bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential diagnosis of stage 2, 3 and 4 pressure injuries of the pelvis and lower extremity: a case series
Authors: Caudill Jennifer , Chrisman Tim , Chen Joanna , Zajac Kelsee , Simman Richard
Published: September 2023

Constant, unrelieved pressure of local tissue, particularly over bony prominences, may provoke damage that progresses to necrosis and pressure injury (PI). Differentiating PIs from conditions of similar appearance is imperative to minimising complications and implementing prompt treatment. This case series describes several conditions that may be mistaken for a PI. Outlined are the key differences in patient history, presentation and clinical cues that assist in correctly identifying the true pathology behind these conditions. Conditions reviewed included: pyoderma gangrenosum; necrotising fasciitis; genital herpes; Marjolin ulcer, Rosai–Dorfman disease; vascular disease; coagulopathies; calciphylaxis; trauma and surgical wounds; pilonidal cysts; graft-versus-host disease; hidradenitis suppurativa; Stevens–Johnson syndrome; epidermolysis bullosa; radiation wounds; spider bites; and end-of-life skin failure pressure ulcers (also known as Kennedy ulcers). Although commonly recognised and diagnosed, stage 2, 3 and 4 PIs occasionally prove to be difficult to pinpoint, with undefined characteristics and similarities in presentation to several other conditions. Therefore, it is clinically vital to be aware of their appearance, risk factors and aetiology in order to make an appropriate patient assessment and avoid misdiagnosis.
Diabetes among Muslims during Ramadan: A narrative review
Authors: Ochani Rohan Kumar , Shaikh Asim , Batra Simran , Pikale Gauri , Surani Salim
Published: September 2023

Fasting during the month of Ramadan is one of the five fundamental principles of Islam, and it is obligatory for healthy Muslim adults and adolescents. During the fasting month, Muslims usually have two meals a day, suhur (before dawn) and iftar (after dusk). However, diabetic patients may face difficulties when fasting, so it is important for medical staff to educate them on safe fasting practices. Prolonged strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis, but with proper knowledge, careful planning, and medication adjustment, diabetic Muslim patients can fast during Ramadan. For this review, a literature search was conducted using PubMed and Google Scholar until May 2023. Articles other than the English language were excluded. Current strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition, regular monitoring of blood glucose, medications, and insulin therapy. Insulin therapy can be continued during fasting if properly titrated to the patients' needs, and finger prick blood sugar levels should be assessed regularly. If certain symptoms such as hypoglycemia, hyperglycemia, dehydration, or acute illness occur, or blood glucose levels become too high (more than 300 mg/dL) or too low (less than 70 mg/dL), the fast should be broken. New insulin formulations such as pegylated insulin and medications like tirzepatide, a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors, have shown promise in managing blood sugar levels during Ramadan. Non-insulin-dependent medications like sodium-glucose-cotransporter-2 inhibitors, including the Food and Drug Administration-approved ertugliflozin, are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.
Predictive value of preoperative albumin-bilirubin score and other risk factors for short-term outcomes after open pancreatoduodenectomy
Authors: Zavrtanik Hana , Cosola Davide , Badovinac David , Hadžialjević Benjamin , Horvat Gašper , Plevel Danaja , Bogoni Selene , Tarchi Paola , de Manzini Nicolò , Tomažič Aleš
Published: September 2023

Fasting during the month of Ramadan is one of the five fundamental principles of Islam, and it is obligatory for healthy Muslim adults and adolescents. During the fasting month, Muslims usually have two meals a day, suhur (before dawn) and iftar (after dusk). However, diabetic patients may face difficulties when fasting, so it is important for medical staff to educate them on safe fasting practices. Prolonged strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis, but with proper knowledge, careful planning, and medication adjustment, diabetic Muslim patients can fast during Ramadan. For this review, a literature search was conducted using PubMed and Google Scholar until May 2023. Articles other than the English language were excluded. Current strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition, regular monitoring of blood glucose, medications, and insulin therapy. Insulin therapy can be continued during fasting if properly titrated to the patients’ needs, and finger prick blood sugar levels should be assessed regularly. If certain symptoms such as hypoglycemia, hyperglycemia, dehydration, or acute illness occur, or blood glucose levels become too high (> 300 mg/dL) or too low (> 70 mg/dL), the fast should be broken. New insulin formulations such as pegylated insulin and medications like tirzepatide, a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors, have shown promise in managing blood sugar levels during Ramadan. Non-insulin-dependent medications like sodium-glucose-cotransporter-2 inhibitors, including the Food and Drug Administration-approved ertugliflozin, are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.
Risk factors for stroke recurrence in young patients with first-ever ischemic stroke: A meta-analysis
Authors: Xia Yu , Liu Han , Zhu Rui
Published: September 2023

Fasting during the month of Ramadan is one of the five fundamental principles of Islam, and it is obligatory for healthy Muslim adults and adolescents. During the fasting month, Muslims usually have two meals a day, suhur (before dawn) and iftar (after dusk). However, diabetic patients may face difficulties when fasting, so it is important for medical staff to educate them on safe fasting practices. Prolonged strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis, but with proper knowledge, careful planning, and medication adjustment, diabetic Muslim patients can fast during Ramadan. For this review, a literature search was conducted using PubMed and Google Scholar until May 2023. Articles other than the English language were excluded. Current strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition, regular monitoring of blood glucose, medications, and insulin therapy. Insulin therapy can be continued during fasting if properly titrated to the patients’ needs, and finger prick blood sugar levels should be assessed regularly. If certain symptoms such as hypoglycemia, hyperglycemia, dehydration, or acute illness occur, or blood glucose levels become too high (> 300 mg/dL) or too low (> 70 mg/dL), the fast should be broken. New insulin formulations such as pegylated insulin and medications like tirzepatide, a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors, have shown promise in managing blood sugar levels during Ramadan. Non-insulin-dependent medications like sodium-glucose-cotransporter-2 inhibitors, including the Food and Drug Administration-approved ertugliflozin, are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.
Surgery for fibrous dysplasia associated with aneurysmal-bone-cyst-like changes in right proximal femur: A case report
Authors: Xie Lun-Li , Yuan Xiao , Zhu Hong-Xia , Pu Dan
Published: September 2023

Fasting during the month of Ramadan is one of the five fundamental principles of Islam, and it is obligatory for healthy Muslim adults and adolescents. During the fasting month, Muslims usually have two meals a day, suhur (before dawn) and iftar (after dusk). However, diabetic patients may face difficulties when fasting, so it is important for medical staff to educate them on safe fasting practices. Prolonged strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis, but with proper knowledge, careful planning, and medication adjustment, diabetic Muslim patients can fast during Ramadan. For this review, a literature search was conducted using PubMed and Google Scholar until May 2023. Articles other than the English language were excluded. Current strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition, regular monitoring of blood glucose, medications, and insulin therapy. Insulin therapy can be continued during fasting if properly titrated to the patients’ needs, and finger prick blood sugar levels should be assessed regularly. If certain symptoms such as hypoglycemia, hyperglycemia, dehydration, or acute illness occur, or blood glucose levels become too high (> 300 mg/dL) or too low (> 70 mg/dL), the fast should be broken. New insulin formulations such as pegylated insulin and medications like tirzepatide, a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors, have shown promise in managing blood sugar levels during Ramadan. Non-insulin-dependent medications like sodium-glucose-cotransporter-2 inhibitors, including the Food and Drug Administration-approved ertugliflozin, are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.
Difficulties in diagnosing angiomatoid fibrous histiocytoma of the head and neck region: A case report
Authors: Michcik Adam , Bień Marta , Wojciechowska Barbara , Polcyn Adam , Garbacewicz Łukasz , Kowalski Jacek , Drogoszewska Barbara
Published: September 2023

Fasting during the month of Ramadan is one of the five fundamental principles of Islam, and it is obligatory for healthy Muslim adults and adolescents. During the fasting month, Muslims usually have two meals a day, suhur (before dawn) and iftar (after dusk). However, diabetic patients may face difficulties when fasting, so it is important for medical staff to educate them on safe fasting practices. Prolonged strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis, but with proper knowledge, careful planning, and medication adjustment, diabetic Muslim patients can fast during Ramadan. For this review, a literature search was conducted using PubMed and Google Scholar until May 2023. Articles other than the English language were excluded. Current strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition, regular monitoring of blood glucose, medications, and insulin therapy. Insulin therapy can be continued during fasting if properly titrated to the patients’ needs, and finger prick blood sugar levels should be assessed regularly. If certain symptoms such as hypoglycemia, hyperglycemia, dehydration, or acute illness occur, or blood glucose levels become too high (> 300 mg/dL) or too low (> 70 mg/dL), the fast should be broken. New insulin formulations such as pegylated insulin and medications like tirzepatide, a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors, have shown promise in managing blood sugar levels during Ramadan. Non-insulin-dependent medications like sodium-glucose-cotransporter-2 inhibitors, including the Food and Drug Administration-approved ertugliflozin, are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.
Successful resolution of gastric perforation caused by a severe complication of pancreatic walled-off necrosis: A case report
Authors: Noh Byeong Gwan , Yoon Myunghee , Park Young Mok , Seo Hyung-Il , Kim Suk , Hong Seung Baek , Park Jae Kyun , Lee Moon Won
Published: September 2023

Fasting during the month of Ramadan is one of the five fundamental principles of Islam, and it is obligatory for healthy Muslim adults and adolescents. During the fasting month, Muslims usually have two meals a day, suhur (before dawn) and iftar (after dusk). However, diabetic patients may face difficulties when fasting, so it is important for medical staff to educate them on safe fasting practices. Prolonged strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis, but with proper knowledge, careful planning, and medication adjustment, diabetic Muslim patients can fast during Ramadan. For this review, a literature search was conducted using PubMed and Google Scholar until May 2023. Articles other than the English language were excluded. Current strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition, regular monitoring of blood glucose, medications, and insulin therapy. Insulin therapy can be continued during fasting if properly titrated to the patients’ needs, and finger prick blood sugar levels should be assessed regularly. If certain symptoms such as hypoglycemia, hyperglycemia, dehydration, or acute illness occur, or blood glucose levels become too high (> 300 mg/dL) or too low (> 70 mg/dL), the fast should be broken. New insulin formulations such as pegylated insulin and medications like tirzepatide, a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors, have shown promise in managing blood sugar levels during Ramadan. Non-insulin-dependent medications like sodium-glucose-cotransporter-2 inhibitors, including the Food and Drug Administration-approved ertugliflozin, are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.
Bilateral dislocation of the long head of biceps tendon with intact rotator cuff tendon: A case report
Authors: Sohn Hyuk-Joon , Cho Chul-Hyun , Kim Du-Han
Published: September 2023

Fasting during the month of Ramadan is one of the five fundamental principles of Islam, and it is obligatory for healthy Muslim adults and adolescents. During the fasting month, Muslims usually have two meals a day, suhur (before dawn) and iftar (after dusk). However, diabetic patients may face difficulties when fasting, so it is important for medical staff to educate them on safe fasting practices. Prolonged strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis, but with proper knowledge, careful planning, and medication adjustment, diabetic Muslim patients can fast during Ramadan. For this review, a literature search was conducted using PubMed and Google Scholar until May 2023. Articles other than the English language were excluded. Current strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition, regular monitoring of blood glucose, medications, and insulin therapy. Insulin therapy can be continued during fasting if properly titrated to the patients’ needs, and finger prick blood sugar levels should be assessed regularly. If certain symptoms such as hypoglycemia, hyperglycemia, dehydration, or acute illness occur, or blood glucose levels become too high (> 300 mg/dL) or too low (> 70 mg/dL), the fast should be broken. New insulin formulations such as pegylated insulin and medications like tirzepatide, a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors, have shown promise in managing blood sugar levels during Ramadan. Non-insulin-dependent medications like sodium-glucose-cotransporter-2 inhibitors, including the Food and Drug Administration-approved ertugliflozin, are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.
Wavefront restoration from lateral shearing data using spectral interpolation
Authors: Tomioka Satoshi , Miyamoto Naoki , Yamauchi Yuji , Matsumoto Yutaka , Heshmat Samia
Published: September 2023

Although a lateral-shear interferometer is robust against optical component vibrations, its interferogram provides information about differential wavefronts rather than the wavefronts themselves, resulting in the loss of specific frequency components. Previous studies have addressed this limitation by measuring four interferograms with different shear amounts to accurately restore the two-dimensional wavefront. This study proposes a technique that employs spectral interpolation to reduce the number of required interferograms. The proposed approach introduces an origin-shift technique for accurate spectral interpolation, which in turn is implemented by combining two methods: natural extension and least-squares determination of ambiguities in uniform biases. Numerical simulations confirmed that the proposed method accurately restored a two-dimensional wavefront from just two interferograms, thereby indicating its potential to address the limitations of the lateral-shear interferometer.
Deep sound-field denoiser: optically-measured sound-field denoising using deep neural network
Authors: Ishikawa Kenji , Takeuchi Daiki , Harada Noboru , Moriya Takehiro
Published: September 2023

This paper proposes a deep sound-field denoiser, a deep neural network (DNN) based denoising of optically measured sound-field images. Sound-field imaging using optical methods has gained considerable attention due to its ability to achieve high-spatial-resolution imaging of acoustic phenomena that conventional acoustic sensors cannot accomplish. However, the optically measured sound-field images are often heavily contaminated by noise because of the low sensitivity of optical interferometric measurements to airborne sound. Here, we propose a DNN-based sound-field denoising method. Time-varying sound-field image sequences are decomposed into harmonic complex-amplitude images by using a time-directional Fourier transform. The complex images are converted into two-channel images consisting of real and imaginary parts and denoised by a nonlinear-activation-free network. The network is trained on a sound-field dataset obtained from numerical acoustic simulations with randomized parameters. We compared the method with conventional ones, such as image filters, a spatiotemporal filter, and other DNN architectures, on numerical and experimental data. The experimental data were measured by parallel phase-shifting interferometry and holographic speckle interferometry. The proposed deep sound-field denoiser significantly outperformed the conventional methods on both the numerical and experimental data. Code is available on GitHub (https://github.com/nttcslab/deep-sound-field-denoiser).
Image scanning lensless fiber-bundle endomicroscopy
Authors: Weinberg Gil , Weiss Uri , Katz Ori
Published: September 2023

Fiber-based confocal endomicroscopy has shown great promise for minimally-invasive deep-tissue imaging. Despite its advantages, confocal fiber-bundle endoscopy inherently suffers from undersampling due to the spacing between fiber cores, and low collection efficiency when the target is not in proximity to the distal fiber facet. Here, we demonstrate an adaptation of image-scanning microscopy (ISM) to lensless fiber bundle endoscopy, doubling the spatial sampling frequency and significantly improving collection efficiency. Our approach only requires replacing the confocal detector with a camera. It improves the spatial resolution for targets placed at a distance from the fiber tip, and addresses the fundamental challenge of aliasing/pixelization artifacts.
Management of the axial modulation of the illumination pattern in structured illumination microscopy using an extended illumination source
Authors: Gimeno-Gomez Alejandro , Dajkhosh Seyedeh Parisa , Son Van Cong Tuan , Barreiro Juan Carlos , Preza Chrysanthe , Saavedra Genaro
Published: September 2023

We have designed and implemented an approach for three-dimensional (3D) structured illumination (SI) microscopy (SIM) based on a quasi-monochromatic extended source illuminating a Wollaston prism to improve robustness, light efficiency and flexibility over our previous design. We show through analytical and experimental verification of the presented theoretical framework for our proposed tunable structured illumination microscopy (TSIM) system, that a simple and accurate determination of the axial modulation of the SI pattern is achieved, enabling a realistic characterization of the system’s effective optical transfer function (OTF). System performance as a function of the extended source size is investigated with simulations. Results from a comparative performance analysis of the proposed TSIM system and traditional SIM systems show some advantages over the traditional two-wave and three-wave interference SIM systems. We show that by controlling the source size and thereby the axial modulation of the 3D SI pattern, the TSIM scheme offers increased OTF compact support and improved optical sectioning capability, quantified by the integrated intensity, under certain conditions, which may be desirable when imaging optically thick samples. The additional tunability of the 3D SI pattern, provides a unique opportunity for OTF engineering in our TSIM system.
Learning based compressive snapshot spectral light field imaging with RGB sensors
Authors: He Tianyu , Ren Wenyi , Feng Yang , Yu Ruoning , Wu Dan , Zhang Rui , Cai Yanan , Xie Yingge , Wang Jian
Published: September 2023

The application of multidimensional optical sensing technologies, such as the spectral light field (SLF) imager, has become increasingly common in recent years. The SLF sensors provide information in the form of one-dimensional spectral data, two-dimensional spatial data, and two-dimensional angular measurements. Spatial-spectral and angular data are essential in a variety of fields, from computer vision to microscopy. Beam-splitters or expensive camera arrays are required for the usage of SLF sensors. The paper describes a low-cost RGB light field camera-based compressed snapshot SLF imaging method. Inspired by the compressive sensing paradigm, the four dimensional SLF can be reconstructed from a measurement of an RGB light field camera via a network which is proposed by utilizing a U-shaped neural network with multi-head self-attention and unparameterized Fourier transform modules. This method is capable of gathering images with a spectral resolution of 10 nm, angular resolution of 9 × 9, and spatial resolution of 622 × 432 within the spectral range of 400 to 700 nm. It provides us an alternative approach to implement the low cost SLF imaging.
A whole-task brain model of associative recognition that accounts for human behavior and neuroimaging data
Authors: Borst Jelmer P. , Aubin Sean , Stewart Terrence C.
Published: September 2023

Brain models typically focus either on low-level biological detail or on qualitative behavioral effects. In contrast, we present a biologically-plausible spiking-neuron model of associative learning and recognition that accounts for both human behavior and low-level brain activity across the whole task. Based on cognitive theories and insights from machine-learning analyses of M/EEG data, the model proceeds through five processing stages: stimulus encoding, familiarity judgement, associative retrieval, decision making, and motor response. The results matched human response times and source-localized MEG data in occipital, temporal, prefrontal, and precentral brain regions; as well as a classic fMRI effect in prefrontal cortex. This required two main conceptual advances: a basal-ganglia-thalamus action-selection system that relies on brief thalamic pulses to change the functional connectivity of the cortex, and a new unsupervised learning rule that causes very strong pattern separation in the hippocampus. The resulting model shows how low-level brain activity can result in goal-directed cognitive behavior in humans.
Computational modeling of multiscale collateral blood supply in a whole-brain-scale arterial network
Authors: Otani Tomohiro , Nishimura Nozomi , Yamashita Hiroshi , Ii Satoshi , Yamada Shigeki , Watanabe Yoshiyuki , Oshima Marie , Wada Shigeo
Published: September 2023

The cerebral arterial network covering the brain cortex has multiscale anastomosis structures with sparse intermediate anastomoses (O[102] μm in diameter) and dense pial networks (O[101] μm in diameter). Recent studies indicate that collateral blood supply by cerebral arterial anastomoses has an essential role in the prognosis of acute ischemic stroke caused by large vessel occlusion. However, the physiological importance of these multiscale morphological properties—and especially of intermediate anastomoses—is poorly understood because of innate structural complexities. In this study, a computational model of multiscale anastomoses in whole-brain-scale cerebral arterial networks was developed and used to evaluate collateral blood supply by anastomoses during middle cerebral artery occlusion. Morphologically validated cerebral arterial networks were constructed by combining medical imaging data and mathematical modeling. Sparse intermediate anastomoses were assigned between adjacent main arterial branches; the pial arterial network was modeled as a dense network structure. Blood flow distributions in the arterial network during middle cerebral artery occlusion simulations were computed. Collateral blood supply by intermediate anastomoses increased sharply with increasing numbers of anastomoses and provided one-order-higher flow recoveries to the occluded region (15%–30%) compared with simulations using a pial network only, even with a small number of intermediate anastomoses (≤10). These findings demonstrate the importance of sparse intermediate anastomoses, which are generally considered redundant structures in cerebral infarction, and provide insights into the physiological significance of the multiscale properties of arterial anastomoses.
Predictors of obesity among school-age children in Debre Berhan City, Ethiopia
Authors: Ayele Abebe Nigussie , Mekonen Alemayehu Gonie , Seid AbdulWahhab , Mitikie Esubalew Guday , Abayneh Abrham Demis , Haile Mitiku Tefera
Published: September 2023

Background

Obesity causes a serious diet-related chronic disease, including type-2 diabetes, cardiovascular disease, hypertension, osteoarthritis, and certain forms of cancer. In Sub- Saharan Africa including Ethiopia, most nutritional interventions mainly focused on a child undernutrition and ignored the impacts of obesity among children. In Ethiopia, the magnitude and associated factors of obesity among school-age children were not clearly described. Therefore this study assesses the predictors of obesity among school- age children in Debre Berhan City, Ethiopia, 2022.

Methods

A cross-sectional study design was conducted from June to July, 2022. Participants were selected by using multistage sampling method. Data were collected using pre-tested and structured questions. Data were coded and entered in Epi-data version 4.6 and exported and analyzed using SPSS version 25.

Result

A total of 600 children were participating in the study. The prevalence of obesity was 10.7% (95% CI: 8.3, 13.2). In this study, attending at private school (AOR = 4.24, 95% CI: 1.58, 11.32), children aged between 10-12years (AOR = 2.67, 95% CI: 1.30, 5.48), soft drink available in home (AOR = 2.27, 95% CI: 1.25,18.13), Loneliness (AOR = 1.67 95% CI: 1.12, 3.15) and mothers with occupational status of daily labour (AOR = 8.54 95% CI: 1.12, 65.39) were significantly associated with childhood obesity.

Conclusion

In this study, the overall magnitude of childhood obesity was (10.7%) which means one in eleven children and relatively high as compare to the EDHS survey. Therefore, more attention should be given to strengthening physical activities, providing nutritional education, and creating community awareness about healthy diets as well as other preventive measures.
A realist review of health passports for Autistic adults
Authors: Ellis Rebecca , Williams Kathryn , Brown Amy , Healer Eleanor , Grant Aimee
Published: September 2023

Background

Autism is a normal part of cognitive diversity, resulting in communication and sensory processing differences, which can become disabling in a neurotypical world. Autistic people have an increased likelihood of physical and mental co-occurring conditions and die earlier than neurotypical peers. Inaccessible healthcare may contribute to this. Autism Health Passports (AHPs) are paper-based or digital tools which can be used to describe healthcare accessibility needs; they are recommended in UK clinical guidance. However, questions remained as to the theoretical underpinnings and effectiveness of AHPs.

Methods

We undertook a systematic literature search identifying studies focused on AHPs for adults (aged over 16 years) from five databases. Included literature was subjected to realist evaluation. Data were extracted using a standardised form, developed by the research team, which considered research design, study quality for realist review and the Context, Mechanisms and Outcomes (CMOs) associated with each AHP tool.

Findings

162 unique records were identified, and 13 items were included in the review. Only one item was considered high quality. Contextual factors focused on the inaccessibility of healthcare to Autistic patients and staff lack of confidence and training in supporting Autistic needs. Interventions were heterogeneous, with most sources reporting few details as to how they had been developed. The most frequently included contents were communication preferences. Mechanisms were often not stated or were inferred by the reviewers and lacked specificity. Outcomes were included in four studies and were primarily focused on AHP uptake, rather than Outcomes which measured impact.

Conclusion

There is insufficient evidence to conclude that AHPs reduce the health inequalities experienced by Autistic people. Using an AHP tool alone in a healthcare Context that does not meet Autistic needs, without the inclusion of the local Autistic community developing the tool, and a wider intervention to reduce known barriers to health inequality, may mean that AHPs do not trigger any Mechanisms, and thus cannot affect Outcomes.
Sexually transmitted infection knowledge among men who have sex with men in Nairobi, Kenya
Authors: Nyasani Delvin Kwamboka , Ondora Onyambu Meshack , Lunani Laura Lusike , Ombati Geoffrey Oino , Mutisya Elizabeth Mueni , Mutua Gaundensia Nzembi , Price Matt. A. , Osero Justus Osano
Published: September 2023

Background

High rates of sexually transmitted infections (STIs) among men who have sex with men (MSM) have been reported, but there is little research on their STI knowledge. Our study sought to determine participants’ characteristics that contribute to either high or low STI knowledge among MSM in Nairobi, Kenya.

Methods

We mobilized MSM aged ≥18 years from Nairobi into a cross-sectional study. To determine their understanding of STIs, a pre-tested structured questionnaire was administered. Knowledge score was generated by summing up the number of responses answered correctly by a participant. We dichotomized scores as “low” and “high”, by splitting the group at <12 and ≥12 which was the mean.

Results

A total of 404 participants were interviewed between March and August 2020. The mean age was 25.2 (SD = 6.4) years. Majority were single (80.4%) and Christians (84.2%). All participants had some formal education ranging from primary to tertiary; the majority (92.3%) had secondary education or more. Most (64.0%) were employed and their monthly income ranged from <50->150 USD. Almost all (98.5%) were Kenyans. Of the 404 (90.6%) self-identified as male and (47.5%) reported to be exclusively top partners. Many (39.9%) reported being versatile, while those reporting to be bottom partners were, (12.6%). The last 12 months, (55.4%) of the participants reported having sex with men only and (88.6%) reported to have had multiple sexual partners. Participants scored an average of 12.2, SD 4.5. Multivariable backward elimination logistic regression revealed that participants who had tertiary education (aOR = 0.50, 95% CI 0.32–0.77), a higher income (aOR = 0.40, 95% CI 0.22–0.75) and were engaging in vaginal sex (aOR = 1.86, 95% CI 1.25–2.78) predicted significantly higher odds of high knowledge in the final multivariable model.

Conclusion

Participant’s knowledge level regarding STIs was low. We recommend health care workers to continue educating patients about STIs.
The efficacy of inspiratory muscle training in patients with coronary artery disease: Protocol for a systematic review and meta-analysis
Authors: Kadoya Yoshito , Balamane Saad , Visintini Sarah , Chow Benjamin
Published: September 2023

Background

Inspiratory muscle training (IMT) has been recognized as an effective form of training in patients with cardiovascular disease and heart failure. However, little is known about the efficacy of IMT in the treatment of patients with coronary artery disease (CAD). The aim of this systematic review will be to evaluate randomized controlled studies to understand the effect of IMT on CAD patients.

Method

We will include randomized controlled trials evaluating the efficacy of IMT in patients 18 years and older diagnosed with CAD. Crossover trials, cluster-randomized, quasi-randomized, and non-randomized trials will be excluded. Study search will be conducted in major databases (MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, and PEDro). The study intervention will be IMT independent of the duration, frequency, or intensity of training. The primary outcome will be quality of life, patient-reported health status, and all adverse events related to IMT. Secondary outcomes will include exercise capacity and respiratory muscle strength. The risk of bias will be evaluated based on the Cochrane Risk of Bias tool. Screening, data extraction, and quality assessment will be performed by two independent reviewers. If two or more studies are considered to be clinically homogeneous, a meta-analysis based on the random-effects model will be performed. The quality of evidence will be evaluated based on the GRADE approach.

Conclusion

This systematic review will improve our understanding of the effects of IMT on CAD patients and potentially establish IMT as an alternative form of exercise training for the treatment of CAD.

Trial registration

Study registration. OSF registries (https://osf.io/3ch7m). Date registered: May 10, 2022. Registration DOI: https://doi.org/10.17605/OSF.IO/GVMY7.
The spatial configuration of local climate zones reveals effects on wayfinding in human walking
Authors: Fan Ping Yu , Chun Kwok Pan , Tan Mou Leong , Mah Daphne Ngar-Yin , Mijic Ana , Strickert Graham , Yetemen Omer
Published: September 2023

The importance of easy wayfinding in complex urban settings has been recognized in spatial planning. Empirical measurement and explicit representation of wayfinding, however, have been limited in deciding spatial configurations. Our study proposed and tested an approach to improving wayfinding by incorporating spatial analysis of urban forms in the Guangdong-Hong Kong-Macau Great Bay Area in China. Wayfinding was measured by an indicator of intelligibility using spatial design network analysis. Urban spatial configurations were quantified using landscape metrics to describe the spatial layouts of local climate zones (LCZs) as standardized urban forms. The statistical analysis demonstrated the significant associations between urban spatial configurations and wayfinding. These findings suggested, to improve wayfinding, 1) dispersing LCZ 1 (compact high-rise) and LCZ 2 (compact mid-rise) and 2) agglomerating LCZ 3 (compact low-rise), LCZ 5 (open mid-rise), LCZ 6 (open low-rise), and LCZ 9 (sparsely built). To our knowledge, this study is the first to incorporate the LCZ classification system into the wayfinding field, clearly providing empirically-supported solutions for dispersing and agglomerating spatial configurations. Our findings also provide insights for human-centered spatial planning by spatial co-development at local, urban, and regional levels.
Examination of ELISA against PCR for assessing treatment efficacy against Cryptosporidium in a clinical trial context
Authors: Nyirenda James T. , Henrion Marc Y. R. , Nyasulu Vita , Msakwiza Mike , Nedi Wilfred , Thole Herbert , Phulusa Jacob , Toto Neema , Jere Khuzwayo C. , Winter Alex , Sawyer Leigh A. , Conrad Thomas , Hebert Donnie , Chen Crystal , Van Voorhis Wesley C. , Houpt Eric R. , Iroh Tam Pui-Ying , Operario Darwin J.
Published: September 2023

Background

Cryptosporidium is a gastrointestinal pathogen that presents a serious opportunistic infection in immunocompromised individuals including those living with human immunodeficiency syndrome. The CRYPTOFAZ trial, previously published, was conducted in Malawi to evaluate the efficacy of clofazimine in response to an unmet need for drugs to treat cryptosporidiosis in HIV populations. A combination of rapid diagnostic tests, ELISA, qPCR, and conventional sequencing were employed to detect Cryptosporidium in 586 individuals during pre-screening and monitor oocyst shedding and identify enteric co-pathogens in 22 enrolled/randomized participants during the in-patient period and follow-up visits.

Methodology

Oocyst shedding as measured by qPCR was used to determine primary trial outcomes, however pathogen was detected even at trial days 41–55 in individuals randomized to either clofazimine or placebo arms of the study. Therefore, in this work we re-examine the trial outcomes and conclusions in light of data from the other diagnostics, particularly ELISA. ELISA data was normalized between experiments prior to comparison to qPCR. The amount of all identified enteric pathogens was examined to determine if co-pathogens other than Cryptosporidium were major causative agents to a participant’s diarrhea.

Conclusion

ELISA had higher sample-to-sample variability and proved to be equally or less sensitive than qPCR in detecting Cryptosporidium positive samples. Compared to qPCR, ELISA had equal or greater specificity in detecting Cryptosporidium negative samples. Sequencing identified several Cryptosporidium species including viatorum which has never been identified in Malawi and Southern Africa. In addition to Cryptosporidium, enterotoxigenic E. coli was also identified as a pathogen in diarrheagenic amounts in 4 out of 22 participants.
GreenGate 2.0: Backwards compatible addons for assembly of complex transcriptional units and their stacking with GreenGate
Authors: Piepers Marcel , Erbstein Katarina , Reyes-Hernandez Jazmin , Song Changzheng , Tessi Tomas , Petrasiunaite Vesta , Faerber Naja , Distel Kathrin , Maizel Alexis
Published: September 2023

Molecular cloning is a crucial technique in genetic engineering that enables the precise design of synthetic transcriptional units (TUs) and the manipulation of genomes. GreenGate and several other modular molecular cloning systems were developed about ten years ago and are widely used in plant research. All these systems define grammars for assembling transcriptional units from building blocks, cloned as Level 0 modules flanked by four-base pair overhangs and recognition sites for a particular Type IIs endonuclease. Modules are efficiently assembled into Level 1 TUs in a hierarchical assembly process, and Level 2 multigene constructs are assembled by stacking Level 1 TUs. GreenGate is highly popular but has three main limitations. First, using ad-hoc overhangs added by PCR and classical restriction/ligation prevents the efficient use of a one-pot, one-step reaction to generate entry clones and domesticate internal sites; second, a Level 1 TU is assembled from a maximum of six modules, which may be limiting for applications such as multiplex genome editing; third, the generation of Level 2 assemblies is sequential and inefficient. GreenGate 2.0 (GG2.0) expands GreenGate features. It introduces additional overhangs, allowing for the combination of up to 12 Level 0 modules in a Level 1 TU. It includes a Universal Entry Generator plasmid (pUEG) to streamline the generation of Level 0 modules. GG2.0 introduces GreenBraid, a convenient method for stacking transcriptional units iteratively for multigene assemblies. Importantly, GG2.0 is backwards compatible with most existing GreenGate modules. Additionally, GG2.0 includes Level 0 modules for multiplex expression of guide RNAs for CRISPR/Cas9 genome editing and pre-assembled Level 1 vectors for dexamethasone-inducible gene expression and ubiquitous expression of plasma membrane and nuclear fluorescent markers. GG2.0 streamlines and increases the versatility of assembling complex transcriptional units and their combination.
Enhancing healthcare at home for older people in rural and regional Australia: A protocol for co-creation to design and implement system change
Authors: Needham Cindy , Wheaton Nikita , Wong Shee Anna , McNamara Kevin , Malakellis Mary , Murray Margaret , Alston Laura , Peeters Anna , Ugalde Anna , Huggins Catherine , Yoong Serene , Allender Steven
Published: September 2023

Background

World-wide, health service providers are moving towards innovative models of clinical home-based care services as a key strategy to improve equity of access and quality of care. To optimise existing and new clinical home-based care programs, evidence informed approaches are needed that consider the complexity of the health care system across different contexts.

Methods

We present a protocol for working with health services and their partners to perform rapid identification, prioritisation, and co-design of content-appropriate strategies to optimise the delivery of healthcare at home for older people in rural and regional areas. The protocol combines Systems Thinking and Implementation Science using a Consensus Mapping and Co-design (CMC) process delivered over five workshops.

Discussion

The protocol will be implemented with rural and regional healthcare providers to identify digital and non-digital solutions that have the potential to inform models of service delivery, improve patient experience, and optimise health outcomes. The combination of system and implementation science is a unique approach for optimising healthcare at home for older populations, especially in the rural context where need is high. This is the first protocol to integrate the use of systems and implementation science into one process and articulating these methods will help with replicating this in future practice. Results of the design phase will translate into practice through standard health service planning methods to enhance implementation and sustainability. The delivery of the protocol will include building capacity of health service workers to embed the design, implementation, and evaluation approach into normal practice. This protocol forms part of the DELIVER (Delivering Enhanced heaLthcare at home through optImising Virtual tools for oldEr people in Rural and regional Australia) Project. Funded by Australia’s Medical Research Future Fund, DELIVER involves a collaboration with public health services of Western Victoria, Australia.
Integrative soft computing approaches for optimizing thermal energy performance in residential buildings
Authors: Peng Yao , Chen Yang
Published: September 2023

As is known, early prediction of thermal load in buildings can give valuable insight to engineers and energy experts in order to optimize the building design. Although different machine learning models have been promisingly employed for this problem, newer sophisticated techniques still require proper attention. This study aims at introducing novel hybrid algorithms for estimating building thermal load. The predictive models are artificial neural networks exposed to five optimizer algorithms, namely Archimedes optimization algorithm (AOA), Beluga whale optimization (BWO), forensic-based investigation (FBI), snake optimizer (SO), and transient search algorithm (TSO), for attaining optimal trainings. These five integrations aim at predicting the annual thermal energy demand. The accuracy of the models is broadly assessed using mean absolute percentage error (MAPE), root mean square error (RMSE), and coefficient of determination (R2) indicators and a ranking system is accordingly developed. As the MAPE and R2 reported, all obtained relative errors were below 5% and correlations were above 92% which confirm the general acceptability of the results and all used models. While the models exhibited different performances in training and testing stages, referring to the overall results, the BWO emerged as the most accurate algorithm, followed by the AOA and SO simultaneously in the second position, the FBI as the third, and TSO as the fourth accurate model. Mean absolute error (MAPE) and Considering the wide variety of artificial intelligence techniques that are used nowadays, the findings of this research may shed light on the selection of proper techniques for reliable energy performance analysis in complex buildings.
Attitude and preventive practices of pressure ulcers among orthopedic nurses in a tertiary hospital in Ghana
Authors: Appiah Evans Osei , Appiah Stella , Oti-Boadi Ezekiel , Boadu Beatrice Ama , Kontoh Samuel , Adams Roland Iddrisu , Appiah Cyndi , Sarpong Collins
Published: September 2023

Background

Pressure ulcers (PUs), which affect millions of people worldwide, are among the five most prevalent hospitalized cases causing adverse impairment. Nevertheless, pressure ulcers are largely preventable, and their management depends on their severity. The authors, therefore, explored the attitude and preventive practices of pressure ulcers among orthopedic nurses in a tertiary hospital in Ghana.

Methods

An exploratory descriptive qualitative approach was employed for this study to help researchers explore the attitude and practices toward PU (Pressure Ulcer). Purposive sampling approach was employed, and data was analyzed using thematic content analysis. The sample size for this study was 30 which was obtained based on saturation. Participants were engaged in face-to-face interviews which were transcribed verbatim.

Findings

Two themes and eight subthemes were generated from the analysis of this study. The two themes were preventive practices and attitude towards PU. The study identified that there were no specific protocols illustrated on the wards for managing pressure ulcers. Nevertheless, the study participants were keen on preventing pressure ulcers and hence engaged in practices such as early patients’ ambulation, early identification of PU signs, removing creases and crumps from patient beds, nutritional management for PU prevention, and dressing of PU wounds.

Conclusion

Practices of pressure ulcer management were highly valued by the orthopedics nurses. Hence, the nurses recommended the need for accepted guidelines on pressure ulcer management to be illustrated in the various orthopedic wards in the country.
Public sector’s efficiency as a reflection of governance quality, an European Union study
Authors: Negri Camelia , Dincă Gheorghița
Published: September 2023

The main objective of this paper is to assess the efficiency of the European Union’s public sector from a quality of governance approach, employing a two-step methodology. In the first stage, EU states’ efficiency scores are determined using Data Envelopment Analysis. Once quantifying public efficiency, the second step of the methodology examines the determinants of efficiency using a quantile regression estimation technique, with an emphasis on demographic features, corruption, economic freedom, and governmental digitalization. The novelty is provided by the assessment of the public sector’s efficiency and efficacy from a broader approach in order to determine the efficiency scores of European Union countries, as well as the key factors that may impact the public sector’s performance. The main findings, namely that governance quality can be considered an important resource in analysing public performance and that human resources, freedom, democracy, corruption, and digitalization have an impact on efficiency, are important considerations not only for policymakers but also for society, researchers, and the academic community. Reform measures should strive to improve both the technical and democratic components of public institutions in order to more effectively and transparently allocate public resources, while taking into consideration local and national peculiarities.