bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiomyopathy associated 5 (CMYA5) implicated as a genetic risk factor for radial hemimelia in Siamese cats
Authors: Bilgen Nüket , Çınar Kul Bengi , Akkurt Mustafa Yenal , Bakıcı Caner , Buckley Reuben M , Lyons Leslie A , Coghill Lyndon M , Çıldır Özge Şebnem , Kutlu Furkan
Published: October 2023

Objectives

The present study aimed to determine the inheritance pattern and genetic cause of congenital radial hemimelia (RH) in cats.

Methods

Clinical and genetic analyses were conducted on a Siamese cat family (n = 18), including two siblings with RH. Radiographs were obtained for the affected kittens and echocardiograms of an affected kitten and sire. Whole genome sequencing was completed on the two cases and the parents. Genomic data were compared with the 99 Lives Cat Genome data set of 420 additional domestic cats with whole genome and whole exome sequencing data. Variants were considered as homozygous in the two cases of the siblings with RH and heterozygous in the parents. Candidate variants were genotyped by Sanger sequencing in the extended pedigree.

Results

Radiographs of the female kitten revealed bilateral absence of the radii and bowing of the humeri, while the male kitten showed a dysplastic right radius. Echocardiography suggested the female kitten had restrictive cardiomyopathy with a positive left atrial-to-aortic root ratio (LA:Ao = 1.83 cm), whereas hypertrophic cardiomyopathy was more likely in the sire, showing diastolic dysfunction using tissue Doppler imaging (59.06 cm/s). Twenty-two DNA variants were unique and homozygous in the affected kittens and heterozygous in the parents. Seven variants clustered in one chromosomal region, including two frameshift variants in cardiomyopathy associated 5 ( CMYA5) and five variants in junction mediating and regulatory protein, P53 cofactor ( JMY ), including a missense and an in-frame deletion.

Conclusions and relevance

The present study suggested an autosomal recessive mode of inheritance with variable expression for RH in the Siamese cat family. Candidate variants for the phenotype were identified, implicating their roles in bone development. These genes should be considered as potentially causal for other cats with RH. Siamese cat breeders should consider genetically testing their cats for these variants to prevent further dissemination of the suspected variants within the breed.
Investigation of the tribological properties of POM and UHMWPE radial journal bearings made with different surface quality
Authors: Artun Yakup , Azeloglu C Oktay , Taylan Gökhan
Published: October 2023

Journal bearings are essential machine elements that are widely used in the bearing of rotating or oscillating machine parts. Many studies in the literature examine the tribological properties of journal bearings. Most of these studies focus on polymer journal bearings and testing the tribological performances of different bearing materials with the same surface quality. In this article, radial journal bearings produced from ultra-high molecular weight polyethylene (UHMWPE) material and polyoxymethylene (POM) material in two different surface qualities in the range of N7–N8 and N10–N11 were tested under different load and different speed scenarios and their tribological performances and relationship of this performance between material and surface roughness were investigated. For this purpose, first of all, bearing samples were designed and manufactured. All samples’ tribological and physical properties before the tests were measured, and then tests were carried out according to the determined scenarios. Different loads, different speeds, and different sliding distances were used in the scenarios. As a result, 96 tests were carried out by testing each situation three times in eight scenarios, with two different surface qualities from two different materials. In the tests, the friction coefficient, temperature, and weight loss values of all samples were measured, and after the tests, surface roughness measurements and SEM analyses were made. As a result, all the data obtained from the tests and measuring devices were compared with the pre-test conditions and material and surface quality. The results obtained from the comparisons and the evaluations of tribological performance are discussed in the conclusion part. The study results show that the material and the surface quality significantly affect the tribological performance.
‘Je te crois’ (‘I believe you’): Pragmatics of a feminist slogan, or silencing and the scene of address in post-#MeToo France
Authors: Gaillard Julie
Published: October 2023

In the context of a failure of #MeToo in France and in light of the intrinsic limitations of this movement, ‘I believe you’ has become one of the battle cries of contemporary French feminism, appearing on protest signs during activist performances and demonstrations, but also on street-pastings disseminated in urban spaces by grassroots feminist collectives. Through a pragmatic analysis of this statement-slogan paradoxically addressed to everyone singularly and to no one in particular, this article demonstrates the performative dimension of post-#MeToo French feminism which aims at once to individually repair and collectively denounce the wrong caused by the silencing of victims of sexual and gender-based violence. Building on Jean-François Lyotard’s philosophical elaboration of the phrastic mechanisms at stake in negationism, as well as feminist scholarship on believability, to demonstrate how the pragmatics of silencing throws survivors into a state of social death, I show how ‘I believe you’ – through the interplay of first- and second-person pronouns – allows the re-subjectivation of individual survivors who encounter it serendipitously in public spaces. Turning to the contextual analysis of activist configurations that have recently mobilized ‘je te crois’ in public space, I then show how this slogan creates feminist counter-spaces where the vulnerability of assembled bodies becomes the site of political subversion.
Zoom-ing with Padlet: Overcoming challenges to deliver emergency remote teaching to young learners in Trinidad
Authors: Abdul-Majied Sabeerah , Figaro-Henry Sandra
Published: October 2023

When school closure was mandated due to COVID-19, staff at a university lab preschool in Trinidad rapidly switched to remote teaching. Although the six teachers were experienced early childhood educators, they were unfamiliar with teaching remotely using video conferencing tools and websites. Guided by a consultant and an educational technologist, an indigenous remote early childhood program for 3- to 4-year-old learners was introduced using the Padlet platform and Zoom. This qualitative descriptive case study investigated the challenges teachers experienced and how they adapted to provide continuity in teaching in a changed pedagogical context. Using the Resilience in Human Development theoretical framework the research questions asked: What were the challenges experienced by early childhood teachers in delivering their first emergency remote teaching program? And, how did teachers overcome the challenges which arose in delivering emergency remote teaching to young learners? Guided by Creswell’s (2016) recommendation to collect and analyze data from multiple sources, teacher questionnaires, written teacher reflections, parent questionnaires, and feedback provided by a consultant were the data sources. Findings revealed themes related to five teacher challenges and four parent challenges. The strategies used to overcome the challenges included: Becoming proactive, Introducing Innovations, and Tapping into motivation. Policy implications and recommendations to support continuity in teaching during emergencies at the school and national levels are included.
Case study: Repowering of ORC system by means of experimental test bench with supercritical carbon dioxide, proposal, and field experience improvements
Authors: Domínguez Pedro , Alarcón Rodrigo , Aviña Héctor , de Santiago Oscar
Published: October 2023

Although organic Rankine cycles (ORCs) have cornered the small-scale energy harvesting market, the generation capacities produced by sCO2 cycles far exceed those of ORCs, reaching higher powers and efficiencies. This paper analyzes the results of the field tests performed in 2022 at the Grupo Dragón, Nayarit, Mexico, facilities, in which the objective was to validate the operation of the ORC IDEA-10 system with a capacity of up to 10 kWe. The thermodynamic states reached during the test time lapses in which there was full operational stability and with direct loads are analyzed. The results obtained together with proposals for improvement led to compare the performance of ORCs with sCO2 systems for low temperature geothermal sources. The efficiencies of simple sCO2 cycles (5.32%) turned out to be lower than that of ORC at the same temperatures (9.7%), however, the efficiency of the sCO2 cycle improved notably in a regenerative configuration, given the properties of CO2 near its critical point, reaching efficiencies above 25% even at low temperatures compared to conventional ORCs with efficiencies below 10%. Finally, the basis for the implementation of sCO2 in low enthalpy geothermal applications was established, designing an experimental circuit with results obtained in the literature.
Sociodemographic analysis of unbraced unbolted cripple wall retrofits in the City of Los Angeles
Authors: Burton Henry V , Galicia Madero Sebastian , Kologo Awa , Dahal Laxman , Derakhshan Sahar
Published: October 2023

Disparities in seismic risk mitigation programs can lead to uneven impacts during an earthquake and an increased burden on socially vulnerable and underserved communities. This article examines the extent to which the distribution of cripple wall retrofits in residential buildings (primarily one- and two-family units) located within the City of Los Angeles (LA), varies based on the sociodemographics of the affected populations. Utilizing multiple data sources including the LA Department of Building and Safety (LADBS) and LA Open Data Portal (LAOPD), a combination of spatial and statistical approaches are implemented at the regional, neighborhood, and census-tract scales. At each scale, the number of retrofitted buildings normalized by the total number of pre-1980 one- and two-family residential buildings (or retrofit rate) is the primary dependent variable. The effect of the Earthquake Brace and Bolt (EBB) program on the disparities in the retrofit rate distribution is also assessed. Despite having relatively older one- and two-family residential buildings, those neighborhoods with the highest representation of Black and Hispanic households are generally associated with lower retrofit rates. We also found that the neighborhoods with the lowest median income have retrofit rates that are less than the average for the entire City of LA. The rate among Black, Hispanic, and low-income households was found to increase significantly after the EBB program was instituted in 2013, suggesting that the initiative may have served as a mechanism to reduce the demographic and economic disparities in the cripple wall retrofits. However, to date, the average retrofit rate in the ten neighborhoods with the highest representation of Hispanic households is roughly one-third that of the rest of LA City.
Cell-of-origin effect of polatuzumab vedotin in diffuse large B-cell lymphoma: no ordinary subgroup analysis
Authors: Russler-Germain David A. , Cliff Edward R. Scheffer , Bartlett Nancy L.
Published: October 2023

Subgroup analysis from the POLARIX trial of polatuzumab vedotin plus chemotherapy for untreated large B-cell lymphoma suggests greater efficacy among patients with activated B-cell subtype disease. Both preclinical and additional clinical evidence support this interaction between cell-of-origin and polatuzumab efficacy.
Incidence change of postoperative delirium after implementation of processed electroencephalography monitoring during surgery: a retrospective evaluation study
Authors: Chen Yi-Chen , Hung I-Yin , Hung Kuo-Chuan , Chang Ying-Jen , Chu Chin-Chen , Chen Jen-Yin , Ho Chung-Han , Yu Chia-Hung
Published: October 2023

Background

Postoperative delirium (POD) is a common complication in the elderly, which is associated with poor outcomes after surgery. Recognized as predisposing factors for POD, anesthetic exposure and burst suppression during general anesthesia can be minimized with intraoperative processed electroencephalography (pEEG) monitoring. In this study, we aimed to evaluate whether implementation of intraoperative pEEG-guided anesthesia is associated with incidence change of POD.

Methods

In this retrospective evaluation study, we analyzed intravenous patient-controlled analgesia (IVPCA) dataset from 2013 to 2017. There were 7425 patients using IVPCA after a noncardiac procedure under general anesthesia. Patients incapable of operating the device independently, such as cognitive dysfunction or prolonged sedation, were declined and not involved in the dataset. After excluding patients who opted out within three days (N = 110) and those with missing data (N = 24), 7318 eligible participants were enrolled. Intraoperative pEEG has been implemented since July 2015. Participants having surgery after this time point had intraoperative pEEG applied before induction until full recovery. All related staff had been trained in the application of pEEG-guided anesthesia and the assessment of POD. Patients were screened twice daily for POD within 3 days after surgery by staff in the pain management team. In the first part of this study, we compared the incidence of POD and its trend from 2013 January–2015 July with 2015 July–2017 December. In the second part, we estimated odds ratios of risk factors for POD using multivariable logistic regression in case-control setting.

Results

The incidence of POD decreased from 1.18 to 0.41% after the administration of intraoperative pEEG. For the age group ≧ 75 years, POD incidence decreased from 5.1 to 1.56%. Further analysis showed that patients with pEEG-guided anesthesia were associated with a lower odd of POD (aOR 0.33; 95% CI 0.18–0.60) than those without after adjusting for other covariates.

Conclusions

Implementation of intraoperative pEEG was associated with a lower incidence of POD within 3 days after surgery, particularly in the elderly. Intraoperative pEEG might be reasonably considered as part of the strategy to prevent POD in the elder population.

Trial registration

Not applicable.
Association of preoperative electrocardiographic markers with sepsis in elderly patients after general surgery
Authors: Xie WeiXian , Wu LiXia , Yang MeiXing , Luo HongLi , Li Weichao , Li Heng
Published: October 2023

Background

Electrocardiographic markers, as surrogates for sympathetic excitotoxicity, are widely predictive of cardiovascular adverse events, but whether these markers can predict postsurgical sepsis (SS) is unclear.

Methods

We retrospectively analyzed patients who underwent abdominal surgery from March 2013 to May 2023. We collected basic data, comorbidities, blood samples, echocardiology, electrocardiogram, and surgical data, as well as short-term outcome. The primary endpoints were postsurgical SS, in which logistic regression analyses can identify independent risk factors. The optimal cut-off value predictive postsurgical SS both P wave and PR interval were calculated in the receiver operating characteristic curve (ROC).

Results

A total of 1988 subjects were analyzed, and the incidence of postsurgical SS was 3.8%. The mean age at enrollment was 68.6 ± 7.1 years, and 53.2% of the participants were men. In the ROC analysis, the areas under the curve (AUC) for P wave and PR interval predictive postsurgical SS were 0.615 (95%CI, 0.548–0.683; p = 0.001) and 0.618 (95%CI, 0.554–0.682; p = 0.001), respectively. The P wave and PR interval predicted postoperative sepsis with optimal discrimination of 103 and 157 ms, with a sensitivity of 0.744 and 0.419, and a specificity of 0.427 and 0.760. P-wave less than 103 ms or PR interval less than 157 ms associated with a 2.06 or 2.33 fold increase occurred risk postsurgical SS.

Conclusions

Shorter P-wave and PR intervals were both independently associated with postsurgical SS. These preoperative electrophysiological markers could have potential useful for early recognition of postoperative SS.
Uncoupling of the center-to-periphery arterial stiffness gradient and pulse pressure amplification in viral pneumonia infection
Authors: Jin Lin , Wu Lingheng , Chen Jianxiong , Zhang Mengjiao , Sun Jiali , Shen Cuiqin , Du Lianfang , She Xiaoyin , Li Zhaojun
Published: October 2023

Objectives

Arterial stiffness is a common manifestation of viral pneumonia infections, including COVID-19. Nevertheless, the relationship between the center-to-periphery arterial stiffness gradient and pulse pressure amplification (PPA) in infectious diseases remains unclear. This study aimed to investigate this relationship utilizing arterial pressure volume index (API) and arterial velocity pulse index (AVI) ratio.

Methods

API/AVI and PPA were measured in 219 participants with COVID-19 and 374 normal participants. Multiple linear regression was used to assess the association of API/AVI and PPA, and restricted cubic spline was used to investigate the non-linear relationship between API/AVI and PPA. Receiver operating characteristic curve (ROC) analysis was used to evaluate the effects of API/AVI in identifying COVID-19 infection and severe stage.

Results

There was a significant J-shaped relationship between API/AVI and PPA in COVID-19 group, while a M-shaped relationship was observed in normal group. API/AVI decreased rapidly as PPA decreased until API/AVI decreased slowly at PPA of 1.07, and then API/AVI decreased slowly again at PPA of 0.78. ROC results showed that API/AVI demonstrated excellent accuracy in identifying COVID-19 infection (AUC = 0.781) and a high specificity (84.88%) in identifying severe stage.

Conclusions

There was a J-shaped association between the API/AVI and PPA in viral infected patients, while a M-shaped relationship in the normal participants. API/AVI is better for identifying infected and uninfected patients, with a high specificity in identifying those in severe stages of the disease. The attenuation or reversal of API/AVI may be associated with the loss of PPA coupling.
Gait video-based prediction of unified Parkinson’s disease rating scale score: a retrospective study
Authors: Eguchi Katsuki , Takigawa Ichigaku , Shirai Shinichi , Takahashi-Iwata Ikuko , Matsushima Masaaki , Kano Takahiro , Yaguchi Hiroaki , Yabe Ichiro
Published: October 2023

Background

The diagnosis of Parkinson’s disease (PD) and evaluation of its symptoms require in-person clinical examination. Remote evaluation of PD symptoms is desirable, especially during a pandemic such as the coronavirus disease 2019 pandemic. One potential method to remotely evaluate PD motor impairments is video-based analysis. In this study, we aimed to assess the feasibility of predicting the Unified Parkinson’s Disease Rating Scale (UPDRS) score from gait videos using a convolutional neural network (CNN) model.

Methods

We retrospectively obtained 737 consecutive gait videos of 74 patients with PD and their corresponding neurologist-rated UPDRS scores. We utilized a CNN model for predicting the total UPDRS part III score and four subscores of axial symptoms (items 27, 28, 29, and 30), bradykinesia (items 23, 24, 25, 26, and 31), rigidity (item 22) and tremor (items 20 and 21). We trained the model on 80% of the gait videos and used 10% of the videos as a validation dataset. We evaluated the predictive performance of the trained model by comparing the model-predicted score with the neurologist-rated score for the remaining 10% of videos (test dataset). We calculated the coefficient of determination (R2) between those scores to evaluate the model’s goodness of fit.

Results

In the test dataset, theR2values between the model-predicted and neurologist-rated values for the total UPDRS part III score and subscores of axial symptoms, bradykinesia, rigidity, and tremor were 0.59, 0.77, 0.56, 0.46, and 0.0, respectively. The performance was relatively low for videos from patients with severe symptoms.

Conclusions

Despite the low predictive performance of the model for the total UPDRS part III score, it demonstrated relatively high performance in predicting subscores of axial symptoms. The model approximately predicted the total UPDRS part III scores of patients with moderate symptoms, but the performance was low for patients with severe symptoms owing to limited data. A larger dataset is needed to improve the model’s performance in clinical settings.
Machine learning applied to fMRI patterns of brain activation in response to mutilation pictures predicts PTSD symptoms
Authors: Portugal Liana Catarina Lima , Ramos Taiane Coelho , Fernandes Orlando , Bastos Aline Furtado , Campos Bruna , Mendlowicz Mauro Vitor , da Luz Mariana , Portella Carla , Berger William , Volchan Eliane , David Isabel Antunes , Erthal Fátima , Pereira Mirtes Garcia , de Oliveira Leticia
Published: October 2023

Background

The present study aimed to apply multivariate pattern recognition methods to predict posttraumatic stress symptoms from whole-brain activation patterns during two contexts where the aversiveness of unpleasant pictures was manipulated by the presence or absence of safety cues.

Methods

Trauma-exposed participants were presented with neutral and mutilation pictures during functional magnetic resonance imaging (fMRI) collection. Before the presentation of pictures, a text informed the subjects that the pictures were fictitious (“safe context”) or real-life scenes (“real context”). We trained machine learning regression models (Gaussian process regression (GPR)) to predict PTSD symptoms in real and safe contexts.

Results

The GPR model could predict PTSD symptoms from brain responses to mutilation pictures in the real context but not in the safe context. The brain regions with the highest contribution to the model were the occipito-parietal regions, including the superior parietal gyrus, inferior parietal gyrus, and supramarginal gyrus. Additional analysis showed that GPR regression models accurately predicted clusters of PTSD symptoms, nominal intrusion, avoidance, and alterations in cognition. As expected, we obtained very similar results as those obtained in a model predicting PTSD total symptoms.

Conclusion

This study is the first to show that machine learning applied to fMRI data collected in an aversive context can predict not only PTSD total symptoms but also clusters of PTSD symptoms in a more aversive context. Furthermore, this approach was able to identify potential biomarkers for PTSD, especially in occipitoparietal regions.
Use of home and community-based services and loneliness in older people with functional limitations: a cross-sectional study
Authors: Zhang Jinxin , Sun Xiaojie , Yao Aaron
Published: October 2023

Background

Loneliness is one of the major health problems among older adults. Among this population, home and community-based services (HCBS) have become increasingly popular. Despite its health benefits, little is known about the relationship between HCBS use and loneliness in older people with functional limitations. We aim to explore the characteristics of loneliness among older people with functional limitations and examine the association between HCBS use and loneliness in China.

Methods

We used a cross-sectional data from the 2018 China Health and Retirement Longitudinal Study, which includes a nationally representative sample of Chinese residents aged 65 and older with functional limitations. Logistic regression models were used to examine the associations between HCBS use and loneliness, and we further used propensity score matching to address potential sample selection bias.

Result

In China, 46% of older people with functional limitations felt lonely and only 22% of older people with functional limitations reported using HCBS in 2018. Compared with participants who did not receive HCBS, those who received HCBS were less likely to report loneliness (OR = 0.81, 95% CI = 0.63, 0.99,p = 0.048), and the results remained significant after addressing sample selection bias using propensity score matching.

Conclusion

Our results showed that loneliness was common among Chinese older people with functional limitations, and the proportion of HCBS use was low. There was robust evidence to support that among older people with functional limitations, HCBS use was associated with decreased loneliness. Further policies should promote the development of broader HCBS use for older people with functional limitations to reduce their loneliness.
Facilitators and barriers to engaging communities in health service research on dengue control in Indo-Pacific region: a systematic review
Authors: Naing Cho , Htet Norah Htet , Tung Wong Siew , Aung Htar Htar , Whittaker Maxine A.
Published: October 2023

Background

Dengue is a public health problem in the Indo-Pacific countries. There are concerns over the facilitators and barriers to community engagement in health service research aimed at dengue control. The objective of his study was to identify and synthesize facilitators and barriers to community engagement in health service research aimed at dengue control.

Methodology

The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) checklist was used to perform this review. Health-related databases including PubMed, Ovid, and Google Scholar were searched for relevant studies. A consolidated framework with five domains was developed after undertaking a six-phase reflective thematic assessment of the data.

Results

Thirteen studies were identified, spanning eight low-and middle-income countries of the Indo-Pacific region including Cambodia, India, Indonesia, Myanmar, Philippines, Sri Lanka, Thailand, and Vietnam. The studies in this review covered the period from 2002 to 2021. A broad range of study designs and objectives were revealed across these 13 studies. An array of communities such as the local government, project-related health staff, local health services staff, community leaders, local communities/residences/general public, heads of households, community health volunteers, school teachers, and schoolchildren participated in these dengue related studies. The five Consolidated Framework for Implementation Research (CFIR) domains of ‘intervention characteristics’, ‘inner setting’, ‘outer setting’,’ individual characteristics’, and ‘program implementations’ were used to identify and describe barriers and facilitators.

Conclusions

The findings indicate a range of barriers and facilitators to community engagement in dengue control in the selected LMIC in the Indo-Pacific countries. Future health services research on dengue control approaches should be carefully planned, methodologically constructed, aligned with community engagement principles, and involve considerable community participation at all stages of the research.
Assessing the barriers and facilitators of climate action planning in local governments: a two-round survey of expert opinion
Authors: Dodd Steven , Butterfield Scott , Davies Jessica , Furbo Mette Kragh , Morris Abigail , Brown Heather
Published: October 2023

Background

Climate change is one of the greatest threats to public health in this century. The UK is one of six countries that has enshrined in law a commitment to become net zero by 2050. However, there is a lack of guidance and structure for local government in the UK, which has responsibility for public health, to reach this goal and help their communities mitigate and adapt to the health and health inequality impacts of climate change. This study aimed to identify common barriers and facilitators related to addressing the health and health inequality impacts of climate change in local governments.

Methods

Using Normalisation Process Theory, we developed a two-round survey for people working in local authorities to identify the barriers and facilitators to including the health and health inequality impact of climate change in their climate action plans. The survey was delivered online via Qualtrics software. In the first-round respondents were able to express their views on barriers and facilitators and in the second round they ranked common themes identified from the first round. Two hundred and fifty people working in local government were invited to take part and n = 28 (11.2%) completed the first round of the survey and n = 14 completed the second round. Thematic analysis was used in Round 1 to identify common themes and weighted rankings were used to assess key barriers and facilitators in Round 2.

Results

Key facilitators were the need to save money on energy, and successful partnership working already in place including across local government, with local communities and external stakeholders. Key barriers were insufficient staff, resources and lack of support from management/leaders, and lack of local evidence.

Conclusion

To mitigate and adapt to the health impacts of climate change, local government must nurture a culture of innovation and collaboration to ensure that different departments work together This means not just working with external partners, but also collaborating and co-producing with communities to achieve health equity and mitigate the debilitating effect of climate change on public health.
Smartphone-based application to control and prevent overweight and obesity in children: design and evaluation
Authors: Zare Zahra , Hajizadeh Elmira , Mahmoodi Maryam , Nazari Reza , Shahmoradi Leila , Rezayi Sorayya
Published: October 2023

Background

Obesity is a multifaceted condition that impacts individuals across various age, racial, and socioeconomic demographics, hence rendering them susceptible to a range of health complications and an increased risk of premature mortality. The frequency of obesity among adolescent females in Iran has exhibited an increase from 6 to 9%, while among boys, it has risen from 2 to 7%. Due to the increasing prevalence and advancements in technology, the primary objective of this study was to develop and evaluate a smartphone-based app that would serve as an educational tool for parents about the matter of childhood overweight and obesity. Additionally, the app aimed to enhance parents’ capacity to effectively address and manage their children’s weight-related concerns.

Methods

The design of the present study is of an applied-developmental type. In the first phase, the content of related smartphone-based app was determined based on the needs identified in similar studies and the findings of a researcher-made questionnaire. The versions of the app were designed in the android studio 3 programming environment, using the Java 8 programming language and SQLite database. Then, in order to evaluate the app’s usability, ease of access, and different features, the standard usability evaluation questionnaire and the user satisfaction questionnaire (QUIS) were completed by the users.

Results

The developed app has five main sections: the main page, recommendation section (with eight parts), charts over the time, child psychology, and reminders for each user. The designed app was given to 20 people including nutritionists and parents with children under 18 years of age for conducting usability evaluation. According to the scores of participants about the usability evaluation of the app, it can be concluded that groups participating in the study could use the program, and they rated the app at a “good” level. Overall performance of the app, screen capabilities, terms and information of the program, learnability, and general features are scored higher than 7.5 out of 9.

Conclusion

By using this app, people can become familiar with the causes and symptoms of weight imbalance and manage their weight as best as possible. This app can be considered as a model for designing and creating similar broader systems and programs for the prevention, management, treatment and care of diseases, which aim to help control diseases as much as possible and increase the quality of life and reduce complications for be patients.
Research on the doctors’ win in crowdsourcing competitions: perspectives on service content and competitive environment
Authors: Zhou Xiuxiu , Guo Shanshan , Wu Hong
Published: October 2023

Medical crowdsourcing competitions can help patients get more efficient and comprehensive treatment advice than “one-to-one” service, and doctors should be encouraged to actively participate. In the crowdsourcing competitions, winning the crowdsourcing competition is the driving force for doctors to continue to participate in the service. Therefore, how to improve the winning probability needs to be revealed. From the service content and competitive environment perspectives, this study introduces doctor competence indicators to investigate the key influence factors of doctors’ wins on the online platform. The results show that the emotional interaction in doctors’ service content positively influences doctors’ wins. However, the influence of information interaction presents heterogeneity. Conclusive information helps doctors win, while suggestive information negatively affects them. For the competitive environment, the competitive environment negatively moderates the relationship between doctors’ service content and doctors’ wins. The results of this study provide important contributions to the research on crowdsourcing competitions and online healthcare services and guide the participants of the competition, including patients, doctors, and platforms.
Critical care capacity and care bundles on medical wards in Malawi: a cross-sectional study
Authors: Connolly Emilia , Kasomekera Noel , Sonenthal Paul D. , Nyirenda Mulinda , Marsh Regan H. , Wroe Emily B. , Scott Kirstin W. , Bukhman Alice , Minyaliwa Tadala , Katete Martha , Banda Grace , Mukherjee Joia , Rouhani Shada A.
Published: October 2023

Introduction

As low-income countries (LICs) shoulder a disproportionate share of the world’s burden of critical illnesses, they must continue to build critical care capacity outside conventional intensive care units (ICUs) to address mortality and morbidity, including on general medical wards. A lack of data on the ability to treat critical illness, especially in non-ICU settings in LICs, hinders efforts to improve outcomes.

Methods

This was a secondary analysis of the cross-sectional Malawi Emergency and Critical Care (MECC) survey, administered from January to February 2020, to a random sample of nine public sector district hospitals and all four central hospitals in Malawi. This analysis describes inputs, systems, and barriers to care in district hospitals compared to central hospital medical wards, including if any medical wards fit the World Federation of Intensive and Critical Care Medicine (WFSICCM) definition of a level 1 ICU. We grouped items into essential care bundles for service readiness compared using Fisher’s exact test.

Results

From the 13 hospitals, we analysed data from 39 medical ward staff members through staffing, infrastructure, equipment, and systems domains. No medical wards met the WFSICCM definition of level 1 ICU. The most common barriers in district hospital medical wards compared to central hospital wards were stock-outs (29%, Cl: 21% to 44% vs 6%, Cl: 0% to 13%) and personnel shortages (40%, Cl: 24% to 67% vs 29%, Cl: 16% to 52%) but central hospital wards reported a higher proportion of training barriers (68%, Cl: 52% to 73% vs 45%, Cl: 29% to 60%). No differences were statistically significant.

Conclusion

Despite current gaps in resources to consistently care for critically ill patients in medical wards, this study shows that with modest inputs, the provision of simple life-saving critical care is within reach. Required inputs for care provision can be informed from this study.
Hsa_circRNA_102051 regulates colorectal cancer proliferation and metastasis by mediating Notch pathway
Authors: Chen Zhongsheng , Cheng Haiyu , Zhang Jiandong , Jiang Dongbing , Chen Gang , Yan Shunkang , Chen Wen , Zhan Wei
Published: October 2023

Background

The purpose of this study was to investigate the role of hsa_circRNA_102051 in colorectal cancer (CRC) and its effect on the stemness of tumor cells.

Methods

CircRNA microarray was under analysis to screen differentially expressed novel circRNAs in the pathology of CRC. Quantitative real-time PCR was used to detect the relative RNA expression in CRC cells and samples. The effects of hsa_circRNA_102051 on biological functions in CRC cells were accessed both in vitro and in vivo. FISH, RIP and luciferase reporter assay were conducted to confirm the regulatory correlations between hsa_circRNA_102051 and miR-203a, as well as miR-203a and BPTF. Xenograft models were applied to further verify the impacts and fluctuations of hsa_circRNA_102051/miR-203a/BPTF. Moreover, the mechanism how hsa_circRNA_102051 affected the Notch signals was also elucidated.

Results

Hsa_circRNA_102051 was up-regulated in CRC tissues and cell lines, capable to promote the growth and invasion of CRC. In addition, hsa_circRNA_102051 could enhance stemness of CRC cells. BPTF was identified as downstream factors of hsa_circRNA_102051, and miR-203a was determined directly targeting both hsa_circRNA_102051 and BPTF as an intermediate regulator. Hsa_circRNA_102051 in CRC could block miR-203a expression, and subsequently activated BPTF. Hsa_circRNA_102051/miR-203a/BPTF axis modulated stemness of CRC cells by affecting Notch pathway.

Conclusions

Our findings provided new clues that hsa_circRNA_102051 might be a potential predictive or prognostic factor in CRC, which induced the fluctuation of downstream miR-203a/BPTF, and subsequently influenced tumor growth, activities and stemness. Thereinto, the Notch signals were also involved. Hence, the hsa_circRNA_102051/miR-203a/BPTF axis could be further explored as a therapeutic target for anti-metastatic therapy in CRC patients.
Are U.S. food and beverage companies now advertising healthy products to children on television? An evaluation of improvements in industry self-regulation, 2017–2021
Authors: Jensen Melissa L. , Fleming-Milici Frances , Harris Jennifer L.
Published: October 2023

Background

Through the Children’s Food and Beverage Advertising Initiative (CFBAI), U.S. food companies pledge to only advertise healthier products in children’s television (TV) programming, but previous research shows that highly advertised products do not qualify as nutritious according to independent nutrition criteria. In 2020, the CFBAI implemented stricter nutrition criteria for products that may be advertised to children, but the potential impact of these changes has not been assessed. This observational study evaluates (1) improvements in energy and individual nutrient composition of products that companies indicated may be advertised to children (i.e., CFBAI-listed products) in 2020 versus 2017, (2) amount of advertising on children’s TV for CFBAI-listed versus other products in 2021, and 3) the nutrition quality of advertised versus non-advertised CFBAI-listed products.

Methods

Data include energy, saturated fat, sodium, and sugar content and overall nutrition quality (Nutrition Profile Index [NPI] scores) of CFBAI-listed products in 2017 (n = 308) and 2020 (n = 245). Nielsen data provided total ad spending and children’s exposure to ads on children’s TV channels for all foods and beverages in 2021.

Results

From 2017 to 2021, energy, saturated fat and sugar declined for CFBAI-listed products in three of six food categories (yogurt, sweet and salty snacks). Although CFBAI-listed products accounted for 79% of food ads viewed by children on children’s TV channels, just 50% of CFBAI-listed food and 36% of drink brands were advertised on children’s TV. Moreover, advertised products were significantly less nutritious than non-advertised CFBAI-listed products.

Conclusion

Despite revised nutrition standards and improvements in nutrient content of some product categories, participating companies continued to primarily advertise nutritionally poor food and beverages on children’s TV. CFBAI companies have not delivered on their promises to advertise healthier products to children.
Mitochondrial heteroplasmic shifts reveal a positive selection of breast cancer
Authors: Li Yanni , Sundquist Kristina , Vats Sakshi , Hong Mun-Gwan , Wang Xiao , Chen Yilun , Hedelius Anna , Saal Lao H. , Sundquist Jan , Memon Ashfaque A.
Published: October 2023

Background

Breast cancer is, despite screening, not always detected early enough and is together with other tumor types known to shed genetic information in circulation. Unlike single-copy nuclear DNA, mitochondrial DNA (mtDNA) copies range from 100s to 10,000s per cell, thus providing a potentially alternative to identify potential missing cancer information in circulation at an early stage.

Methods

To characterize mitochondrial mutation landscapes in breast cancer, whole mtDNA sequencing and bioinformatics analyses were performed on 86 breast cancer biopsies and 50 available matched baseline cancer-free whole blood samples from the same individuals, selected from a cohort of middle-aged women in Sweden. To determine whether the mutations can be detected in blood plasma prior to cancer diagnosis, we further designed a nested case-control study (n = 663) and validated the shortlisted mutations using droplet digital PCR.

Results

We detected different mutation landscapes between biopsies and matched whole blood samples. Compared to whole blood samples, mtDNA from biopsies had higher heteroplasmic mutations in the D-loop region (P = 0.02),RNR2(P = 0.005),COX1(P = 0.037) andCYTB(P = 0.006). Furthermore, the germline mtDNA mutations had higher heteroplasmy level than the lost (P = 0.002) and de novo mutations (P = 0.04). The nonsynonymous to synonymous substitution ratio (dN/dS) was higher for the heteroplasmic mutations (P = 7.25 × 10−12) than that for the homoplasmic mutations, but the de novo (P = 0.06) and lost mutations (P = 0.03) had lower dN/dS than the germline mutations. Interestingly, we found that the critical regions for mitochondrial transcription: MT-HSP1 (odds ratio [OR]: 21.41), MT-TFH (OR: 7.70) and MT-TAS2 (OR: 3.62), had significantly higher heteroplasmic mutations than the rest of the D-loop sub-regions. Finally, we found that the presence of mt.16093T > C mutation increases 67% risk of developing breast cancer.

Conclusions

Our findings show that mitochondrial genetic landscape changes during cancer pathogenesis and positive selection of mtDNA heteroplasmic mutations in breast cancer. Most importantly, the mitochondrial mutations identified in biopsies can be traced back in matched plasma samples and could potentially be used as early breast cancer diagnostic biomarkers.
Understanding health outcome drivers among adherence club patients in clinics of Gauteng, South Africa: a structural equation modelling (SEM) approach
Authors: Tshuma Ndumiso , Ngbede Elakpa Daniel , Nyengerai Tawanda , Mtapuri Oliver , Moyo Sangiwe , Mphuthi David D. , Nyasulu Peter
Published: October 2023

Background

There has been growing interest in understanding the drivers of health outcomes, both in developed and developing countries. The drivers of health outcomes, on the other hand, are the factors that influence the likelihood of experiencing positive or negative health outcomes. Human Immunodeficiency Virus (HIV) continues to be a significant global public health challenge, with an estimated 38 million people living with the aim of this study was therefore to develop and empirically test a conceptual research model using SEM, aimed at explaining the magnitude of various factors influencing HIV and other health outcomes among patients attending Adherence Clubs.

Method

This was a cross sectional survey study design conducted in 16 health facilities in the City of Ekurhuleni in Gauteng Province, South Africa. A total of 730 adherence club patients were systematically sampled to participate in a closed ended questionnaire survey. The questionnaire was assessed by Cronbach's alpha coefficient for internal consistency. The proposed model was tested using structural equation modelling (AMOS software: ADC, Chicago, IL, USA).

Results

A total of 730 adherence club members participated in the study. Of these, 425 (58.2%) were female and 305 (41.8%) were male. The overall results indicated a good reliability of all the scale involved in this study as Cronbach alphas ranged from 0.706 to 0.874, and composite reliability from 0.735 to 0.874. The structural model showed that the constructs health seeking behavior (β = 0.267, p = 0.000), health care services (β = 0.416, p = 0.000), stigma and discrimination (β = 0.135, p = 0.022) significantly predicted health outcomes and explained 45% of its variance. The construct healthcare service was the highest predictor of health outcomes among patients in adherence clubs.

Conclusion

Patient health seeking behaviour, healthcare services, stigma and discrimination were associated with perceived health outcomes. Since adherence clubs have been found to have a significant impact in improving patient outcomes and quality of life, there is a need to ensure replication of this model.
A cost benefit analysis of a virtual overdose monitoring service/mobile overdose response service: the national overdose response service
Authors: Rioux William , Enns Benjamin , Jackson Jennifer , Quereshi Hena , Irvine Mike , Ghosh S. Monty
Published: October 2023

Background

The overdose crisis continues across Canada which calls for novel harm reduction strategies. Previous research indicates that a majority of eHealth solutions are cost-effective however current literature on the cost-benefit of eHealth for harm reduction is sparse. The National Overdose Response Service (NORS) is a Canada-wide telephone-based harm reduction service. Service users can call the phone number and connect to a peer who can virtually monitor the substance use session and dispatch appropriate interventions in the case of overdose.

Objectives of the research/project

We aim to assess the cost-benefit of NORS by comparing the estimated cost-savings from prevented overdose mortality to the operating costs of the program, alongside healthcare costs associated with its operation.

Methods

Data around systems costs and operational costs were gathered for our calculations. Our primary outcome was cost-benefit ratios, derived from estimates and models of mortality rates in current literature and value of life lost. We presented our main results across a range of values for costs and the probability of death following an unwitnessed overdose. These values were utilized to calculate cost-benefit ratios and value per dollar spent on service provision by NORS over the length of the program’s operation (December 2020–2022).

Results

Over the total funded lifespan of the program, and using a Monte Carlo estimate, the benefit-to-cost ratio of the NORS program was 8.59 (1.53–15.28) per dollar spent, depending on estimated mortality rates following unwitnessed overdose and program operation costs. Further, we conservatively estimate that early community-based naloxone intervention results in healthcare system savings of $4470.82 per overdose response.

Conclusions

We found the NORS program to have a positive benefit-to-cost ratio when the probability of death following an unwitnessed overdose was greater than 5%. NORS and potentially other virtual overdose monitoring services have the potential to be cost-effective solutions for managing the drug poisoning crisis.