bluuebunny/crossref_metadata_2025 huggingface dataset:
Construction of the Digital Health Equity-Focused Implementation Research Conceptual Model - Bridging the Divide Between Equity-focused Digital Health and Implementation Research
Authors: Groom Lisa L. , Schoenthaler Antoinette M. , Mann Devin M. , Brody Abraham A.
Published: May 2024

Digital health implementations and investments continue to expand. As the reliance on digital health increases, it is imperative to implement technologies with inclusive and accessible approaches. A conceptual model can be used to guide equity-focused digital health implementations to improve suitability and uptake in diverse populations. The objective of this study is expand an implementation model with recommendations on the equitable implementation of new digital health technologies. The Digital Health Equity-Focused Implementation Research (DH-EquIR) conceptual model was developed based on a rigorous review of digital health implementation and health equity literature. The Equity-Focused Implementation Research for Health Programs (EquIR) model was used as a starting point and merged with digital equity and digital health implementation models. Existing theoretical frameworks and models were appraised as well as individual equity-sensitive implementation studies. Patient and program-related concepts related to digital equity, digital health implementation, and assessment of social/digital determinants of health were included. Sixty-two articles were analyzed to inform the adaption of the EquIR model for digital health. These articles included digital health equity models and frameworks, digital health implementation models and frameworks, research articles, guidelines, and concept analyses. Concepts were organized into EquIR conceptual groupings, including population health status, planning the program, designing the program, implementing the program, and equity-focused implementation outcomes. The adapted DH-EquIR conceptual model diagram was created as well as detailed tables displaying related equity concepts, evidence gaps in source articles, and analysis of existing equity-related models and tools. The DH-EquIR model serves to guide digital health developers and implementation specialists to promote the inclusion of health-equity planning in every phase of implementation. In addition, it can assist researchers and product developers to avoid repeating the mistakes that have led to inequities in the implementation of digital health across populations.
Customer Profitability Analysis in decision-making–The roles of customer characteristics, cost structures, and strategizing
Authors: Lueg Rainer , Ilieva Dima
Published: May 2024

Purpose

This study investigates the interplay between strategic goals and calculative practices, specifically Customer Profitability Analysis (CPA). Drawing on practice-based theories, the research aims to understand how managers strategize with CPA, including the balancing of financial and strategic objectives and the interplay of institutionalized practices with individual practitioners’ actions.

Design

The study uses a qualitative, revelatory, and exploratory case study approach at the sub-organizational level in a manufacturing company. The researchers compare CPA practices across six departments, guided by a phenomenological research design. Data collection methods include informal conversations, qualitative observations, written documentation, numerical evidence from the accounting system, and interviews.

Findings

The study offers four novel findings to the field. First, it highlights how managers employ procedural and interactive strategizing to reframe CPA practices. The sophistication of CPA practices increases with unevenly distributed customer volume, high customer-specific, controllable overhead, customer-to-customer interaction, and service complexity. Conversely, the sophistication of cost-focused CPA practices tends to decrease with diverse strategic goals. Additionally, CPA become more effective through the utilization of non-financial information, employee empowerment, localization, and strategic alignment. Second, CPA can be adapted through integrative strategizing where managers avoid using it as a financial benchmark for strategic initiatives. Third, accountants actively seek intermediary roles to incorporate arguments from strategy and marketing to balance strategic objectives–contrary to their portrayal as myopic guardians of profitability. Fourth, the localization of CPA practices to front-line employees compensates for a lack of sophisticated CPA practices.

Future research

Future research should, investigate the adaptation of calculative practices in different cultures, and industries. Exploring additional contextual factors such as uncertainty, management characteristics, and linguistic framing of practices would be beneficial. Examining the interactions in utilizing CPA practices between front-line staff and customers would shed light on their effectiveness. Lastly, investigating the role of consultants in diffusing such practices would offer valuable perspectives.
Levelling up health in the early years: A cost-analysis of infant feeding and healthcare
Authors: Ajetunmobi Omotomilola , McIntosh Emma , Stockton Diane , Tappin David , Whyte Bruce
Published: May 2024

Background

Although breastfeeding is recommended as the optimal form of nutrition in the first six months, it is not sustained as the predominant mode of feeding infants in Scotland. This study estimated the impact of infant feeding choices on primary and secondary healthcare service costs in a 13-year birth cohort.

Method

Using linked administrative datasets, in a retrospective cohort design of 502,948 singletons born in Scotland between 1997 and 2009, we estimated the cost of GP consultations and hospital admissions by area deprivation and mode of infant feeding up to 6–8 weeks for ten common childhood conditions from birth to 27 months. Additionally, we calculated the potential healthcare savings if all infants in the cohort had been exclusively breastfed at 6–8 weeks. Discounting of 1.5% was applied following current health economic conventions and 2009/10 used as the base year.

Results

Over the study period, the estimated cost of hospital admissions in the cohort was £111 million and £2 million for the 2% subset of the cohort with primary care records. Within each quintile of deprivation, exclusively breastfed infants used fewer healthcare services and incurred lower costs compared to infants fed (any) formula milk. At least £10 million of healthcare costs may have been avoided if formula-fed infants had been exclusively breastfed within the first 6–8 weeks of birth.

Conclusions

This study using a representative birth cohort demonstrates how breastmilk can promote equitable child health by reducing childhood illness and healthcare utilisation in the early years.
Which students skip school? A comparative study of sociodemographic factors and student absenteeism using PISA data
Authors: Fredriksson Ulf , Rasmusson Maria , Backlund Åsa , Isaksson Joakim , Kreitz-Sandberg Susanne
Published: May 2024

This article explores which students–with regard to gender, socio-economic background and migration background–skip school in Germany, Japan, Sweden and the United Kingdom (UK) according to PISA data. Students who skip school are observed in many countries, but there is not much systematic research that studies this across countries. Comparable data is to a large extent missing. PISA data offers an opportunity to use comparable data. In PISA, students were asked in 2018, 2015 and 2012 whether they had skipped school a whole day in the last two weeks prior to their completion of the PISA student questionnaire. Patterns of how absence relates to sociodemographic factors vary in countries and school systems. In the comparison between the four countries the UK stands out as having a higher percentage of students who have reported that they have skipped school than in the other countries. This does not seem to be related to any specific group of students. Japan also stands out with a lower percentage of students who have reported that they have skipped school. According to PISA data, skipping school is more related to socio-economic background than any other of the variables studied. The socio-economic background seems to be related to skipping school in all three PISA studies in Sweden and the UK. Gender seems not to be an important factor in the four countries. In Sweden and Germany there is a lower percentage of non-immigrant students who report that they have skipped school than first-and second-generation immigrant students. In the UK the figures are more ambiguous. When the percentages of students skipping school are compared over time and in the countries, it is difficult to find any trends, but the data only covered three measurements during a period of six years, which may be too short a time span to see trends.
Lemon basil seed-derived peptide: Hydrolysis, purification, and its role as a pancreatic lipase inhibitor that reduces adipogenesis by downregulating SREBP-1c and PPAR-γ in 3T3-L1 adipocytes
Authors: Kuptawach Kittisak , Noitung Sajee , Buakeaw Anumart , Puthong Songchan , Sawangkeaw Ruengwit , Sangtanoo Papassara , Srimongkol Piroonporn , Reamtong Onrapak , Choowongkomon Kiattawee , Karnchanatat Aphichart
Published: May 2024

The purpose of this study is to assess the bioactive peptides derived from the defatted lemon basil seeds hydrolysate (DLSH) for their ability to inhibit pancreatic lipase, decrease intracellular lipid accumulation, and reduce adipogenesis. Response surface methodology (RSM) was employed to optimize trypsin hydrolysis conditions for maximizing lipase inhibitory activity (LI). A hydrolysis time of 387.06 min, a temperature of 49.03°C, and an enzyme concentration of 1.61% w/v, resulted in the highest LI with an IC50 of 368.07 μg/mL. The ultrafiltration of the protein hydrolysate revealed that the fraction below 0.65kDa exhibited the greatest LI potential. Further purification via RP-HPLC identified the Gly-Arg-Ser-Pro-Asp-Thr-His-Ser-Gly (GRSPDTHSG) peptide in the HPLC fraction F1 using mass spectrometry. The peptide was synthesized and demonstrated LI with an IC50 of 0.255 mM through a non-competitive mechanism, with a constant (Ki) of 0.61 mM. Docking studies revealed its binding site with the pancreatic lipase-colipase complex. Additionally, GRSPDTHSG inhibited lipid accumulation in 3T3-L1 cells in a dose-dependent manner without cytotoxic effects. Western blot analysis indicated downregulation of PPAR-γ and SREBP-1c levels under GRSPDTHSG treatment, while an increase in AMPK-α phosphorylation was observed, suggesting a role in regulating cellular lipid metabolism. Overall, GRSPDTHSG demonstrates potential in attenuating lipid absorption and adipogenesis, suggesting a prospective application in functional foods and nutraceuticals.
Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults: A protocol for systematic review and meta-analysis
Authors: Junkes Larissa , Gherman Bruno R. , Appolinario Jose Carlos , Nardi Antonio E.
Published: May 2024

Background

Major Depressive Disorder is a long-term, recurring, and very common illness that is associated with a significant decline in functional ability. The gold-standard method of treating depression is pharmacotherapy, which involves the use of antidepressant medications either alone or in various combinations. However, approximately 30% of Major Depressive Disorder patients suffer from Treatment Resistant Depression, a more severe condition that has a profound impact on patients’ lives. Our study aims to conduct the first comprehensive review and meta-analysis to assess the effectiveness and safety of adding Dialectical Behavior Therapy to antidepressant medications compared to groups using pharmacotherapy alone as an intervention for adults with Treatment Resistant Depression.

Materials and methods

We will search for publications in the following databases: Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Lilacs, Web of Science, and PsycINFO. We will manually review the reference lists of the included studies to identify potentially relevant studies. There will be no restrictions on the language or publication date. Quality assessment of the included studies will be performed independently according to the Cochrane Risk of Bias instrument. To assess the certainty of the findings’ body of evidence, we will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. This study aims to determine the effectiveness and safety of Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults.

Ethics and dissemination

Ethical approval was not required as individual patient data was not obtained. Our intention is to publish the systematic review in a medical journal that offers open access upon completion of the process.

Trial registration

PROSPERO registration number CRD42023406301. Registered on March 24, 2023.
The in vitro assessment of rheological properties and dentin remineralization of saliva substitutes containing propolis and aloe vera extracts
Authors: Srisomboon Surapong , Intharah Thanapong , Jarujareet Ungkarn , Toneluck Arnit , Panpisut Piyaphong
Published: May 2024

Saliva substitutes with enhanced dentin remineralization properties were expected to help manage caries progression in patients with xerostomia. This in vitro study examined the rheological properties and remineralization action of experimental saliva substitutes containing propolis extract and aloe vera extract on demineralized dentin. Four experimental saliva substitutes were formulated with varying concentrations of propolis extract (P) and aloe vera extract (A) were prepared. A commercial saliva substitute (Biotene Oral Rinse) was used as a commercial comparison. The rheological properties and viscosity of these materials were measured using a strain-controlled rheometer (n = 3). The remineralizing actions of saliva substitutes on demineralized dentin after 2 weeks were determined using ATR-FTIR and SEM-EDX (n = 8). The results were expressed as a percentage increase in the mineral-to-matrix ratio. Biotene demonstrated a significantly higher viscosity (13.5 mPa·s) than experimental saliva substitutes (p<0.05). The addition of extracts increased the viscosity of the saliva substitutes from 4.7 mPa·s to 5.2 mPa·s. All formulations showed minimal shear thinning behavior, which was the viscoelastic properties of natural saliva. The formulation containing 5 wt% of propolis exhibited the highest increase in the median mineral-to-matrix ratio (25.48%). The SEM-EDX analysis revealed substantial mineral precipitation in demineralized dentin, especially in formulations with 5 wt% or 2.5 wt% of propolis. The effect of the aloe vera extract was minimal. The addition of propolis and aloe vera extracts increased the viscosity of saliva substitutes. the addition of propolis for 2.5 or 5 wt% to saliva substitutes increased mineral apatite precipitation and tubule occlusion. To conclude, the saliva substitute containing propolis extract demonstrated superior remineralizing actions compared with those containing only aloe vera extract.
Conditions for successful nitrogen removal from source-separated urine by partial nitritation/anammox
Authors: Faust Valentin , Markus Philipp , Schielke-Jenni Sarina , Timmer Marijn J. , De Paepe Jolien , Ganigué Ramon , Vlaeminck Siegfried E. , Udert Kai M.
Published: May 2024

Partial nitritation/anammox (PN/A) of source-separated urine is less energy-intensive and potentially cheaper and more environmentally friendly than conventional nitrogen removal from mixed sewage. However, PN/A of undiluted source-separated urine has not yet been established. In this study, the feasibility of PN/A for source-separated urine (total nitrogen ≈ 2 to 3 g-N L-1). To evaluate the influence of different factors, one- and two-stage configurations were operated using different influents, i.e. source-separated urine, synthetic urine, and urine with additional divalent cations. While partial nitritation was successfully achieved in both configurations with digester supernatant and urine, anammox activity was lost shortly after switching from digester supernatant to the urine influents. Toxic organic compounds or pharmaceuticals and the high monovalent to divalent cation ratio were suspected as causes of anammox failure, but were ruled out due to the different reactor configurations and influent compositions tested. Other suspected factors such as COD/N ratio, phosphate and sulfate inhibition, nitrogen compound inhibition, metal inhibition, pH and dissolved oxygen were also systematically excluded. Instead, the high salt concentration in urine compared to the digester supernatant most likely caused the reactor to fail due to the disintegration of large flocs, and the resulting challenge of biomass retention. The shortcomings of the floccular sludge system were overcome by using biofilm carriers, resulting in successful PN/A. This hybrid system ran for 140 days with nitrogen removal rates of up to 1000 mg-N L-1 d-1 with an average of 410 ± 220 mg-N L-1 d-1, and a nitrogen removal efficiency of 93 ± 3% at 30°C.
IV Congresso Internacional - CINEICC
Authors: CINEICC - FPCEUC CINEICC - FPCEUC
Published: May 2024

O Centro de Investigação em Neuropsicologia e Intervenção Cognitivo-Comportamental (CINEICC) da Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra (FPCEUC) realizou o “IV Congresso Internacional do CINEICC” entre 29 de março e 1 abril de 2024.
Dedicado ao tema “Inovações na psicologia básica e aplicada”, o evento científico abordou temas como saúde mental, neurociência, avaliação psicológica, personalidade e emoções, psicologia social e política, desenvolvimento infantil e adolescente, psicologia forense ou envelhecimento.
Exenteración ocular en la mucormicosis rino-órbito-cerebral
Authors: Lugo-Machado Juan Antonio , Gutiérrez-Pérez Martha Lucia , Zazueta-Cárdenas Araceli , Hernández-Sánchez Yaima , Medina-Valentón Elizabeth , García-Ramírez Patricia Emiliana
Published: May 2024

Introducción:
La mucormicosis es una infección generada por hongos aerobios muy agresiva que pude involucrar vía aérea superior y extenderse a estructuras adyacentes.

Objetivo:
Analizar la asociación entre el deceso y la exenteración ocular en pacientes con mucormicosis rino-orbito-cerebral.

Método:
Se analizaron los aspectos clínicos y desenlace de los pacientes con mucormicosis rino-orbito-cerebral. Se empleó estadística descriptiva, se empleó Ji cuadrado para asociación, para riesgo se utilizó odd ratio, considerando como significativo con un valor de p≤0.05.

Resultados:
De 45, 11 no cumplieron los criterios de inclusión, no se encontraron asociaciones entre sexo, diabetes con otras comorbilidades, los estadios de la MROC y deceso, la infección por COVID-19, ni la hemoglobina glucosilada (HbA1c). Sin embargo, la lisis ósea en la tomografía (p=0.001), el tipo de procedimiento quirúrgico (p=0.002), y la exenteración ocular (p=0.001) se asociaron significativamente con deceso. Se encontraron diferencias entre los niveles de proteína C reactiva (PCR) (p=0.035), la velocidad de sedimentación globular (VSG) (p=0.056), y el recuento absoluto de neutrófilos (p=0.000) con muerte.

Discusión:
La decisión de exenteración ocular, es un aspecto complejo en los pacientes con MROC, existen autores quienes señalan que el impacto psicológico es significativo en una proporción sustancial de pacientes.

Conclusiones:
Las únicas características asociadas a deceso en pacientes con MROC en el estudio fueron la presencia de lisis ósea en la tomografía y la exenteración ocular.
Assessment of the glycemic index in a white bread enriched with fermented cassava dough using Lactobacillus plantarum in apparently healthy volunteers
Authors: Martínez R. Marisol , Cruz Mario , Loredo Araceli , Martínez Jose Luis , Garza Aurora , BELMARES RUTH
Published: May 2024

Introduction: The substitution of wheat flour with cassava flour has resulted in high glycemic indices or products with low quality, while limited research on substitution with fermented dough has shown improved quality. Therefore, the aim of this research was to evaluate the In vivo glycemic index of a baked product supplemented with cassava dough fermented with lactic acid bacteria.
Methodology: Twenty-eight young adult students both genders participated, of whom 15 met the stipulated standards. Overall and by gender, the glycemic index of bread enriched to 20% with fermented cassava dough with glucose as standard was determined by capillary glycemia.
Results: There was a significant difference in the glycemic curve of bread against the standard. An average glycemic index of 40±6.33 was obtained, classifying it as Low, showing a different index between genders of 52±8.21 in men and 36±6.96 in women with no significant difference.
Conclusions: The use of fermented cassava dough as a partial substitution in wheat-based baked products is favorable for obtaining products with a lower glycemic index.
Comparison of the effectiveness of various methods for determining the level of metanephrines in the diagnosis of pheochromocytomas
Authors: Shikhmagomedov Sh. Sh. , Rebrova D. V. , Krasnov L. M. , Fedorov E. A. , Chinchuk I. K. , Chernikov R. A. , Rusakov V. F. , Slepstov I. V. , Zgoda E. A.
Published: May 2024

BACKGROUND: Pheochromocytoma (PHEO) is a tumor from the chromaffin tissue of the adrenal medulla, capable of hyperproduction of catecholamines. The increased production of hormones by the tumor leads to catecholamine crises, which have a pathological effect on all organs and systems. In the primary diagnosis of pheochromocytomas, it is important to determine the level of the metabolite of catecholamines — metanephrines. Currently, in clinical practice, various methods are used to determine the level of this metabolite: in blood plasma or in urine, total or only free form, fractionated analysis or unfractionated.

AIM: Comparison of the effectiveness of various methods for determining the level of metanephrines for the diagnosis of pheochromocytomas.

MATERIALS AND METHODS: A retrospective single-center cohort study was conducted on a sample of patients who were initially operated on for adrenal neoplasm at the Pirogov St. Petersburg State University High Medical Technology Clinic from November 2007 to December 2022 and who passed analysis to determine the level of blood or urine metanephrins before surgical treatment. The results of tests for metanephrine and tumor size were evaluated.

RESULTS: 1088 patients with adrenal neoplasms who underwent surgical treatment were examined, of which 348 had histologically confirmed the presence of pheochromocytoma. Four types of metanephrine assays were compared: free fractionated plasma metanephrines (232 patients), unfractionated daily urine metanephrines (431 patients), fractionated total daily urine metanephrines (427 patients) and fractionated free daily urine metanephrines (178 patients). The greatest sensitivity was demonstrated by the analysis of free fractionated plasma methanephrines (95.4%). Unlike others, the sensitivity of this analysis did not decrease in the group of patients with small pheochromocytomas (3 cm or less). The greatest specificity was demonstrated by the analysis of unfractionated metanephrines in daily urine (97.8%), with the lowest sensitivity among all tests (67.6%). The study of fractionated total daily urine metanephrins showed good results of sensitivity and specificity, only slightly inferior to the best indicators, and the analysis of free daily urine metanephrins demonstrated unexpectedly low efficiency. There is a positive correlation between the level of metanephrine in the blood and the size of the tumor.

CONCLUSION: Based on the data obtained, the preferred assays for the primary diagnosis of pheochromocytoma can be considered the determination of fractionated free plasma metanephrines and fractionated total daily urine metanephrines, which is consistent with relevant clinical recommendations. It was found that the size of the tumor correlates with the severity of an increase in the level of metanephrins determined by any of the described methods.
Metastatic risk factors in pheochromocytoma/paraganglioma
Authors: Rebrova D. V. , Loginova O. I. , Vorobyev S. L. , Vorokhobina N. V. , Kozorezova E. S. , Indeykin F. A. , Savelyeva T. V. , Sleptsov I. V. , Chernikov R. A. , Fedorov E. A. , Semenov A. A. , Chinchuk I. K. , Shikhmagomedov Sh. Sh. , Alekseev M. A. , Krasnov L. M. , Rusakov V. F.
Published: May 2024

Currently, all pheochromocytoma/paraganglioma (PPGLs) are considered malignant due to metastatic potential. Consequently, PPGLs are divided into «metastatic» and «non-metastatic». Metastatic PPGLs can be with synchronous metastasis (metastases appear simultaneously with the identified primary tumor) or metachronous (metastases develop after removal of the primary tumor). The term metastatic PPGLs is not used in the presence of tumor invasion into surrounding organs and tissues, without the presence of distant metastases of lymphogenic or hematogenic origin. It is generally believed that about 10% of pheochromocytomas and about 40% of sympathetic paragangliomas have metastatic potential. On average, the prevalence of PPGLs with the presence of metastases is 15–20%. Risk factors for metastatic PPGLs are widely discussed in the literature, the most significant of which are groups of clinical, morphological and genetic characteristics. The review presents a discussion of such risk factors for metastatic PPGLs as age, localization and type of hormonal secretion of the tumor, the size and growth pattern of the adrenal lesion, the presence of necrosis and invasion into the vessels, the tumor capsule surrounding adipose tissue, high cellular and mitotic activity, Ki-67 index, expression of chromogranin B and S100 protein, the presence of genetic mutations of three main clusters (pseudohypoxia, kinase signaling and Wnt signaling).

Over the past two decades, a number of authors have proposed various predictor factors and scales for assessing a probability of metastatic PPGLs. The review contains detailed description and comparison of sensitivity and specificity of such predictor scales as PASS, GAPP, M-GAPP, ASES and COPPS.
Acromegaly screening in patients with hyperprolactinemia and pituitary adenoma
Authors: Ukhanova Yu. A. , Ilovayskaya I. A.
Published: May 2024

BACKGROUND: Hyperprolactinemia accompanies growth hormone hypersecretion in approximately 25-39% of cases. There is a recommendation to determine the level of prolactin in clinical guidelines for diagnosis and treatment of acromegaly. However, there is no understanding of the necessity to investigate the IGF-1 level in patients with hyperprolactinemia and a pituitary adenoma.

AIM: Determining the proportion of patients with hyperprolactinemia and pituitary adenoma, who were examined for IGF-1 levels, and identifying the proportion of patients with acromegaly among this cohort.

MATERIALS AND METHODS: Between December 2019 and December 2022 a single-center observational single-stage single-sample uncontrolled study was conducted. At the first stage of the study, the proportion of patients with pituitary adenoma and hyperprolactinemia with studied IGF-1 levels was determined, according to medical records. At the second stage of the study, patients without known indicators of IGF-1 were determined. The concentration of growth hormone was studied during the oral glucose load in the case of increased IGF-1 levels.

RESULTS: At the first stage, 105 patients were included in the study. The level of IGF-1 was determined in 41/105 (39%) cases. There were 22/41 (53.7%) cases in the subgroup with pituitary incidentalomas and 19/64 (29.7%) cases in the subgroup with hyperprolactinemia among them. At the second stage, the IGF-1 level was additionally determined in 53 patients with hyperprolactinemia and pituitary adenoma (total 94 patients). The level of IGF-1 was elevated in 11/94 patients, further acromegaly was confirmed in 3/94 patients (3.2%).

CONCLUSION: In real clinical practice the level of IGF-1 is studied only in 39% of cases in patients with pituitary adenoma and hyperprolactinemia. The disease was detected in 3 cases (3.2%) out of 94 people with hyperprolactinemia and pituitary adenoma without clinical manifestations of acromegaly. We consider the study of IGF-1 levels justified as a screening for acromegaly in patients with hyperprolactinemia and pituitary adenoma.
Neurofibromatosis type 1 associated with pheochromocytoma: a case report with a brief review of the literature
Authors: Lugovskaya A. Y. , Britvin T. A. , Gurevich L. E. , Rog I. S. , Nefedova L. N. , Ilovayskaya I. A.
Published: May 2024

We presented the clinical case of neurofibromatosis type 1 (NF-1) associated with pheochromocytoma (PHEO) in a man under 40 years old without family history. The diagnosis of NF-1 was established based on 4 signs of the disease (multiple café au lait macules, scoliotic changes in posture, the presence of multiple neurofibromas, Lisch nodules). The diagnosis of PHEO was determined by a significant increase of free metanephrin/normethanephrin levels in daily urine, a malignant CT phenotype of the right adrenal tumor, and confirmed by pathomorphological study. Genetic tests revealed a new mutation in one of the alleles of NF1 gene, a deletion of a 566 bp gene fragment, including exon 19 with a size of 73 bp. This mutation leads to splicing of exons 18 and 20, frameshift, and termination of protein synthesis. A study of the level of transcription of the genes associated with PHEO (RET, TMEM127, MAX, FGFR, MET, MERTK, BRAF, NGFR, Pi3, AKT, MTOR, KRAS, MAPK) was conducted, a statistically significant decrease in the level of transcription of the KRAS and BRAF genes and increase in the level of transcription of the TMEM127 gene in comparison with control samples have been detected. This case demonstrates the need for timely recognition of NF-1 for further appropriate patient’s follow up and show the effectiveness of a multidisciplinary approach to the diagnosis and treatment of NF-1-associated catecholamine-secreting tumors.
The clinical case of IgG4-related thyroid disease in a 6-year-old child
Authors: Kolodkina A. A. , Zubkova N. A. , Urusova L. S. , Bondarenko S. P. , Brovin D. N. , Anikiev A. V. , Bezlepkina O. B.
Published: May 2024

IgG4-related disease is a rare chronic pathology manifested by lymphoplasmacytic infiltration of one or more organs, the formation of storiform fibrosis, tissue edema, and an increase of IgG4 in the blood. This disease was singled out as an independent nosological unit only in 2001. The incidence is less than 1 in 100,000 people per year. Almost any organ can be affected in IgG4-related disease. The association of Riedel's thyroiditis with IgG4 was established in 2010. Riedel's thyroiditis is an extremely rare inflammatory disease of the thyroid gland, which diagnosis is complicated by an atypical course and the absence of characteristic symptoms. Less than 300 clinical cases of the disease have been described in the world, only two from them were in children. This article presents a clinical case of a 6-year-old boy with Riedel's thyroiditis.
What about adolescents’ mental health after the pandemics? An analyses of a grade II hospital
Authors: Mendonça Catarina , Passos Croca Gonçalo , Magalhães Teresa , Viegas Mariana , Marques Bárbara , Morais Andreia
Published: May 2024

Objectives

Suicidal ideation and suicide are serious situations that affect children and adolescents. The restrictions imposed by the SARS-CoV-2 pandemic have had a significant negative impact, due to social isolation, prolonged screen exposure and reduced outdoor activities. This study aims to compare the access to the Pediatric Emergency Department due to suicidal ideation and suicide attempts before and during the pandemic.

Methods

This descriptive and retrospective study analyzed clinical records of children/adolescents who attended a Level II Pediatric Emergency Department of a hospital due to suicidal ideation and/or suicide attempts, between March 2018 and March 2020 (pre-pandemic period) and April 2020 to March 2022 (pandemic period). Demographic (age and sex) and clinical (psychopharmacological therapy, discharge destination and follow-up psychiatric/psychological consultations) variables were collected. Statistical analysis was performed using Microsoft Excel 2022® and SPSS v20.0®, considering statistical significance at p<0.05.

Results

A total of 71 children/adolescents were admitted for suicidal ideation, with a median age of 15 years (minimum: 10 years, maximum: 17 years), 27 in pre-pandemic period and 44 in pandemic period (p<0.001). The majority were girls, with a significant increase in pandemic period (pre-pandemic: 55.6 %, pandemic: 79.6 %; p<0.05). The age group with the highest increase in admissions was 15 years. There was a significant increase in suicidal attempts among girls (p<0.05) as well as self-harm behaviors (p<0.01). There was also a significant increase in the number of psychology/child psychiatry follow-up consultations in pandemic period (p<0.05). Most patients were referred to another hospital in both periods (pre-pandemic: 55.6 %, pandemic: 68.2 %) at discharge.

Conclusions

During the pandemic period, there was an increase in the number of suicidal ideation cases, particularly among females, as well as in suicide attempts cases, which appears to be correlated with the pandemic restrictions. Larger-scale studies are needed to draw more accurate conclusions.
Wind-plus-storage integration in emerging markets – a GIS-driven proof-of-concept for Papua New Guinea
Authors: McClenny Ian , Tynes Emily , Xydis George
Published: May 2024

Developing nations are facing market, regulatory, and monetary issues that often prevent them from being on the cutting edge of the energy industry. Climate commitments set forth by international cooperation like the Paris Agreement are calling for countries to decarbonize their energy infrastructure. The International Finance Corporation (IFC) predicts that much of the development in the renewable energy sector is poised to come from developing nations; this is where the greatest opportunities lie for systemic change. This study will highlight the shifting trend towards wind-plus-storage, the development cycle of disruptive technologies, key characteristics of wind-plus-storage projects, and a discussion on best practices to stimulate market demand, technological innovation, and associated regulations. A case study in Oceania, in Papua New Guinea was constructed using ArcGIS as a proof of concept to highlight data that can be leveraged to preliminarily identify high potential sites for wind-plus-storage project development. A detailed map was revealed and the different wind-plus-storage options for future project development were found. It has not been studied so far how a wind-plus-storage project can contribute to more holistic energy systems in emerging markets, such as in the case of Papua New Guinea.
Relationship between learner creativity, task planning, and speaking performance in L2 narrative tasks
Authors: Qin Jie
Published: May 2024

This study examined the relationship between learners’ creativity viewed as a divergent thinking cognitive trait and the language/content dimensions of their L2 speaking performance under two task planning conditions, while controlling for the effects of L2 proficiency. Sixty-one Chinese learners of English took an Elicited Imitation Task, a verbal and a figural creativity test, and performed two picture-prompted narrative tasks. Results showed that when learners had time to plan, their L2 proficiency and creativity were predictors of their speaking performance in terms of fluency and idea productivity, while under the no planning condition, creativity predicted learners’ performance measured by idea productivity, discoursal structure, and lexical diversity. Moreover, different creativity measures contributed to L2 task performance in differential manners. This study contributes to the field by shedding light on the interaction between learner-related and task-related variables on L2 speaking production and the nature of the new individual difference variable of creativity.
Open mappings of locally compact groups
Authors: Cowling Michael G. , Hofmann Karl H. , Morris Sidney A.
Published: May 2024

The aim of this note is to insert in the literature some easy but apparently not widely known facts about morphisms of locally compact groups, all of which are concerned with the openness of the morphism.
Strong convergence for weighted sums of (α, β)-mixing random variables and application to simple linear EV regression model
Authors: Hu Wenjing , Wang Wei , Wu Yi
Published: May 2024

In this article, the complete convergence and the Kolmogorov strong law of large numbers for weighted sums of

(

α
,
β

)

\left(\alpha ,\beta )

-mixing random variables are presented. An application to simple linear errors-in-variables model is provided. Simulation studies are also carried out to support the theoretical results.
Marathon runner algorithm: theory and application in mathematical, mechanical and structural optimization problems
Authors: Mortazavi Ali
Published: May 2024

This study proposes a novel human-inspired metaheuristic search algorithm called marathon runner algorithm. This method mimics competitive behaviors observed in real marathon runners through mathematical modeling. Unlike classical elitist algorithms that prioritize position of the best agent, the marathon runner algorithm introduces a novel concept called vision point. This point considers the quality of the entire population, not just the leader. By guiding the population towards vision point, the risk of getting trapped in local optima is reduced. A two-part evaluation was conducted to thoroughly assess the search capabilities of the marathon runner algorithm. First, it is tested against a set of unconstrained benchmark mathematical functions and the algorithm’s quantitative attributes, such as complexity, accuracy, stability, diversity, sensitivity, and convergence rate are analyzed. Subsequently, the algorithm was applied to mechanical and structural optimization problems with both continuous and discrete variables. This application demonstrated the effectiveness of the algorithm in solving practical engineering challenges with constraints. The outcomes are compared with those obtained by six other well-established techniques. The obtained results indicate that the marathon runner algorithm yields promising and competitive solutions for both mathematical, mechanical, and structural problems.
Tools forCre-Mediated Conditional Deletion of Floxed Alleles from Developing Cerebellar Purkinje Cells
Authors: Jahncke Jennifer N. , Wright Kevin M.
Published: May 2024

The Cre-lox system is an indispensable tool in neuroscience research for targeting gene deletions to specific cellular populations. Here we assess the utility of several transgenicCrelines, along with a viral approach, for targeting cerebellar Purkinje cells (PCs) in mice. Using a combination of a fluorescent reporter line (Ai14) to indicateCre-mediated recombination and a floxed Dystroglycan line (Dag1flox), we show that reporter expression does not always align precisely with loss of protein. The commonly usedPcp2Creline exhibits a gradual mosaic pattern ofCrerecombination in PCs from Postnatal Day 7 (P7) to P14, while loss of Dag1 protein is not complete until P30.Ptf1aCredrives recombination in precursor cells that give rise to GABAergic neurons in the embryonic cerebellum, including PCs and molecular layer interneurons. However, due to its transient expression in precursors,Ptf1aCreresults in stochastic loss of Dag1 protein in these neurons.NestinCre, which is often described as a “pan-neuronal”Creline for the central nervous system, does not driveCre-mediated recombination in PCs. We identify aCalb1Creline that drives efficient and complete recombination in embryonic PCs, resulting in loss of Dag1 protein before the period of synaptogenesis.AAV8-mediated delivery ofCreat P0 results in gradual transduction of PCs during the second postnatal week, with loss of Dag1 protein not reaching appreciable levels until P35. These results characterize several tools for targeting conditional deletions in cerebellar PCs at different developmental stages and illustrate the importance of validating the loss of protein following recombination.
The Vestibulospinal Nucleus Is a Locus of Balance Development
Authors: Hamling Kyla R. , Harmon Katherine , Kimura Yukiko , Higashijima Shin-ichi , Schoppik David
Published: May 2024

Mature vertebrates maintain posture using vestibulospinal neurons that transform sensed instability into reflexive commands to spinal motor circuits. Postural stability improves across development. However, due to the complexity of terrestrial locomotion, vestibulospinal contributions to postural refinement in early life remain unexplored. Here we leveraged the relative simplicity of underwater locomotion to quantify the postural consequences of losing vestibulospinal neurons during development in larval zebrafish of undifferentiated sex. By comparing posture at two timepoints, we discovered that later lesions of vestibulospinal neurons led to greater instability. Analysis of thousands of individual swim bouts revealed that lesions disrupted movement timing and corrective reflexes without impacting swim kinematics, and that this effect was particularly strong in older larvae. Using a generative model of swimming, we showed how these disruptions could account for the increased postural variability at both timepoints. Finally, late lesions disrupted the fin/trunk coordination observed in older larvae, linking vestibulospinal neurons to postural control schemes used to navigate in depth. Since later lesions were considerably more disruptive to postural stability, we conclude that vestibulospinal contributions to balance increase as larvae mature. Vestibulospinal neurons are highly conserved across vertebrates; we therefore propose that they are a substrate for developmental improvements to postural control.
Breaking Points: Youth Mental Health Crises and How We All Can Help
Authors: Myers Neely Laurenzo
Published: May 2024

Unprecedented numbers of young people are in crisis today, and our health care systems are set up to fail them. Breaking Points explores the stories of a diverse group of American young adults experiencing psychiatric hospitalization for psychotic symptoms for the first time and documents how patients and their families make decisions about treatment after their release. Approximately half of young people refuse mental-health care after their initial hospitalization even though better outcomes depend on early support. In attempting to determine why this is the case, Neely Laurenzo Myers identifies what matters most to young people in crisis, passionately arguing that health care providers must attend not only to the medical and material dimensions of care but also to a patient’s moral agency.
An assessment of the inclusive early childhood development program (IncluDe) in Kandy district, Sri Lanka a case study
Authors: KMPD Jayasundara , A Hewamalage
Published: May 2024

Sri Lanka has identified the importance of providing quality and effective health care to all women, children, and families. In 1968, the Ministry of Health established the Family Health Bureau (FHB) to conduct the Maternal and Child Health (MCH) program nationally. The FHB's Inclusive Early Childhood Development Program (IncluDe), which will be phased across all districts, aims to systematically screen all Sri Lankan children to detect developmental delays and disabilities as early as possible and intervene through a multidisciplinary team approach to improve their quality of life. The purpose of this study is to evaluate the IncluDe program in the Kandy district and to prioritize the issues that need to be addressed to establish a comprehensive, sustainable program to serve the district's children with disabilities. Data collection was done by Key Informant Interviews, Focus Group Discussions, Team discussions, Observation visits to study settings, and review of secondary data. Numerous issues were identified across the program's service settings (Screening program of the children, Services of Child Development Intervention Center (CDIC), and specialized referrals at Tertiary Care Hospitals). Improving the comprehensiveness of care given at CDIC at rehabilitation hospital Digana, addressing the training needs of health staff, fulfilling the human resource requirement, and establishing a monitoring and evaluation mechanism of the program were among the priority problems. After conducting an in-depth analysis, recommendations were made to enhance the comprehensiveness of care provided at CDIC. The study reveals the importance of parallel development of all facets of the IncluDe program to provide adequate care to children with developmental delays and disabilities in the Kandy district. In conclusion, the Inclusive Early Childhood Development Program in Kandy District, Sri Lanka needs urgent attention in implementing measures to achieve its objectives successfully.
Synchronic basal skin cancer: resection and double full-thickness dermoepidermal graft in a comorbid patient. complex to simple
Authors: Ricciardi V Juan A , Avariano Yubisay , Infante Francisco , Masroua Bernardette Gil , Calles Garwin
Published: May 2024

Using skin flaps and grafts is a well-established and reliable method for skin reconstruction in plastic surgery. Although the surgical technique has been used for several decades, the basic principles remain similar. Factors such as skin thickness, color, and texture, the pattern of sun exposure, and adnexal quality should be considered when selecting the appro­priate donor site. Objective: Report a double full-thickness dermoepidermal graft as a reconstructive alternative in a comorbid patient instead of using local flaps. Clinical case: 80 years old comorbid male patient with a synchronic (scalp and frontal) morfeiform basal skin cancer who was taken under local anesthesia to perform an oncological resection and a double supraclavicular full-thickness dermoepidermal graft. Satisfactory evolution, well integrated double graft, adequate oncological management and acceptable aesthetic result. Conclusion: Soft tissue reconstruction is performed according to the size and depth of the wound. If the pericranium is viable split-thickness skin grafts can be used for quick and simple reconstruction, but the first choice for reconstruction is usually local scalp tissue. However, in cases like these one, when a comorbid patient can have cardiovascular complications at the operation room, the full-thickness graft under local anesthesia are quickly and less risk reconstructive option. Besides, lateral forehead defects can be managed with a skin graft alone over an intact pericranium. Finally, after 1cm margins resection in a morfeiform basal skin cancer, soft tissue coverage with several options like skin graft are acceptable.