – the first prelude of the first book of Bach's Well‐Tempered Clavier, as analysed by Heinrich Schenker in Five Graphic Analyses. The emphasis is on the hypermetric aspect, which has direct implications for performance. The authors juxtapose Schenker's hypermetric perception of the Prelude with the performance instructions contributed by well‐known composers, pianists and musicologists to 37 historical instructive editions of WTC I. In addition, we compare Schenker's reading with works by composers who employed the Prelude as the basis for their works, with other music theorists who analysed the hypermetre of the Prelude and with Bach's preliminary versions of the piece. We consider arguments in support of Schenker's interpretation and ask whether one should follow one's musical intuition or the dictates of music theory.
Retrospective Epidemiology of Dermatomycosis in Kinshasa, Democratic Republic of Congo, From 2000 to 2023
Authors: Seudjip Nono Lydie Joëlle , Libeko Simplice Konga , Ntshila Luc Kalala , Bunga Paulo Muntu , Mvumbi Georges Lelo , Kabututu Pius Zakayi , Kabedi Marie José Bajani , Tshimanga Tshimy Yona , Yobi Doudou Malekita , Hayette Marie‐Pierre , Zono Bive Bive
Published: December 2024

Background

Although cutaneous mycoses are a global public health problem, very few data are available in the Democratic Republic of Congo (DRC).

Objectives

This study aimed to describe the retrospective clinical epidemiology of dermatomycosis and their associated risk factors in dermatological consultations in Kinshasa, DRC.

Methods

A retrospective study based on the medical records of patients seen in the departments of dermatology of 2 major hospitals in Kinshasa from March 2000 to August 2023 was carried out. The diagnosis of the various types of dermatomycoses was established based on the dermatologist's clinical examination. Patient demographic and clinical data were collected for study purposes.

Results

Of 27,439 patients consulted at the two sites, 1142 were diagnosed with dermatomycosis (4.16%). Young women aged 27 (17–43) were most affected. Diagnosed patients shared a history of skin mycoses (26%), use of skin‐lightening products (19%) and diabetes mellitus (9.6%). Among these patients, 59.3% suffered from dermatophytosis (tinea), 39.1% from malassesiosis and 1.2% from candidal dermatosis. While tinea was predominantly found in children (81.88%, p < 0.001), pruritus and pain in the lesions were preferentially reported by the dermatophytosis patients [65.25% (p < 0.001) and 79.1% (p < 0.001), respectively]. Tinea corporis (45.5%), tinea capitis (20.4%), tinea pedis (19.3%) and onychomycosis (10.2%) were the main nosological entities in the dermatophytosis group, and their distribution on the body surface depended on patients' age (p < 0.001) and sex (p = 0.012).

Conclusions

Dominated by dermatophytosis, dermatomycosis are frequent in dermatological consultations in Kinshasa. While clinical diagnosis remains an important element in the description of dermatomycosis, a better epidemiological understanding would also require biological identification of the fungi involved, which was lacking in this study.
Carboxylation and Oxygenation Kinetics and Large Subunit (rbcL) DNA Sequences for Rubisco From Two Ecotypes of Plantago lanceolata L. That Are Native to Sites Differing in Atmospheric CO2 Levels
Authors: Shi Xiaoxiao , Hannon Nathan M. , Bloom Arnold J.
Published: December 2024

Rubisco, the most prevalent protein on Earth, catalysers both a reaction that initiates C3 carbon fixation, and a reaction that initiates photorespiration, which stimulates protein synthesis. Regulation of the balance between these reactions under atmospheric CO2 fluctuations remains poorly understood. We have hypothesised that vascular plants maintain organic carbon‐to‐nitrogen homoeostasis by adjusting the relative activities of magnesium and manganese in chloroplasts to balance carbon fixation and nitrate assimilation rates. The following examined the influence of magnesium and manganese on carboxylation and oxygenation for rubisco purified from two ecotypes of Plantago lanceolata L.: one adapted to the elevated CO2 atmospheres that occur near a natural CO2 spring and the other adapted to more typical CO2 atmospheres that occur nearby. The plastid DNA coding for the large unit of rubisco was similar in both ecotypes. The kinetics of rubiscos from the two ecotypes differed more when associated with manganese than magnesium. Specificity for CO2 over O2 (Sc/o) for rubisco from both ecotypes was higher when the enzymes were bound to magnesium than manganese. Differences in the responses of rubisco from P. lanceolata to the metals may account for the adaptation of this species to different CO2 environments.
Neural Reactivity to Emotional Stimuli in Children With and Without a History of Self‐Injurious Thoughts and Behaviors
Authors: Shankar Pooja , Gibb Brandon E.
Published: December 2024

Suicide is a significant public health concern and a leading cause of death for children in the United States. As such, there is a growing need to identify correlates of self‐injurious thoughts and behaviors in youth, particularly potentially modifiable factors that could be targeted by interventions. One potential factor is neural reactivity to emotional stimuli. Prior research has suggested that the late positive potential (LPP), an event‐related potential (ERP) component that indexes this reactivity, may be blunted in adults with a history of suicidality (i.e., ideation and/or suicidal behaviors). These findings have been interpreted in the context of cognitive models of risk, which focus on blunted reactivity to emotional stimuli broadly or to positive stimuli specifically (with perhaps heightened reactivity to negative stimuli). The goal of this study was to determine whether blunted patterns of neural reactivity toward emotional stimuli are observed in children with a history of self‐injurious thoughts and behaviors (SITBs) and whether this may differ across emotional contexts (afraid, happy, sad) and intensities (low, medium, high). The study focused on 7‐11‐year‐old children (50.51% girls, 62.63% non‐Hispanic White) with (n = 16) and without (n = 83) a history of SITBs. LPP amplitudes were indexed during a Morphed Faces task, in which stimuli displaying a variety of emotional expressions (afraid, happy, and sad) were morphed to display low, medium, and high levels of each emotion. The strongest between‐group difference was observed for medium‐intensity positive emotional stimuli, with children with SITBs showing blunted responses. These findings provide some support for the positive attenuation hypothesis and suggest that blunted LPP response to ambiguous positive emotional stimuli may be useful as a marker of risk and potential target for intervention.
The Use of Single Pass Albumin Dialysis and Hemoadsorption in Management of Life‐Threatening Amlodipine Overdose
Authors: Hui Wun Fung , Choi Ann Wing Man , Cheung Wing Lum , Hon Kam Lun , Ku Shu Wing
Published: December 2024

We report the successful application of single pass albumin dialysis (SPAD) and hemoadsorption (HA) in two teenagers with amlodipine poisoning. A 16‐year‐old girl with amlodipine overdose developed refractory shock and lactic acidosis despite multiple inotropes, calcium, insulin, and glucagon infusion. SPAD was initiated 18 h after the incident for 21 h. She improved dramatically and was able to wean off all inotropes 54 h after admission. Another 16‐year‐old girl required extracorporeal membrane oxygenation (ECMO) support after deliberate consumption of 1100‐mg amlodipine. SPAD was initiated 13 h after the incident for 38 h, followed by two more sessions of HA using the Cytosorb column. All inotropes were stopped 18 h after terminating the HA, and ECMO was weaned off 28 h later. There were no major complications during the therapy. Our cases demonstrated that early extracorporeal removal can be considered as an adjunctive therapy in children with life‐threatening amlodipine overdose.
The Women Empowerment and Innovation Nexus: A Global Context
Authors: Wang Cong , Mahn Daniel
Published: December 2024

The aim of this study is to explain the influence of women's empowerment on innovation. To achieve this goal, we analyzed a global dataset from 1996 to 2020, covering 68 developed and developing countries and regions, which represent the most extensive sample available for the full core specification. In order to address endogeneity concerns, we apply the system GMM and Lewbel 2SLS estimators. Our results indicate a positive and statistically significant impact of women's economic empowerment on innovation. This effect is robust to alternative measures of innovation and women empowerment; the subcomponents of women empowerment; and alternative estimators that address endogeneity.
The Fiction-Nonfiction Divide: Can Teachers’ Personal Reading Preferences Impact the Diversity of Genres Shared in Elementary Classrooms?
Authors: Russell Sharon L.
Published: December 2024

Despite expanded efforts to increase the amount of nonfiction literature taught in elementary classrooms and a recent publication boom in the quantity and quality nonfiction children’s literature, a disparity still remains. While elementary teachers recognize the need to include more nonfiction, the primary genre for reading and literacy instruction remains fiction literature. Some of this may be about lack of acceptable children’s literature selections in the curriculum, but it may also indicate teachers’ preference for fiction. Using discourse analysis, this qualitative study analyzed the online discussion board responses of 99 graduate student in-service teachers who were asked about their early literacy experiences. Results indicated overwhelmingly positive early childhood memories of fiction (n=77), including many activities culturally situated within home and family, such as story time and library visits. Teachers did not recall similar early memories of nonfiction. Responses to nonfiction were more closely tied to schooling activities such as report writing and research. Some teachers also indicated a conscious effort to provide students with more exposure to nonfiction genres in their own classrooms. This study highlights the importance of directly addressing teachers’ personal preferences in both teacher preparation and in-service professional development to help them move toward more balanced classroom literacy across diverse genres.
Reviewer Acknowledgements for Journal of Education and Training Studies, Vol. 13, No. 1
Authors: Smith Robert
Published: December 2024

Journal of Education and Training Studies (JETS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether JETS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 13, Number 1 Alphonce John Amuli, ADEM, TanzaniaCarlos Sanz, Cardiff University, UKChosang Tendhar, Hackensack Meridian School of Medicine, USAEbenezer Kofi Enninful, Takoradi Technical University, GhanaEbrahim Mohammadpour, Farhangian University , IranHelena Reis, Polytechnic Institute of Leiria, PortugalJacinthe Rihan, Ain Shams University, EgyptJane Liang, California Department of Education, USAJoel Maligaya Cuadra, NU Laguna, PhilippinesJohn Mark Asio, Gordon College, PhilippinesJonathan Chitiyo, University of Pittsburgh Bradford, USAJulio Cesar André, Center for Studies and Development of Health Education-CEDES, BrazilKun Yu, Universiti Putra Malaysia, ChinaLinda J. Rappel, Yorkville University/University of Calgary, CanadaLisa Marie Portugal, American College of Education, USAMeral Seker, Alanya Alaaddin Keykubat University, TurkeyNiveen M. Zayed, MENA College of Management, JordanRichard Penny, University of Washington Bothell, USAShanita L. Pettaway, University of South Alabama, USA  Robert SmithEditorial AssistantOn behalf of, The Editorial Board of Journal of Education and Training StudiesRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAE-mail: jets@redfame.comURL: http://jets.redfame.com
El montaje cinematográfico y la memoria
Authors: Rodríguez Arévalo Diego Mauricio
Published: December 2024

El método desarrollado por Sergei Eisenstein, a través del cual logra encadenar y dar sentido a una serie de planos cinematográficos, pone de manifiesto la importancia del montaje, en tanto que permite revelar sensaciones y afectaciones, es decir, un pathos que hace referencia a intereses vitales, miedos, deseos y nostalgias de diferentes lugares y épocas, que irrumpen de manera fulgurante en forma de imagen. En términos de la memoria, existe de manera similar un montaje de imágenes, por medio de las cuales se representa el pasado. Por tanto, el presente artículo desarrolla algunas reflexiones acerca de la película El acorazado Potemkin, y, a su vez, plantea la posibilidad de trasladar una serie de características del montaje eisensteniano a los procesos de la memoria. En consecuencia, se establece un paralelo entre la obra de la artista Doris Salcedo y las variadas formas mediante las cuales se puede representar la memoria. En este sentido, la obra de arte, vista como una suerte de montaje de las emociones y la historia, marca una deriva metodológica mediante la cual se pueden analizar los procesos del recuerdo y del olvido.
CO2 Utilization and Transportation
Authors: Ojuekaiye Olusegun
Published: December 2024

This research delves into the multifaceted realm of carbon dioxide (CO2) utilization and transportation, focusing on combatting the pressing global challenge of climate change. Through an extensive review of literature, this study offers a comprehensive overview of existing knowledge on CO2 utilization technologies and transportation methods, identifying critical gaps and establishing research objectives to address these voids. Various CO2 utilization technologies such as enhanced oil recovery (EOR), carbonation of minerals, and synthetic fuel production are examined, with case studies highlighting their applications, efficiency, and environmental impact. The economic viability and technical feasibility of these technologies are explored, considering their potential to mitigate greenhouse gas emissions. Simultaneously, the study evaluates CO2 transportation methods including pipelines, shipping, and trucking, analyzing safety considerations, infrastructure challenges, and environmental implications to optimize transportation logistics while minimizing environmental impact. Results drawn from quantitative data, case studies, and comparative analysis are presented, followed by a discussion interpreting these findings in the context of climate change mitigation and sustainable development. The research concludes with key findings, acknowledgment of limitations, and suggestions for future exploration, contributing to the essential knowledge base for effective strategies in combating climate change through innovative CO2 utilization and transportation practices.
Robust fundamental frequency-detection algorithm unaffected by the presence of hoarseness in human voice
Authors: Kitayama Itsuki , Hosokawa Kiyohito , Iwaki Shinobu , Yoshida Misao , Miyauchi Akira , Kishikawa Toshihiro , Tanaka Hidenori , Tsuda Takeshi , Sato Takashi , Takenaka Yukinori , Ogawa Makoto , Inohara Hidenori
Published: December 2024

The fundamental frequency (fo) is pivotal for quantifying vocal-fold characteristics. However, the accuracy of fo estimation in hoarse voices is notably low, and no definitive algorithm for fo estimation has been previously established. In this study, we introduce an algorithm named, “Spectral-based fo Estimator Emphasized by Domination and Sequence (SFEEDS),” which enhances the spectrum method and conducted comparative analyses with conventional estimation methods. We analyzed 454 voice samples and used conventional methods and SFEEDS to calculate fo. The ground truth of fo was determined as the lowest frequency within the most dominant harmonic complex observed on the spectrogram. Subsequently, we assessed the concordance between each fo-estimation method and the fo ground truth. We also examined the variations in the accuracy of these methods when analyzing speech with hoarseness. Regardless of hoarseness, the fo-estimation accuracy was significantly greater by SFEEDS than by conventional methods. Moreover, whereas the conventional methods impaired fo-estimation accuracy in samples with roughness, the SFEEDS algorithm was robust and significantly reduced subharmonic errors. The SFEEDS fo-estimation algorithm accurately estimated the fo of both normal and hoarse voices.
Estimation of the spatial variability of the New England Mud Patch geoacoustic properties using a distributed array of hydrophones and deep learning
Authors: Vardi Ariel , Dahl Peter H. , Dall'Osto David , Knobles David , Wilson Preston , Leonard John , Bonnel Julien
Published: December 2024

This article presents a spatial environmental inversion scheme using broadband impulse signals with deep learning (DL) to model a single spatially-varying sediment layer over a fixed basement. The method is applied to data from the Seabed Characterization Experiment 2022 (SBCEX22) in the New England Mud-Patch (NEMP). Signal Underwater Sound (SUS) explosive charges generated impulsive signals recorded by a distributed array of bottom-moored hydrophones. The inversion scheme is first validated on a range-dependent synthetic test set simulating SBCEX22 conditions, then applied to experimental data to predict the lateral spatial structure of sediment sound speed and its ratio with the interfacial water sound speed. Traditional geoacoustic inversion requires significant computational resources. Here, a neural network enables rapid single-signal inversion, allowing the processing of 1836 signals along 722 tracks. The method is applied to both synthetic and experimental data. Results from experimental data suggest an increase in both absolute compressional sound speed and sound speed ratio from southwest to northeast in the NEMP, consistent with published coring surveys and geoacoustic inversion results. This approach demonstrates the potential of DL for efficient spatial geoacoustic inversion in shallow water environments.
Case study: Evidence of long-term stability in a stereotyped whistle in a single free-ranging humpback dolphin (Sousa plumbea) found in sympatry (Tursiops aduncus)
Authors: Dines S. , Probert R. , Gullan A. , Elwen S. , Frainer G. , Gridley T.
Published: December 2024

This 11-year case study describes the acoustic behaviour of a resident Indian Ocean humpback dolphin during commercial swim-with-dolphin activities in Mozambique. Combining data collected using low-cost action cameras with full bandwidth hydrophone recordings, we identified a temporally stable stereotyped whistle contour that met the SIGnature IDentification bout criteria. This whistle was produced with potential information-enhancing features (bi-phonation and subtle variations in frequency modulation). This case study provides evidence for a single, stable, stereotyped call type from a single individual in a mixed species group, contributing to the growing body of evidence for possible signature whistle use in the Sousa genus.
The Effect of Vehicle Motion (Cab Vibration) on Accelerometer Cut-Point Determined Moderate-to-Vigorous Physical Activity in Heavy Goods Vehicle Drivers
Authors: Sayyah Mohsen , Clemes Stacy A , Maylor Benjamin D. , Edwardson Charlotte L. , Sherry Aron P. , Ruettger Katharina , Chen Yu-Ling , Varela-Mato Veronica , Guest Amber J. , King James A. , Paine Nicola J. , Rowlands Alex V.
Published: December 2024

This study aimed to determine the impact of cab noise when driving Heavy Goods Vehicles (HGV) on cut-point estimated moderate-to-vigorous physical activity (MVPA) from wrist-worn accelerometers. First, we investigated the impact of cab noise on accelerometer output during HGV driving and then on cut-point estimated MVPA in HGV drivers. A GENEActiv accelerometer was located beneath the seat in six HGVs for 8 days. Acceleration recorded during driving lay predominantly (∼94%) within the sedentary range (<40mg). HGV drivers (N = 386, 47.9 ± 9.3 years) wore a wrist-worn GENEActiv and a thigh-worn activPAL simultaneously for 8 days covering workdays and nonworkdays. MVPA recorded by the activPAL excludes seated transport, thus provided the criterion. Wrist accelerometer MVPA was classified using two cut-points approximating 3 metabolic equivalents (MVPA100mg) and 4.3 metabolic equivalents (indicative of brisk walking, MVPABRISK_WALK). Acceleration classified as MVPA100mg or MVPABRISK_WALK during activPAL-determined seated transport was considered erroneous. Across all-days, activPAL MVPA was 15 (interquartile range: 9, 26) min/day. Compared with activPAL, MVPA100mg was 100 min/day higher (95% limits of agreement ±53 min), but MVPABRISK_WALK similar (mean bias = −2 min/day, 95% limits of agreement ±15). On workdays, 23 (interquartile range: 11, 52) min of MVPA100mg and 2 (1, 7) min of MVPABRISK_WALK were erroneous. However, on nonworkdays, only 4 (3, 14) and 0.4 (0, 1) min, respectively, were erroneous. In conclusion, MVPA may be erroneously captured using cut-point analyses of accelerometer data in HGV drivers. However, this was substantially reduced by using an MVPA cut-point indicative of brisk walking, which also approximated activPAL estimated MVPA.
Future-Proofing Exercise Physiology: We Have to Get Out of Our Own Way!
Authors: Arent Shawn M. , Hirsch Katie R. , Stray-Gundersen Sten O. , Mastrofini Gianna F.
Published: December 2024

The discipline of exercise physiology sits at an inflection point, influenced by rapid technological advancements, shifting health paradigms, and an evolving job market demanding diverse and adaptable skill sets. The future of exercise physiology is dependent on the ability to adapt and transform, ensuring that professionals are equipped with the knowledge and practical experience necessary to thrive in the ever-changing health and performance sectors. However, in some cases, the existing educational models and emphases may be limiting the evolution of the students being produced. Outdated approaches, a disconnect between curricula and real-world demands, and resistance to change within academia all present very real challenges. In this paper, we explore barriers facing the evolution of the field of exercise physiology, discuss strategies to align educational programs with industry and health care needs, and propose a roadmap to future-proof the field. We argue that embracing technological integration, generational and societal evolution, specialization, and hands-on, real-world experience are essential to ensuring that exercise physiology remains a leader in health and performance science and application.
Unravelling the role of health literacy among individuals with multimorbidity: a systematic review and meta-analysis
Authors: Chauhan Arohi , Linares-Jimenez Fernando Gregorio , Dash Girish Chandra , de Zeeuw Janine , Kumawat Archana , Mahapatra Pranab , de Winter Andrea F , Mohan Sailesh , van den Akker Marjan , Pati Sanghamitra
Published: December 2024

Objective

To examine existing literature regarding health literacy levels and their association with multimorbidity and the potential underlying mechanisms behind the said association.

Design

Systematic review and meta-analysis.

Data sources

The databases MEDLINE, EMBASE, CINAHL and Science Direct were searched for articles published between 1 January 2000 and 31 October 2023 using a systematic search strategy.

Eligibility criteria

Included were all primary studies conducted in people over 18 years old with data on health literacy levels and the presence of multimorbidity. No language restrictions were used.

Data extraction and synthesis

Two authors independently extracted data and assessed the bias using the Joanna Briggs Institute critical appraisal tools.

Results

We included a total of 39 studies (36 quantitative, two qualitative and one mixed-method), representing 154 337 participants. We found a 32% proportion of limited health literacy among individuals with multimorbidity. Analysis of three articles using the Health Literacy Questionnaire tool (n=31 228) (Pooled OR 2.88 (95% CI 1.92 to 4.31)) and three articles using the Health Literacy Survey Questionnaire–European Union tool (n=35 358) (OR 1.16 (95% CI 1.07 to 1.25)) indicated that people with limited health literacy were likely to have multiple conditions. One of three articles studying underlying mechanisms reported that self-efficacy mediates the association between health literacy and multimorbidity. Additionally, substantial literature identified education and income as the most consistent determinants of health literacy among individuals with multimorbidity. Of the only two articles studying the effectiveness of health literacy-related interventions, both reported an improvement in clinical outcomes after the intervention.

Conclusions

Our review demonstrated a consistent association between health literacy and multimorbidity, indicating that people with lower health literacy levels are more likely to have multimorbidity. More evidence is needed regarding the effect of health literacy interventions on multimorbidity.

PROSPERO registration number

CRD42022301369.
Thoracic perfusion of antiangiogenic agents combined with chemotherapy for treating malignant pleural effusion in non-small cell lung cancer: a network meta-analysis
Authors: Xu Yan , Cui Yingying , Jiang Liming , Yu Yinan , Si Wei , Zhu Xiaohua
Published: December 2024

Objectives

Different intrathoracic perfusion therapeutic regimens are available for non-small cell lung cancer with malignant pleural effusion (MPE). Antiangiogenic agents are often used to control MPE, and the results are satisfactory. Here, we performed a network meta-analysis to reveal optimal combinations of antiangiogenic agents and chemical agents and assess their effectiveness and safety.

Design

Systematic review and network meta-analysis.

Data sources

PubMed/Medline, Embase, Cochrane, Web of Science, Wanfang, VIP Database and Chinese National Knowledge Infrastructure were searched from inception to May 2023. Eligible studies were randomised controlled trials that reported on curative effect of MPE.

Data extraction and synthesis

The Cochrane Collaboration tool was used to assess risk of bias. The consistency was evaluated by examining the agreement between direct and indirect effects. Network meta-analysis was performed and the ranking probabilities of being at each possible rank for each intervention were estimated. Comparison-adjusted funnel plots were obtained to assess publication bias.

Results

A total of 46 studies were included in the analysis. Among them, we included a total of seven interventions. A total of 3026 patients participated in this analysis. According to the results of the network meta-analysis, some antiangiogenic agents combined with chemotherapy regimens improved objective response rate (ORR) and disease control rate (DCR) and quality of life (QOL). The rank probabilities suggested that in terms of ORR, DCR and QOL, Endostar plus lobaplatin was the first-ranked intervention.

Conclusion

Administration of antiangiogenic agents plus chemical agents significantly improved the clinical response and QOL. In addition, Endostar plus lobaplatin was the most effective combination.

PROSPERO registration number

CRD42021284786.
Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in China
Authors: Cai Boyong , Zheng Mengli , Li Yimin , Chen Zhicao , Zhong Canxin , Chen Xiaochun , Chen Guiquan
Published: December 2024

Objectives

This study investigated the prognostic role of log odds of negative lymph node/T stage (LONT) and established a nomogram based on LONT to predict the prognosis in colorectal cancer (CRC) patients.

Design

A retrospective cohort study.

Setting and participants

We enrolled 80 518 CRC patients from the Surveillance, Epidemiology and End Results database between 2010 and 2015. The dataset was split into a training cohort (56 364 patients) and a validation cohort (24 154 patients) at a ratio of 7:3. Furthermore, 500 CRC patients who underwent surgery in the Tenth Affiliated Hospital of Southern Medical University between 1 January 2017 and 20 December 2018, were recruited as the external validation set.

Outcome measures

1-, 3- and 5-year cancer-specific survival (CSS).

Methods

The univariate and multivariate Cox regression analyses were carried out to identify the significant independent prognostic factors of CSS. A nomogram was established based on LONT to predict the prognosis. The performance of the nomogram was comprehensively assessed via the time-dependent receiver operating characteristic curve, concordance index (C-index), calibration curve and decision curve analysis (DCA) comprehensively. Moreover, Kaplan-Meier curves were performed to assess the CSS of the three risk subgroups.

Result

LONT was a significant independent prognostic factor for CSS (LONT1 vs LONT2, HR=0.670, 95% CI 0.642 to 0.698, p<0.001; LONT1 vs LONT3, HR=0.443, 95% CI 0.420 to 0.467, p<0.001). LONT, age, sex, race, subsite, differentiation, histology, tumour size, T stage, N stage, M stage and chemotherapy were included in the nomogram. The 1-, 3- and 5-year survival area under the curve were 0.856, 0.862 and 0.852, respectively. The C-index of the model was 0.809 (95% CI 0.825 to 0.839) in the model. The calibration curve and DCA verified the favourable predictive performance and clinical application of the nomogram.

Conclusion

CRC patients with a high LONT had a low incidence of CSS. The nomogram based on LONT could effectively predict the CSS of CRC.
Ocular biometric parameters in Chinese preschool children and physiological axial length growth prediction using machine learning algorithms: a retrospective cross-sectional study
Authors: Liu Duanke , Zhao Heng , Tang Tao , Li Xuewei , Shi Xiaoqing , Ma Jiahui , Zhou Jingwei , Zhao Chenxu , Li Yan , Wang Kai , Zhao Mingwei
Published: December 2024

Objectives

To examine the ocular biometric parameters and predict the annual growth rate of the physiological axial length (AL) in Chinese preschool children aged 4–6 years old.

Methods

This retrospective cross-sectional study included 1090 kindergarten students (1090 right eyes) between the ages of 4 and 6 years from Pinggu and Chaoyang District, Beijing. Dioptre values were ascertained following cycloplegic autorefraction. Predicted AL was obtained through the application of the Gaussian process regression model as an optimisation technique. Subsequently, the annual growth rate of physiological AL for non-myopic preschool children (n=1061) was computed via the backward difference method.

Results

In total, 85.4% of preschool children (931 individuals) had hyperopic refractive status in the 4–6 years age group, while only 2.7% (29 individuals) showed myopia. Boys had longer AL, larger AL-to-corneal radius ratio, deeper anterior chamber depth and lower lens power. The average physiological axial growth for boys and girls ranged from 0.050 mm/year to 0.165 mm/year and 0.063 mm/year to 0.168 mm/year, respectively. As age increased, the physiological AL growth in non-myopic cases decreased. Additionally, as hyperopic spherical equivalent refraction error lessened, the physiological AL growth component slowed down.

Conclusions

In preschool children, refractive development predominantly exhibits mild hyperopia. The concept of physiological AL provides valuable insights into the complexities of ocular development.
Parents’ knowledge, attitudes and practices towards the prevention and treatment of dust mite allergy: a cross-sectional study in Shenyang (China)
Authors: Liu Si , Zhou Qianlan , Dai Bing , Chen Li , Zhang Qinzhen , Han Lina , Li Xiaowen , Shen Wenxin , Shan Lishen
Published: December 2024

Objective

This cross-sectional study aimed to evaluate parents’ knowledge, attitudes and practices (KAP) concerning the prevention and treatment of dust mite allergy in children.

Design

This cross-sectional study survey was conducted from September to December 2022 at Shengjing Hospital, Affiliated with China Medical University.

Participants

A total of 503 parents of children with dust mite allergies participated, with 253 parents having children undergoing desensitisation treatment and 250 parents whose children did not. Selection criteria were carefully defined to include parents directly responsible for caring children with dust mite allergies.

Primary and secondary outcome measures

Two distinct questionnaires were administered to parents, tailored for those with and without children undergoing desensitisation treatment. These questionnaires covered demographic information, allergy diagnosis, treatment details and KAP related to dust mite allergy. Primary outcomes included parents’ scores on KAP regarding dust mite allergy prevention and treatment. Secondary outcomes involved analysing the interaction between these factors using pathway analysis.

Results

Parents of children undergoing desensitisation treatment exhibited higher scores for all items of knowledge, attitude and overall practice than those without desensitisation therapy (all p values<0.05). The pathway analyses revealed that in the non-desensitisation group, knowledge directly affected attitude (β=0.22, p<0.001) and attitude directly affected practice (β=0.16, p<0.001), but the knowledge did not affect practice (β=−0.01, 0.06, p<0.001). In the desensitisation group, knowledge directly affected attitude (β=0.13, p=0.028), but the practice was not affected by attitude (β=0.08, p<0.001) or knowledge (β=0.03, 0.12, p<0.001).

Conclusions

The study highlighted differing levels of KAP among parents of children with dust mite allergies. The KAP was influenced by desensitisation therapy status. While attitudes tended to be favourable, practices were suboptimal, particularly among parents whose children did not receive desensitisation treatment. These findings emphasise the importance of targeted educational interventions to enhance parental awareness and practices regarding dust mite allergy management, especially in cases where desensitisation treatment is not pursued. Further research is warranted to explore effective strategies for improving parental engagement and adherence to preventive measures.
Heart–brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brain
Authors: Bradley Conor Patrick , Orchard Vanessa , Sykes Robert A , McKinley Gemma , McConnachie Alex , Donnelly Paul , Watt Jodi , Kellman Peter , Quinn Terry , Fullerton Natasha , Berry Colin
Published: December 2024

Introduction

Ischaemic heart disease (IHD) and cerebrovascular disease are leading causes of morbidity and mortality worldwide. Cerebral small vessel disease (CSVD) is a leading cause of dementia and stroke. While coronary small vessel disease (coronary microvascular dysfunction) causes microvascular angina and is associated with increased morbidity and mortality. The vascular anatomy of the heart and brain is similar with conduit arteries distributed over the surface of these organs which in turn branch into a network of microscopic penetrating arteries which provide organ perfusion via an end-organ microcirculation. It has also been demonstrated that coronary microvascular dysfunction and CSVD share common vascular risk factors and pathophysiological mechanisms of disease. This has led to a link between the conditions being hypothesised, however, there is an evidence gap clearly demonstrating this relationship. The CorCMR (coronary microvascular angina cardiovascular magnetic resonance imaging) brain imaging study will provide novel insights into the associations between small vessel disease of the heart and brain and related clinical significance.

Methods and analysis

The CorCMR brain imaging study is a prospective, observational, multicentre cohort study including a blinded, central analysis and independent clinical trials unit; a prespecified study nested within the CorCMR trial. We will enrol patients with anginal symptoms who have undergone invasive coronary angiography which has demonstrated no obstructive coronary artery disease. The participants will then undergo brain MRI (to detect CSVD) immediately followed by a quantitative stress perfusion cardiac MRI (to detect coronary microvascular dysfunction). Participants will also undergo neurocognitive testing. The objectives of the study are to assess the prevalence of MRI features of CSVD in patients with angina and no obstructive coronary artery disease; to assess the association between coronary microvascular dysfunction and CSVD and to assess the association between CSVD and cognition.

Ethics and dissemination

The CorCMR study is approved by the UK National Research Ethics Service (Reference 20/WS/0159). Findings will be disseminated through peer-reviewed publications. All patients provided written informed consent.

Trial registration number

ClinicalTrials.gov ID
NCT04805814
.
Evaluation instruments for public health policies for elderly care: a scoping review protocol
Authors: Amorim Margareth Santos de , Medeiros Kleyton Santos de , Seixas Clarissa Terenzi , Nobre Thaiza Teixeira Xavier
Published: December 2024

Introduction

The global phenomenon of population ageing is expanding rapidly, with WHO projecting that the number of individuals aged 60 and over will reach 2.1 billion by 2050, a significant rise from 900 million in 2015. This pronounced growth poses substantial challenges to healthcare systems globally, necessitating the development of effective public policies to ensure adequate access to healthcare services for the elderly demographic. In this context, this scoping review aims to identify and analyse theoretical and logical models, as well as evaluation instruments, of public policies directed at elderly healthcare.

Methods and analysis

This scoping review protocol is developed in accordance with the Joanna Briggs Institute manual and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Article searches will be conducted in the following databases: Embase, Medline/PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences and Science Direct. Additionally, searches will be performed on Google Scholar and in the grey literature (www.opengrey.eu). The search strategy will be conducted in January 2025, without language restriction for identifying texts. A descriptive analysis of the mapped studies will be conducted, categorising them by analysis categories. The results will be presented through a narrative summary of the findings to examine how they correlate with the review’s objective and research question.

Ethics and dissemination

This study does not require ethical review due to its nature. The results will be submitted for publication in a peer-reviewed journal and presented at a scientific conference.

Trial registration number

Open Science Framework:https://doi.org/10.17605/OSF.IO/AV4WH.
PREVENTion and treatment of incontinence-associated dermatitis through a codesigned manual (PREVENT-IAD): a study protocol for a feasibility cluster randomised controlled trial with a nested process evaluation
Authors: Woodward Sue , Graham Tanya , Sooriah Sangeeta , Beeckman Dimitri , Chatterton Chris , Fader Mandy , Fiorentino Francesca , Fitzpatrick Joanne M , Harris Ruth , Kottner Jan , Norton Christine , Worsley Peter
Published: December 2024

Introduction

Incontinence is commonly experienced by adults who receive care support in a residential facility or in their own home. These individuals are at risk of developing incontinence‐associated dermatitis (IAD), which is caused by prolonged and repeated exposure of the skin to urine or faeces. An IAD manual was developed providing an evidence-based clinical algorithm and an e-learning training programme for the prevention and treatment of IAD. The aim of the study is to establish the feasibility of conducting a definitive trial to examine the clinical and cost-effectiveness of the IAD manual. The objectives are to assess recruitment and attrition rates, acceptability of the IAD manual and intervention fidelity.

Methods and analysis

A feasibility cluster randomised controlled trial will be conducted in residential nursing homes and in the homes of people receiving formal care support in London and Hampshire, England. A total of six clusters including n=248 participants who are incontinent of urine, or faeces will be included. At each intervention site, care staff will be trained to implement the IAD manual over a 6-month period. Quantitative outcomes include IAD incidence and severity, IAD-related pain, satisfaction with care and mental health. A qualitative evaluation of care staff and care receivers’ experiences of participation will be conducted. Rates and proportions of each feasibility outcome will be described informing the sample size estimation for a definitive cluster randomised controlled trial. A thematic analysis of the qualitative data will be guided by a logic model detailing potential factors impacting on both the study methodology and adoption of the IAD manual into routine care.

Ethics and dissemination

The study received the approval of the Queens Square Ethics Committee Health Research Authority 23/LO/036, (Project ID 296167). Results will be disseminated through peer-reviewed open-access journals and international conferences

Trial registration number

ISRCTN70866724.