bluuebunny/crossref_metadata_2025 huggingface dataset:
isiXhosa translation of the Patient Health Questionnaire (PHQ-9) shows satisfactory psychometric properties for the measurement of depressive symptoms [Stage 2]
Authors: Rakshasa-Loots Arish Mudra , Hamana Thandi , Fanqa Busiswa , Lindani Filicity , van Wyhe Kaylee , Kruger Sharon , Laughton Barbara
Published: September 2023

Depression is a debilitating illness, and stigma associated with it often prevents people from seeking support. Easy-to-administer and culturally- inclusive tools can allow for early screening for depressive symptoms in primary care clinics, especially in resource-limited settings. In this pre-registered pilot study (Stage 1 Report available at DOI: 10.3389/fpsyt.2022.840912), we produced an open-access isiXhosa-language version of the nine-item Patient Health Questionnaire (PHQ-9), a well-validated measure of depression incidence and severity, using a transcultural translation framework. We validated this isiXhosa PHQ-9 in a sample of N = 47 adolescents living with and without HIV in Cape Town, South Africa who speak isiXhosa at home. Reliability, convergent validity, and criterion validity were assessed, with T scores on the Achenbach System of Empirically Based Assessment Youth Self Report (YSR) form completed previously as reference standard. Our isiXhosa PHQ-9 exhibited satisfactory reliability, with Cronbach’s [Formula: see text], inter-item correlations ranging from 0.229 to 0.730, and mean item-total correlation of 0.69. PHQ-9 score and Withdrawn/Depressed component T scores on the Youth Self Report were moderately associated (Spearman’s [Formula: see text], indicating acceptable convergent validity. The isiXhosa PHQ-9 showed satisfactory criterion validity (area under the receiver operating characteristic curve, AUC = 0.706), but these analyses were under-powered. Principal component analysis revealed a one-factor solution, with 45.8% of variance explained by the first principal component and all factor loadings above conventional thresholds. Our isiXhosa translation of the PHQ-9 thus exhibited satisfactory psychometric properties in this pilot validation study and performed comparably to other PHQ-9 versions validated in different languages in African and global contexts. This questionnaire may serve as an invaluable culturally-inclusive screening tool for measuring depressive symptoms among isiXhosa speakers. Caution must be exercised as screening tools including the PHQ-9 may over- or under-estimate prevalence of depression. Further validation in larger, independent cohorts may enable wider use of our isiXhosa PHQ-9 as a screening tool in clinics, research studies, and mental health non-profits who serve amaXhosa.
Design and Research of Form Controlled Planar Folding Mechanism based on 4D Printing Technology
Authors: Zhang Wencai , Ge Zhenghao , Li Duanling
Published: September 2023

The use of non-smart materials in structural components and kinematic pairs allows for flexible assembly in practical applications and is promising for aerospace applications. However, this approach can result in a complex structure and excessive kinematic pairs, which limits its potential applications due to the difficulty in controlling and actuating the mechanism. While smart materials have been integrated into certain mechanisms, such integration is generally considered a unique design for specific cases and lacks universality. Therefore, organically combining universal mechanism design with smart materials and 4D printing technology, innovating mechanism types, and systematically exploring the interplay between structural design and morphing control remains an open research area. In this work, a novel form-controlled planar folding mechanism is proposed, which seamlessly integrates the control and actuation system with the structural components and kinematic pairs based on the combination of universal mechanism design with smart materials and 4D printing technology, while achieving self-controlled dimensional ratio adjustment under a predetermined thermal excitation. The design characteristics of the mechanism are analyzed, and the required structural design parameters for the preprogrammed design are derived using a kinematic model. Using smart materials and 4D printing technology, folding programs based on material properties and control programs based on manufacturing parameters are encoded into the form-controlled rod to achieve the preprogrammed design of the mechanism. Finally, two sets of prototype mechanisms are printed to validate the feasibility of the design, the effectiveness of the morphing control programs, and the accuracy of the theoretical analysis. This mechanism not only promotes innovation in mechanism design methods but also shows exceptional promise in satellite calibration devices and spacecraft walking systems.
The effect of cognitive behavioral counseling on anxiety and worry level of women with intermediate risk during first trimester screening for down syndrome: a randomized controlled trial: a randomized controlled trial
Authors: Kharaghani Roghieh , Vaezi Farhaneh , Dadashi Mohsen , Rastegari Leila , Maleki Azam
Published: September 2023

Background

Anxiety related to prenatal screening programs negatively affects maternal and child health.

Objective

The study aimed to determine the effect of Cognitive Behavioral Counseling on the anxiety and worry levels of women with intermediate risk during first-trimester screening for Down Syndrome.

Methods

The study was a randomized controlled trial conducted on 52 pregnant women with intermediate risk (1: 51 − 1:1500) during first-trimester screening for Down Syndrome and without additional structural anomalies that referred to three cities of Zanjan province in 2021. The eligible women were randomly assigned to intervention and control groups, with a block size of four. The intervention group received CBC in four sessions of 120 min two times a week by phone. Data were collected using Vandenberg Anxiety Questionnaire, and Cambridge Worry Questionnaire in three phases baseline, after the intervention, and 6 weeks follow-ups. Data were analyzed using independent t-test, chi-square, and repeated measures ANOVA at a 95% confidence level. (P < 0.05).

Results

In the counselling group, the mean (SD) of a total score of anxiety before the intervention was 67.11 (20.68) which decreased to 32.50 (13.58) in six weeks after the intervention. Furthermore, the mean (SD) of a total score of worry before the intervention was 56.19 (16.76) which decreased to 32.96 (8.89) six weeks after the intervention. Based on the repeated measures ANOVA test, the mean total score of anxiety and worry were statistically significant 6 weeks after the intervention compared with the control group(p < 0.001).

Conclusion

Based on the study results, CBC can reduce the anxiety and worry levels of women with intermediate risk during first trimester screening for Down Syndrome.

Trial registration

The study was registered at the Iranian Registry of Clinical Trials website under the code IRCT20160608028352N8, (https://en.irct.ir/trial/49998). The first trial registration date was (29/08/2020).
Preeclampsia complicated with hypofibrinogenemia: 2 case reports and review of the literature
Authors: Li Shiguang , Jin Yanhui , Gong Yanmin , Luo Xia
Published: September 2023

Background

Preeclampsia complicated with hypofibrinogenemia is a rare disorder. We report two cases of severe preeclampsia complicated with hypofibrinogenemia followed by postpartum haemorrhage (PPH).

Case

Two women diagnosed as preeclampsia and hypofibrinogenemia developed severe PPH after undergoing Cesarean sections. Besides supplement with fibrinogen concentrate and supportive treatment, the second patient got administration of heparin after delivery and bleeding was stopped. The haemorrhage in case 1 didn’t disappear until an hysterectomy. The two patients both recovered and were discharged soon.

Conclusions

Severe preeclampsia patients with hypofibrinogenemia could suffer PPH. It’s necessary to detect and master coagulation function. Heparin could be considered to balance hypercoagulation and hypocoagulation to avoid catastrophic haemorrhage and hysterectomy.
Association between the weight-adjusted waist index and stroke: a cross-sectional study
Authors: Ye Jiayi , Hu Yanjie , Chen Xinrong , Yin Zhe , Yuan Xingzhu , Huang Liping , Li Ka
Published: September 2023

Background

The weight-adjusted waist index (WWI) is a new measure of obesity, and this study aimed to determine the association between the WWI and stroke.

Methods

Using the National Health and Nutrition Examination Survey (NHANES) 2011–2020 dataset, cross-sectional data from 23,389 participants were analysed. The correlation between the WWI and stroke was investigated through multivariate logistic regression and smoothing curve fitting. Subgroup analysis and interaction tests were also carried out.

Results

The research involved 23,389 participants, of whom 893 (3.82%) had a stroke. The fully adjusted model revealed a positive correlation between the WWI and stroke [1.25 (1.05, 1.48)]. Individuals who were in the highest quartile of WWI exhibited a 62% higher likelihood of experiencing a stroke than those in the lowest quartile [1.62 (1.06, 2.48)]. Subgroup analysis and interaction tests revealed that this positive correlation was similar in different population settings (all P for interaction  > 0.05).

Conclusion

A higher WWI was associated with a higher prevalence of stroke. The results of this study underscore the value of the WWI in stroke prevention and management.
Do early life factors explain the educational differences in early labour market exit? A register-based cohort study
Authors: Carlsson Emma , Hemmingsson Tomas , Landberg Jonas , Burström Bo , Thern Emelie
Published: September 2023

Background

Socioeconomic inequalities in labour market participation are well established. However, we do not fully know what causes these inequalities. The present study aims to examine to what extent factors in childhood and late adolescence can explain educational differences in early labour market exit among older workers.

Methods

All men born in 1951–1953 who underwent conscription examination for the Swedish military in 1969–1973 (n = 145 551) were followed from 50 to 64 years of age regarding early labour market exit (disability pension, long-term sickness absence, long-term unemployment and early old-age retirement with and without income). Early life factors, such as cognitive ability, stress resilience, and parental socioeconomic position, were included. Cox proportional-hazards regressions were used to estimate the association between the level of education and each early labour market exit pathway, including adjustment for early life factors.

Results

The lowest educated men had a higher risk of exit through disability pension (HR: 2.72), long-term sickness absence (HR: 2.29), long-term unemployment (HR: 1.45), and early old-age retirement with (HR: 1.29) and without income (HR: 1.55) compared to the highest educated men. Factors from early life explained a large part of the educational differences in disability pension, long-term sickness absence and long-term unemployment but not for early old-age retirement. Important explanatory factors were cognitive ability and stress resilience, whilst cardiorespiratory fitness had negligible impact.

Conclusions

The association between education and early exit due to disability pension, long-term sickness absence and long-term unemployment was to a large part explained by factors from early life. However, this was not seen for early old-age retirement. These results indicate the importance of taking a life-course perspective when examining labour market participation in later working life.
Stop-bang questionnaire for screening obstructive sleep apnea syndrome among hypertensive patients in Kenya
Authors: Salim Salim Abdallah , Shah Jasmit , Bwika Jumaa , Ali Sayed K.
Published: September 2023

Introduction

Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods

This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ score of ≥ 4 were categorized as high risk for OSA. Descriptive statistics were employed to describe both categorical and continuous variables and binary logistic regression to assess factors associated with the high risk of OSA.

Results

The study reported that 78.5% of the participants had high-risk OSA. The median age and body mass index (BMI) were 57.0 years (IQR: 50.0–64.0) and 28.3 kg/m2, respectively. Age, neck circumference, gender, and BMI were significantly higher in the high-risk OSA group as compared to the low-risk group.

Conclusion

The study highlights the importance of screening hypertensive patients for OSA using the SBQ in clinical settings, particularly in low-and middle-income countries (LMICs). Healthcare providers can use patient characteristics such as age, gender, neck circumference, and BMI to identify those at greater risk of developing OSA. Further research could focus on developing effective OSA prevention and treatment interventions in hypertensive patients.
Construction and validation of machine learning models for sepsis prediction in patients with acute pancreatitis
Authors: Liu Fei , Yao Jie , Liu Chunyan , Shou Songtao
Published: September 2023

Background

This study aimed to construct predictive models for the risk of sepsis in patients with Acute pancreatitis (AP) using machine learning methods and compared optimal one with the logistic regression (LR) model and scoring systems.

Methods

In this retrospective cohort study, data were collected from the Medical Information Mart for Intensive Care III (MIMIC III) database between 2001 and 2012 and the MIMIC IV database between 2008 and 2019. Patients were randomly divided into training and test sets (8:2). The least absolute shrinkage and selection operator (LASSO) regression plus 5-fold cross-validation were used to screen and confirm the predictive factors. Based on the selected predictive factors, 6 machine learning models were constructed, including support vector machine (SVM), K-nearest neighbour (KNN), multi-layer perceptron (MLP), LR, gradient boosting decision tree (GBDT) and adaptive enhancement algorithm (AdaBoost). The models and scoring systems were evaluated and compared using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and the area under the curve (AUC).

Results

A total of 1, 672 patients were eligible for participation. In the training set, 261 AP patients (19.51%) were diagnosed with sepsis. The predictive factors for the risk of sepsis in AP patients included age, insurance, vasopressors, mechanical ventilation, Glasgow Coma Scale (GCS), heart rate, respiratory rate, temperature, SpO2, platelet, red blood cell distribution width (RDW), International Normalized Ratio (INR), and blood urea nitrogen (BUN). The AUC of the GBDT model for sepsis prediction in the AP patients in the testing set was 0.985. The GBDT model showed better performance in sepsis prediction than the LR, systemic inflammatory response syndrome (SIRS) score, bedside index for severity in acute pancreatitis (BISAP) score, sequential organ failure assessment (SOFA) score, quick-SOFA (qSOFA), and simplified acute physiology score II (SAPS II).

Conclusion

The present findings suggest that compared to the classical LR model and SOFA, qSOFA, SAPS II, SIRS, and BISAP scores, the machine learning model-GBDT model had a better performance in predicting sepsis in the AP patients, which is a useful tool for early identification of high-risk patients and timely clinical interventions.
Effects of a commercial whitening toothpaste containing hydrogen peroxide and citric acid on dentin abrasion and erosion
Authors: Kim Jae-Heon , Kim Soyeon , Park Young-Seok
Published: September 2023

Background

Hydrogen peroxide (HP) and citric acid (CA), key contributors to toothpaste acidity, can lead to dental loss. This study aimed to compare the amount of abrasion or loss of dentin based on pH, buffering, and concentration of HP and CA in commercial and experimental toothpastes after toothbrushing or immersion.

Methods

Bovine dentin specimens were randomly assigned to nine solutions. The prepared solutions included two commercial toothpastes (whitening toothpaste [WT] with HP and CA; conventional toothpaste [CT] without HP and CA), reference slurry (RS), two CA solutions (1.92%, CAS1; 0.001%, CAS2), basic solution (7.16% sodium phosphate dibasic [SPDS]), CA phosphate buffer solution (3.58% SPDS and 0.96% CA [CAPB]), HP solution (4%, HPS), and distilled water (DW). Dentin specimens were performed in two treatments: one with only abrasion (10,000 brushings) and one with only immersion (1 h). After treatments, the amount of dentin loss and surface images were measured and observed using noncontact profilometry. Data were analyzed using an one-way analysis of variance and the Tukey test as a post hoc analysis (p < 0.05).

Results

WT with pH 5.0 had lower dentin abrasion than CT and RS after brushing but had higher dentin loss than both after immersion. The dentin surfaces of CAS1, CAPB, and WT were damaged after immersion, whereas HPS, CAS2, CT, SPDS, RS, and DW remained intact after soaking. CAS2 and HPS, which had a pH of 5.0 like WT, did not significantly differ from those of DW after brushing.

Conclusions

WT containing HP and CA did not cause significant dentin abrasion but may cause additional dentin loss even without brushing. After brushing or immersion, the CA concentration may affect the dentin surface more than the HP concentration included in WT. The amount of abrasion or loss of dentin after brushing or soaking can vary based on the composition, concentration, and buffer in the solution, even if the pH of the solution is similar to pH 5.0.
Effect of three different grafting materials on immediate implant placement using vestibular socket therapy in class II extraction sockets in the maxillary esthetic zone: a randomized controlled clinical trial
Authors: Hamed Mohamed Mofreh , El-Tonsy Maher Mohamed , Elaskary Abdelsalam , Abdelaziz Gaser O. , Saeed Safinaz Saleh , Elfahl Bassem Nabil
Published: September 2023

Background

This study compared the effectiveness of three bone grafting materials used for treating class II fresh extraction sockets in the esthetic zone with immediate implant placement using Vestibular Socket Therapy (VST) to evaluate the pink esthetic score (PES), peri-implant mucosal levels (PML), and facial bone thickness (FBT).

Methods

Twenty-four surgical sites in the maxillary anterior region presented with type II socket defects received immediate implants and simultaneous bone grafting with either a collagen plug soaked in blood, demineralized bone matrix Grafton, or a particulate mixture of 2/3 autogenous bone chips and 1/3 deproteinized bovine bone mineral MinerOss X. The outcome measures were evaluated at 6 and 12 months. The study was registered on www.clinicaltrial.gov (12/07/2021 - ID: NCT04957654).

Results

Twenty-two cases (91.6%) showed a total PES score of > 10, without a significant difference between all groups. The vertical height soft tissue changes showed significant improvement in the Collagen plug and Grafton groups at 6 and 12 months, while MinerOss X showed no significant difference at 6 and 12 months compared to baseline. Radiographically, FBT was 0.72 ± 0.20, 0.44 ± 0.12, and 0.95 ± 0.37 at baseline, which significantly increased to 1.61 ± 0.88, 1.48 ± 1.20 and 2.31 ± 0.86 at 12 months for all three groups, respectively.

Conclusion

The use of a particulate bone graft mixture significantly increases the FBT compared to collagen plugs and DBM-Grafton when performing VST during immediate implant placement in compromised Class II extraction sockets.
Dietary quality index and the risk of breast cancer: a case-control study
Authors: Pourhabibi-Zarandi Fatemeh , Kahrizsangi Masoud Amini , Eskandarzadeh Sevda , Mansouri Fatemeh , Vali Mohebat , Jalali Saba , Heidari Zeinab , Shateri Zainab , Nouri Mehran , Rashidkhani Bahram
Published: September 2023

Background

Diet quality is a significant determinant in the etiology of breast cancer (BrCa), but further studies are required to explore this relationship. Therefore, we tried to assess if diet quality, assessed using the Diet Quality Index-International (DQI-I), was related to BrCa among the Iranian population.

Methods

In the present case-control research, 134 women with a recent diagnosis of BrCa and 267 without BrCa were selected as case and control groups. Individual food intake data from a food frequency questionnaire was used to compute DQI-I. Also, the multivariable logistic regression models were utilized to evaluate the association between DQI-I and BrCa odds .

Results

We found a significant association between the last tertile of DQI-I and BrCa odds in the fully adjusted model (odds ratio (OR) = 0.30; 95% confidence interval (CI): 0.15–0.56). The subgroup analysis based on menopausal status also showed a significant decrease in BrCa odds in pre-and post-menopausal women (pre-menopausal: OR = 0.27; 95% CI: 0.10–0.70 – post-menopausal status: OR = 0.35; 95% CI: 0.13–0.92).

Conclusions

Our findings indicated that a higher DQI-I score was related to a lower chance of BrCa. According to our research, a healthy diet pattern is crucial for BrCa prevention.
Transforming traditional physiotherapy hands-on skills teaching into video-based learning
Authors: Luginbuehl Helena , Nabecker Sabine , Greif Robert , Zuber Stefan , Koenig Irene , Rogan Slavko
Published: September 2023

Background

Pandemic-induced restrictions forced curriculum transformation from on-site education to virtual learning options. This report describes this transition, the challenge of creating technology-enhanced learning for hands-on psychomotor skills teaching in physiotherapy, and students’ evaluations of the new technology-enhanced learning approach in Complex Decongestive Physiotherapy.

Methods

On-site theoretical background lectures were replaced with e-learning sessions. Faculty hands-on skills demonstrations for the entire class were replaced with video-recorded demonstrations. Videos included verbal and written instructions and were complemented with checklists guiding the students, training in pairs, through their learning tasks. A cross-sectional observational survey for teaching quality evaluated this new technology-enhanced learning approach and assessed students’ preference for traditional or video-based hands-on skills learning.

Results

Survey return rate was > 50% (46 participating students). Teaching quality was rated between 1.5 ± 0.5 and 1.8 ± 0.4 (Likert scale from − 2 to + 2). Most students (66.7%) preferred the new approach. They appreciated for example that videos were available all the time, enabling self-paced learning, providing an equally good view on skills demonstrations, and the convenience to be able to rewind, re-view, and use speed adjustment options.

Conclusions

Students preferred the new video-based learning of skills for Complex Decongestive Physiotherapy. Because in-class live skills demonstrations were omitted, faculty had more time to provide individual feedback and answer questions. The shift from teacher- to student-centered learning enabled students to control their own learning pace. The innovative program was maintained after pandemic-induced restrictions were lifted. The success of this approach should be tested in other physiotherapy settings and different educational institutions.
The effect of micro-learning on trauma care knowledge and learning satisfaction in nursing students
Authors: Haghighat Hossein , Shiri Maryam , Esmaeili Abdar Mohammad , Taher Harikandee Seyedeh Soghra , Tayebi Zahra
Published: September 2023

Background

Despite the fact that there are few formal trauma training courses for nurses, they play an important role in the care of trauma patients. This study aims to investigate the effect of micro-learning on the knowledge of managing trauma patients and learning satisfaction in nursing students.

Methods

The convenience sampling method was used to enroll 30 final-year nursing students from Alborz University of Medical Sciences in this quasi experimental One-group pretest -posttest design. The educational content was created and repeated 4 times over the course of 36 days using a micro-learning approach through whiteboard animations, video casts, and live videos. MCQ scenario-based exam was used to assess participants’ knowledge of trauma in three phases: pretest, immediately following the intervention, and one month after the end of the educational program. An e-learning satisfaction psychometric questionnaire was used to measure satisfaction.

Results

The mean knowledge score 1 month after the intervention did not differ significantly from the score immediately after the intervention (p = 1), but there was a significant relationship between the mean knowledge score immediately after the intervention and before that (p = 0.047). Demographic variables and knowledge of trauma management did not differ statistically significant. The majority of students were pleased with how the course was implemented (5.64).

Conclusion

The use of micro-learning has a positive effect on the promotion and retention of knowledge of trauma care, as well as increasing nursing students’ satisfaction. Micro-learning is proposed as a new educational approach that can be used as a complementary or as a stand-alone method to convey important educational concepts and increase learner satisfaction.
Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus
Authors: Mubarik Sumaira , Malik Saima Shakil , Yanran Zhang , Hak Eelko , Nawsherwan  , Wang Fang , Yu Chuanhua
Published: September 2023

Background

Numerous studies over the past four decades have revealed that breast cancer screening (BCS) significantly reduces breast cancer (BC) mortality. However, in BRICS-plus countries, the association between BCS and BC case fatality and disability are unknown. This study examines the association of different BCS approaches with age-standardized mortality, case-fatality, and disability-adjusted life years (DALYs) rates, as well as with other biological and sociodemographic risk variables, across BRICS-plus from a national and economic perspective.

Methods

In this ecological study applying mixed-effect multilevel regression models, a country-specific dataset was analyzed by combining data from the Global Burden of Disease study 2019 on female age-standardized BC mortality, incidence, and DALYs rates with information on national/regional BCS availability (against no such program or only a pilot program) and BCS type (only self-breast examination (SBE) and/or clinical breast examination (CBE) [SBE/CBE] versus SBE/CBE with mammographic screening availability [MM and/or SBE/CBE] versus SBE/CBE/mammographic with digital mammography and/or ultrasound (US) [DMM/US and/or previous tests] in BRICS-plus countries.

Results

Compared to self/clinical breast examinations (SBE/CBE) across BRICS-plus, more complex BCS program availability was the most significant predictor of decreased mortality [MM and/or SBE/CBE: − 2.64, p < 0.001; DMM/US and/or previous tests: − 1.40, p < 0.001]. In the BRICS-plus, CVD presence, high BMI, second-hand smoke, and active smoking all contributed to an increase in BC mortality and DALY rate. High-income and middle-income regions in BRICS-plus had significantly lower age-standardized BC mortality, case-fatality, and DALYs rates than low-income regions when nationwide BC screening programs were implemented.

Conclusions

The availability of mammography (digital or traditional) and BCS is associated with breast cancer burden in BRICS-plus countries, with regional variations. In light of high-quality evidence from previous causal studies, these findings further support the preventive role of mammography screening for BCS at the national level. Intervening on BCS related risk factors may further reduce the disease burden associated with BC.
Effect of different post-partum therapeutic protocols with intrauterine oxytetracycline, oxytocin and/or GnRH injection in post-kidding goats on oxytetracyclines residues in goat milk and postpartum ovarian resumption with referring to clinical and haematological pictures
Authors: Zakaria Asem M. , Al-Daek Taher , Elmeligy Enas , Mohamed Ragab H. , El-Naga Eman M. Abu , Mohammed Haitham H. , Abdulkarim Abdulrahman , Ali Mohammed Abdelhadi , Khesruf Khaled. A. , Khalphallah Arafat
Published: September 2023

Background

The post-parturient period in goat had marked changes in an animal’s endocrine and metabolic status as well as by reduction in feed intake when the nutrient demand for impending lactogenesis was increasing. The current study aimed to monitor the residues of oxytetracycline in Baladi goat milk and their hazards on public health as well as the time required until complete disappearance of this medicament from milk through following up periods included 0, 12, 24, 36, 48, 60, 72, 84, 96 and 120 h in post-kidding goat following intrauterine application of oxytetracycline. The study also compared between the efficacy of oxytetracycline only, oxytetracycline with oxytocin, or oxytetracycline with GnRH, through monitoring the clinical findings and haematological pictures at days 0, 5 and 7 post-partum as well as studying the changes in numbers and size of follicles at days 15, 30 and 45 postpartum after different treatments strategies in different groups i.e. Control healthy goat (Contgr), Oxytetracycline treated goat (Oxytetgr), Oxytetracycline-oxytocin treated goat (Oxytet-Oxytogr) and Oxytetracycline-GnRH treated goat (Oxytet-GnRHgr). The study was carried out on clinically healthy Baladi goats (n = 40) that gave birth recently. They were divided into 4 equal groups (n = 10 goats for each); Contgr which received no medication after birth, Oxytetgr which administrated oxytetracycline tablets intrauterine at day of birth, Oxytet-Oxytogr which treated by oxytetracycline tablets intrauterine at day of birth followed by oxytocin injection at 3rd day after birth, and Oxytet-GnRHgr which treated by oxytetracycline tablets intrauterine at day of birth followed by GNRH injection at 3rd day after birth.

Results and Conclusions

The study concluded the highest oxytetracyclines residues in goats’ milk were reported after 36 h following intrauterine oxytetracycline application where complete disappearance of oxytetracyclines residues in goats’ milk required 120 h elapsed after intrauterine oxytetracycline application in which the goats milk became safe for human consumption. The study also reported powerful influence of the applied variable therapeutic regimens on post-partum ovarian resumption through clear significant variations in numbers and sizes of follicles either between different goats’ groups within the same day, or between days 15, 30 and 45 post-partum within each independent goat group.
Structural changes in perineuronal nets and their perforating GABAergic synapses precede motor coordination recovery post stroke
Authors: Dzyubenko Egor , Willig Katrin I. , Yin Dongpei , Sardari Maryam , Tokmak Erdin , Labus Patrick , Schmermund Ben , Hermann Dirk M.
Published: September 2023

Background

Stroke remains one of the leading causes of long-term disability worldwide, and the development of effective restorative therapies is hindered by an incomplete understanding of intrinsic brain recovery mechanisms. Growing evidence indicates that the brain extracellular matrix (ECM) has major implications for neuroplasticity. Here we explored how perineuronal nets (PNNs), the facet-like ECM layers surrounding fast-spiking interneurons, contribute to neurological recovery after focal cerebral ischemia in mice with and without induced stroke tolerance.

Methods

We investigated the structural remodeling of PNNs after stroke using 3D superresolution stimulated emission depletion (STED) and structured illumination (SR-SIM) microscopy. Superresolution imaging allowed for the precise reconstruction of PNN morphology using graphs, which are mathematical constructs designed for topological analysis. Focal cerebral ischemia was induced by transient occlusion of the middle cerebral artery (tMCAO). PNN-associated synapses and contacts with microglia/macrophages were quantified using high-resolution confocal microscopy.

Results

PNNs undergo transient structural changes after stroke allowing for the dynamic reorganization of GABAergic input to motor cortical L5 interneurons. The coherent remodeling of PNNs and their perforating inhibitory synapses precedes the recovery of motor coordination after stroke and depends on the severity of the ischemic injury. Morphological alterations in PNNs correlate with the increased surface of contact between activated microglia/macrophages and PNN-coated neurons.

Conclusions

Our data indicate a novel mechanism of post stroke neuroplasticity involving the tripartite interaction between PNNs, synapses, and microglia/macrophages. We propose that prolonging PNN loosening during the post-acute period can extend the opening neuroplasticity window into the chronic stroke phase.

Graphical Abstract
Association between circadian physical activity patterns and mortality in the UK Biobank
Authors: Stein Michael J. , Baurecht Hansjörg , Sedlmeier Anja M. , Konzok Julian , Bohmann Patricia , Fontvieille Emma , Peruchet-Noray Laia , Bowden Jack , Friedenreich Christine M. , Fervers Béatrice , Ferrari Pietro , Gunter Marc J. , Freisling Heinz , Leitzmann Michael F. , Viallon Vivian , Weber Andrea
Published: September 2023

Background

The benefit of physical activity (PA) for increasing longevity is well-established, however, the impact of diurnal timing of PA on mortality remains poorly understood. We aimed to derive circadian PA patterns and investigate their associations with all-cause mortality.

Methods

We used 24 h PA time series from 96,351 UK Biobank participants aged between 42 and 79 years at accelerometry in 2013–2015. Functional principal component analysis (fPCA) was applied to obtain circadian PA patterns. Using multivariable Cox proportional hazard models, we related the loading scores of these fPCs to estimate risk of mortality.

Results

During 6.9 years of follow-up, 2,850 deaths occurred. Four distinct fPCs accounted for 96% of the variation of the accelerometry data. Using a loading score of zero (i.e., average overall PA during the day) as the reference, a fPC1 score of + 2 (high overall PA) was inversely associated with mortality (Hazard ratio, HR = 0.91; 95% CI: 0.84–0.99), whereas a score of -2 (low overall PA) was associated with higher mortality (1.69; 95% CI: 1.57–1.81; p for non-linearity < 0.001). Significant inverse linear associations with mortality were observed for engaging in midday PA instead of early and late PA (fPC3) (HR for a 1-unit increase 0.88; 95% CI: 0.83–0.93). In contrast, midday and nocturnal PA instead of early and evening PA (fPC4) were positively associated with mortality (HR for a 1-unit increase 1.16; 95% CI: 1.08–1.25).

Conclusion

Our results suggest that it is less important during which daytime hours one is active but rather, to engage in some level of elevated PA for longevity.
Extreme Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis (PFAPA): a discrete group of patients
Authors: Broide Mor , Levinsky Yoel , Tal Rotem , Harel Liora , Shoham Shoval , Ahmad Sabreen Abu , Butbul Aviel Yonatan , Amarilyo Gil
Published: September 2023

Objective

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is the most common periodic fever syndrome in children; by definition, episodes occur every 2 to 8 weeks. However, in a subset of our patients, we noticed a higher frequency of attacks, of less than 2 weeks, which we refer to as extreme PFAPA (ePFAPA). This group consisted of patients who were extreme upon presentation of PFAPA, and those who became extreme after initiation of abortive corticosteroid treatment. We aimed to characterize demographic and clinical features of ePFAPA, including the two groups, and to compare them to patients with non-extreme PFAPA (nPFAPA).

Study design

: The medical records of 365 patients with PFAPA who attended Schneider Children’s Medical Center of Israel from March 2014 to April 2021 were reviewed. Patients with concomitant familial Mediterranean fever were excluded. Characteristics of the ePFAPA (including subgroups) and nPFAPA groups were compared using Wilcoxon rank sum, Pearson’s chi-squared, and Fisher’s exact tests.

Results

Forty-seven patients (12.9%) were identified as having ePFAPA. Among patients with ePFAPA, compared to patients with nPFAPA, the median (interquartile range) age at disease onset was earlier: 1.5 years (0.7–2.5) vs. 2.5 years (1.5-4.0), P < 0.001; and diagnosis was younger: 2.6 years (2.0-3.6) vs. 4.5 years (3.0-6.2), P < 0.001. A higher proportion of patients with ePFAPA than nPFAPA were treated with colchicine prophylaxis (53% vs. 19%, P < 0.001), but symptoms and signs during flares did not differ significantly between these groups. Demographic and clinical characteristics were similar between patients with ePFAPA from presentation of PFAPA (22, 47% of those with ePFAPA) and ePFAPA from after corticosteroid treatment.

Conclusion

About half the patients categorized with ePFAPA syndrome already had extreme features upon presentation. Patients with ePFAPA compared to nPFAPA presented and were diagnosed at an earlier age.
Atorvastatin rescues hyperhomocysteinemia-induced cognitive deficits and neuroinflammatory gene changes
Authors: Weekman Erica M. , Johnson Sherika N. , Rogers Colin B. , Sudduth Tiffany L. , Xie Kevin , Qiao Qi , Fardo David W. , Bottiglieri Teodoro , Wilcock Donna M.
Published: September 2023

Background

Epidemiological data suggests statins could reduce the risk of dementia, and more specifically, Alzheimer’s disease (AD). Pre-clinical data suggests statins reduce the risk of dementia through their pleiotropic effects rather than their cholesterol lowering effects. While AD is a leading cause of dementia, it is frequently found co-morbidly with cerebral small vessel disease and other vascular contributions to cognitive impairment and dementia (VCID), which are another leading cause of dementia. In this study, we determined if atorvastatin ameliorated hyperhomocysteinemia (HHcy)-induced VCID.

Methods

Wild-type (C57Bl6/J) mice were placed on a diet to induce HHcy or a control diet each with or without atorvastatin for 14 weeks. Mice underwent novel object recognition testing before tissue collection. Plasma total cholesterol and total homocysteine as well as related metabolites were measured. Using qPCR and NanoString technology, we profiled glial cell-associated gene expression changes. Finally, microglial morphology, astrocyte end feet, and microhemorrhages were analyzed using histological methods.

Results

Atorvastatin treatment of HHcy in mice led to no changes in total cholesterol but decreases in total homocysteine in plasma. While HHcy decreased expression of many glial genes, atorvastatin rescued these gene changes, which mostly occurred in oligodendrocytes and microglia. Microglia in HHcy mice with atorvastatin were trending towards fewer processes compared to control with atorvastatin, but there were no atorvastatin effects on astrocyte end feet. While atorvastatin treatment was trending towards increasing the area of microhemorrhages in HHcy mice in the frontal cortex, it only slightly (non-significantly) reduced the number of microhemorrhages. Finally, atorvastatin treatment in HHcy mice led to improved cognition on the novel object recognition task.

Conclusions

These data suggest that atorvastatin rescued cognitive changes induced by HHcy most likely through lowering plasma total homocysteine and rescuing gene expression changes rather than impacts on vascular integrity or microglial changes.
Validating the measurement of upper limb sensorimotor behavior utilizing a tablet in neurologically intact controls and individuals with chronic stroke
Authors: Austin Devin Sean , Dixon Makenna J. , Tulimieri Duncan Thibodeau , Cashaback Joshua G. A. , Semrau Jennifer A.
Published: September 2023

Background

Intact sensorimotor function of the upper extremity is essential for successfully performing activities of daily living. After a stroke, upper limb function is often compromised and requires rehabilitation. To develop appropriate rehabilitation interventions, sensitive and objective assessments are required. Current clinical measures often lack precision and technological devices (e.g. robotics) that are objective and sensitive to small changes in sensorimotor function are often unsuitable and impractical for performing home-based assessments. Here we developed a portable, tablet-based application capable of quantifying upper limb sensorimotor function after stroke. Our goal was to validate the developed application and accompanying data analysis against previously validated robotic measures of upper limb function in stroke.

Methods

Twenty individuals with stroke, twenty age-matched older controls, and twenty younger controls completed an eight-target Visually Guided Reaching (VGR) task using a Kinarm Robotic Exoskeleton and a Samsung Galaxy Tablet. Participants completed eighty trials of the VGR task on each device, where each trial consisted of making a reaching movement to one of eight pseudorandomly appearing targets. We calculated several outcome parameters capturing various aspects of sensorimotor behavior (e.g., Reaction Time, Initial Direction Error, Max Speed, and Movement Time) from each reaching movement, and our analyses compared metric consistency between devices. We used the previously validated Kinarm Standard Analysis (KSA) and a custom in-house analysis to calculate each outcome parameter.

Results

We observed strong correlations between the KSA and our custom analysis for all outcome parameters within each participant group, indicating our custom analysis accurately replicates the KSA. Minimal differences were observed for between-device comparisons (tablet vs. robot) in our outcome parameters. Additionally, we observed similar correlations for each device when comparing the Fugl-Meyer Assessment (FMA) scores of individuals with stroke to tablet-derived metrics, demonstrating that the tablet can capture clinically-based elements of upper limb impairment.

Conclusions

Tablet devices can accurately assess upper limb sensorimotor function in neurologically intact individuals and individuals with stroke. Our findings validate the use of tablets as a cost-effective and efficient assessment tool for upper-limb function after stroke.
Policy responses to COVID-19: lessons for the global trade and investment regime
Authors: Thrasher Rachel , Kaplan Warren , Wirtz Veronika J. , Clear Louise , Bodduluri Shiva Priya , Polaski Sandra
Published: September 2023

Background

During the past two years, the COVID-19 pandemic has cost millions of lives around the globe, caused major morbidity and provoked widespread economic and social disruption. In response, governments have enacted policies to mitigate the impacts of the pandemic. This research focuses in on policies aimed at increasing access to essential health products and services by comparing them to the global rules governing trade, investment and intellectual property. We have assessed whether these rules have or could have constrained countries in responding to this and future crises. The study identifies the nature and scope of the trade-related health sector policies implemented by our sample group of countries, selected because of their systemic significance: the United States, Germany, France, China, South Africa and India. Each policy is placed into one of five broad categories covered by trade and investment rules so that we could assess their consistency with those rules.

Results

We found, among other things, that the types of trade-related health measures were quite diverse. The high-income countries in our study were the most active in the policy space and tended to rely on subsidies-based measures while the middle-income countries relied more heavily on export and import measures. Policies directly relevant to intellectual property protection were virtually non-existent. When evaluating the implemented policies against the global trade and investment rules, we found potential constraints under five different types of rules: those governing subsidies, import and export trade barriers, investment measures, government procurement and trade-related intellectual property.

Conclusions

Given the tension between the global rules and the practices of policymaking during the pandemic, we conclude that the tension must be resolved in favor of governments making policy rather than relying on existing exceptions or pushing national governments to comply more exactly with the rules. Although the pandemic itself does not respect national borders, governance still generally occurs at the national level because national governments are often the only entities with both the legal authority and the practical ability to respond.
Ocular and neural genes jointly regulate the visuospatial working memory in ADHD children
Authors: Zhao Yilu , Zhong Yuanxin , Chen Wei , Chang Suhua , Cao Qingjiu , Wang Yufeng , Yang Li
Published: September 2023

Objective

Working memory (WM) deficits have frequently been linked to attention deficit hyperactivity disorder (ADHD). Despite previous studies suggested its high heritability, its genetic basis, especially in ADHD, remains unclear. The current study aimed to comprehensively explore the genetic basis of visual-spatial working memory (VSWM) in ADHD using wide-ranging genetic analyses.

Methods

The current study recruited a cohort consisted of 802 ADHD individuals, all met DSM-IV ADHD diagnostic criteria. VSWM was assessed by Rey-Osterrieth complex figure test (RCFT), which is a widely used psychological test include four memory indexes: detail delayed (DD), structure delayed (SD), structure immediate (SI), detail immediate (DI). Genetic analyses were conducted at the single nucleotide polymorphism (SNP), gene, pathway, polygenic and protein network levels. Polygenic Risk Scores (PRS) were based on summary statistics of various psychiatric disorders, including ADHD, autism spectrum disorder (ASD), major depressive disorder (MDD), schizophrenia (SCZ), obsessive compulsive disorders (OCD), and substance use disorder (SUD).

Results

Analyses at the single-marker level did not yield significant results (5E−08). However, the potential signals with P values less than E−05 and their mapped genes suggested the regulation of VSWM involved both ocular and neural system related genes, moreover, ADHD-related genes were also involved. The gene-based analysis found RAB11FIP1, whose encoded protein modulates several neurodevelopment processes and visual system, as significantly associated with DD scores (P = 1.96E−06, Padj = 0.036). Candidate pathway enrichment analyses (N = 53) found that forebrain neuron fate commitment significantly enriched in DD (P = 4.78E−04, Padj = 0.025), and dopamine transport enriched in SD (P = 5.90E-04, Padj = 0.031). We also observed a significant negative relationship between DD scores and ADHD PRS scores (P = 0.0025, Empirical P = 0.048).

Conclusions

Our results emphasized the joint contribution of ocular and neural genes in regulating VSWM. The study reveals a shared genetic basis between ADHD and VSWM, with GWAS indicating the involvement of ADHD-related genes in VSWM. Additionally, the PRS analysis identifies a significant relationship between ADHD-PRS and DD scores. Overall, our findings shed light on the genetic basis of VSWM deficits in ADHD, and may have important implications for future research and clinical practice.