bluuebunny/crossref_metadata_2025 huggingface dataset:
SAFER: sub-hypergraph attention-based neural network for predicting effective responses to dose combinations
Authors: tang yiching , Li Rongbin , Tang Jing , Zheng W. Jim , Jiang Xiaoqian
Published: April 2024

Background
The potential benefits of drug combination synergy in cancer medicine are significant, yet the risks must be carefully managed due to the possibility of increased toxicity. Although artificial intelligence applications have demonstrated notable success in predicting drug combination synergy, several key challenges persist: (1) Existing models often predict average synergy values across a restricted range of testing dosages, neglecting crucial dose amounts and the mechanisms of action of the drugs involved. (2) Many graph-based models rely on static protein-protein interactions, failing to adapt to dynamic and context-dependent networks. This limitation constrains the applicability of current methods.
Results
We introduced SAFER, a Sub-hypergraph Attention-based graph model, addressing these issues by incorporating complex relationships among biological knowledge networks and considering dosing effects on subject-specific networks. SAFER outperformed previous models on the benchmark and the independent test set. The analysis of subgraph attention weight for the lung cancer cell line highlighted JAK-STAT signaling pathway, PRDM12, ZNF781, and CDC5L that have been implicated in lung fibrosis.
Conclusions
SAFER presents an interpretable framework designed to identify drug-responsive signals. Tailored for comprehending dose effects on subject-specific molecular contexts, our model uniquely captures dose-level drug combination responses. This capability unlocks previously inaccessible avenues of investigation compared to earlier models. Finally, the SAFER framework can be leveraged by future inquiries to investigate molecular networks that uniquely characterize individual patients.
A study on the fine management mode of obstetric pregnancy drugs under the payment of disease diagnosis-related groups (DRG)
Authors: Zhang Qiqin , Zhang Geer , Yang Shuangneng , Zhang Meng , Shu Shujuan , Zhao Mengdan
Published: April 2024

Combining disease diagnosis-related grouping (DRG) with drug management index, the rational drug application management model of patients in a certain disease group was explored to promote rational drug use in obstetric care. The DRG data of obstetric patients discharged from the hospital from January 2020 to December 2022 were obtained. The target disease groups were identified based on the principle of Boston matrix analysis. The correlation between hospitalization costs and medical expenses details was studied using Spearman correlation analysis. The occurrence times and amounts of drug categories in prescriptions were counted using descriptive analysis. Drug management indicators were used to conduct cross-sectional and longitudinal cross-sectional analyses of drug use in the DRG disease group. A total of 67281 obstetric cases were included in this study, involving 32 DRG disease groups, and the overall status of the departments was overspent. The OZ13 disease group was taken as an example for follow-up analysis. The results of the correlation analysis showed that the hospitalization cost had the highest correlation with drug cost, and the use of anti-preterm drugs was the most frequent and the highest amount. Horizontal analysis of different doctors’ indicators in the OZ13 disease group found that there was a relatively large difference in drug use among different doctors, and reasonable comments were made on the abnormal medical groups. The longitudinal analysis found that the combined use of anti-preterm drugs needs further management with the aim of improving the level of clinical rational drug use.
Multi-Response Optimization of Process Parameters in Friction Stir Welding of AA 8011-H14 / AA 5052-H34 using Taguchi Grey Relational Analysis
Authors: Radj B. Magamai , Natarajan Sendhil Kumar , Vasudevan Gopi
Published: April 2024

Friction stir welding (FSW) offers a distinct advantage in its ability to effectively join dissimilar metals and alloys. This study focuses on the butt welding of AA 8011-H14 and AA5052-H34 through FSW, aiming to explore the influence of process parameters on crucial mechanical properties such as ultimate tensile strength, yield strength, percentage elongation, and hardness. The examination of the welded cross-section revealed variations in both grain orientation and size across different zones. Notably, most failures were identified at the base of AA8011-H14 on the Advancing side. Furthermore, the hardness of the nugget zone exhibited variability based on the material ratio mix, with the maximum hardness observed on the AA5052-H34 side. Comparisons of optimal joint efficiencies were made to assess the overall effectiveness of the welded joints. This investigation contributes valuable insights into the intricacies of FSW when applied to dissimilar metal combinations, shedding light on the impact of process parameters on the mechanical characteristics of the joints.
Virtual Assessment of Physical Activity-Related Built Environment in Soweto, South Africa: What is the Role of Contextual Familiarity?
Authors: Godongwana Motlatso , Gama Khulu , Maluleke Vongani , Micklesfield Lisa , Odekunle Damilola , Wasnyo Yves Florent , Elouna Boris , Ngwa Edwin , Lopes Adalberto , Balarabe Muhammed Rabiu , Coringrato Eva , McGushin Alice , Oni Tolullah , Foley Louise , Canelas Tiago
Published: April 2024

Understanding how urban environments shape physical activity is critical in rapidly urbanizing countries such as South Africa. We assessed the reliability of virtual audits for characterizing urban features related to physical activity in Soweto, South Africa. We used the Microscale Audit of Pedestrian Streetscapes Global tool to characterize pedestrian-related features from Google Street View images in four neighborhoods of Soweto. Neighborhoods were selected to represent different levels of deprivation. Inter-rater reliability was analyzed according to the rater’s familiarity with the local area. The results show a higher inter-rater reliability was observed among auditors with greater contextual familiarity. Many measurements however, generated inconclusive results due to either low variability in the raters’ responses or the absence of the features in the streets. It is evident from our findings that virtual audits are efficient tools that can be used to assess the built environment. However, to ensure meaningful use of these tools in diverse settings, we recommend that auditors comprise of people with contextual familiarity.
Real-world effectiveness of molnupiravir, azvudine and paxlovid against mortality and viral clearance among hospitalized patients with COVID-19 infection during the omicron wave in China: a retrospective cohort study
Authors: Chen Yingsha , Lin Yushi , Lu Huidan , Wu Xiaocui , Pan Ying , Xia Anyue , Pang Lantian , Xu Feng
Published: April 2024

Objectives:
In this retrospective cohort study, we aimed to assess clinical effectiveness and viral clearance following the use of molnupiravir, azvudine and paxlovid in hospitalised patients with COVID-19 in China dominated by the omicron BA.5.2 and BF.7 subvariant of SARS-CoV-2.
Methods:
Enrolled patients were assigned to the molnupiravir group or the azvudine group or the paxlovid group or the control group (not taking any antiviral drugs). The primary outcome of the cohort study was viral clearance and viral burden rebound after treatment and the secondary outcome was 28-day all-cause mortality. The four groupswere propensity score-matched (1:1). We plotted viral load trends for each antiviral drug intervention using locally weighted regression (LOWESS) smoothed data.
Multivariate logistic regression (stepwise algorithm) models were used to determine any risk factors for 28-day mortality.
Results:
Of the 1537 patients receiving any treatment, 886 (57.6%) received molnupiravir, 390 (25.4%) received azvudine, 94 (6.1%) received paxlovid, and 167 (10.9%) did not use any antiviral drugs. Our data analysis showed that age (OR = 1.05, 95% CI: 1.03-1.07, p<0.001), Charlson comorbidty index (OR = 1.32, 95% CI: 1.18-1.48, p<0.001), severity of COVID-19 (p<0.001), gamma globulin (OR = 2.04, 95% CI: 1.03-3.99, p=0.039) and corticosteroids use (OR = 2.3, 95% CI: 1.19-4.69, p=0.017) were independent prognostic factors for 28-day mortality in COVID-19 patients. After
propensity score matching (PSM), the paxlovid recipients (OR=0.22, 95% CI: 0.05-0.83, p=0.036) or azvudine recipients (OR=0.27, 95% CI: 0.07-0.91, p=0.046) had lower 28-day mortality compared to their matched controls. Viral rebound occurred in the control group around days 9-16, while no viral rebound was found in any of the three oral antiviral groups. We found that molnupiravir group performed comparably in terms of the rate of nucleic acid conversion negative compared with the paxlovid group, while azvudine group performed slightly worse compared with the paxlovid group or molnupiravir group.
Conclusions:
In our retrospective cohort of hospitalised patients with COVID-19 during the wave of omicron strain, the molnupiravir, paxlovid and azvudine recipients showed a faster and more stable decrease in viral load and rare virus rebound in response to antiviral treatments when compared to the controls. The study supported that initiation treatment with paxlovid and azvudine was associated with significantly lower risk of all-cause death within 28 days.
Causal association between rheumatoid arthritis and stroke: Insights from a two-sample Mendelian randomization study and Bioinformatics Analyses
Authors: Zhu Shu-lai , Zhao Zhi-heng , Pan Xin-xin
Published: April 2024

Background: Previous studies have reported on the relationship between rheumatoid arthritis and ischemic stroke, but it remains unclear whether there is a causal association between rheumatoid arthritis and stroke subtypes.
Methods: In this study, we utilized two-sample Mendelian randomization to investigate the impact of rheumatoid arthritis on stroke and its subtypes. The inverse variance weighted (IVW) method was employed as the primary analysis, while MR-Egger regression, weighted median, simple mode, and weighted mode were used as supplementary analyses to ensure result robustness. We obtained RNA sequencing datasets GSE56649 and GSE58294 from the Gene Expression Omnibus (GEO) database to identify differentially expressed genes (DEGs) associated with both rheumatoid arthritis and cardioembolic stroke. By taking their intersection, we identified common genes for further bioinformatics analyses including gene ontology enrichment analysis, pathway enrichment analysis, and protein-protein interaction (PPI) analysis.
Results: The Mendelian randomization analysis, weighted by inverse variance, demonstrated no significant association between rheumatoid arthritis and ischemic stroke (OR 1.000, 95% CI 0.956-1.042, p=0.921), including its subtypes: small vessel stroke (OR 1.0164, 95% CI 0.922-1.120, p=0.744) and large vessel stroke (OR 0.986, 95% CI 0.891-1.090,p=0.784). However, a positive relationship was observed with cardioembolic stroke (OR 1.094, 95% CI 1.027-1.167,p=0 .006). We identified a total of forty-eight common genes shared between rheumatoid arthritis and cardioembolic stroke and conducted comprehensive enrichment analysis to gain insights into their biological functions and signaling pathways.
Conclusions: The findings of this study provide genetic evidence supporting the association between rheumatoid arthritis and an increased risk of cardioembolic stroke, while no significant relationship was observed with other subtypes of stroke. Through bioinformatics analyses, we identified common gene interaction networks shared by rheumatoid arthritis and cardioembolic stroke, which may offer potential therapeutic targets for clinical applications. However, further laboratory investigations and multicenter studies are warranted to gain a deeper mechanistic understanding in the future.
Contrasting behavioural response to concurrent stressors in an aquatic snail: importance of stress type and combination
Authors: Alonso Alvaro , Llandres-Díez M Celeste , Cruces-Estepa Paula
Published: April 2024

Behaviour is a fundamental parameter for understanding the animal fitness, serving as an indicator of exposure to stressors. In ecosystems, animals often face multiple stressors simultaneously. Their behavioural responses may vary when exposed to each stressor individually, as synergistic, additive, or antagonistic effects can result from the interaction of multiple stressors. Therefore, it is imperative to conduct studies that take into account the common occurrence of multi-stress scenarios in aquatic ecosystems. We tested the effects of three sources of stress (low water pH, toxicity (acetone) and conspecific chemical cues) on the behaviour of the aquatic nail Potamopyrgus antipodarum (Tateidae, Mollusca). We evaluated the impact of each stressor, as well as in combinations of two or three stressors simultaneously. The highest time to start movement was shown by the animals of the low water pH (acid treatment-A) followed by A plus toxic treatment (AT). The linear models showed an increase in the cumulative differences in time to start movement for the snails of A, AT, and T treatments over time. This indicates that snails in these treatments took longer to begin sliding movements compared to the control animals. On the contrary, animals of the conspecific chemical cues (S) and ST treatments showed an increased in the time to start sliding with time in comparison with control snails. It is conclude that behaviour was altered depending on the source and combination of stress, with antagonistic effects when simultaneously exposing the animals to an acidic environment and conspecific signals.
Learning ballet technique modulates the stretch reflex in students with cerebral palsy: Case series
Authors: López-Ortiz Citlali , He Maxine , Gaebler-Spira Deborah , Levin Mindy F.
Published: April 2024

Background: Cerebral palsy (CP) is considered the most prevalent developmental motor disorder in children. There is a need for training programs that enhance motor abilities and normalize function from an early age. Previous studies report improved motor outcomes in dance interventions for CP. Investigating the neurophysiological mechanisms underlying such improvements is necessary for efficient and safe intervention design. This study reports changes in stretch reflex responses as the primary neurophysiological motor outcome of a targeted ballet class intervention.
Results: A case series of participants with mixed spastic and dyskinetic CP (n = 4, mean age = 12.5 years, SD = 6.9S years, three female, one male) who learned ballet technique in a course of one-hour classes twice per week for six weeks is presented. Changes in stretch reflex responses and in clinical motor tests as secondary outcomes were observed after the course and at one-month follow-up. Quantitative measures of elbow or ankle stretch reflex were obtained using electromyography and electrogoniometry. The joint angle of the stretch reflex onset varied across velocities of stretch, and its variability decreased after the intervention. Within-subject tests of the central tendency of stretch reflex angle coefficients of variation and frequency distribution demonstrated significant changes (p-values< 0.05). Secondary outcomes included the Quality of Upper Extremity Skills Test (QUEST), Pediatric Balance Scale (PBS), Modified Tardieu Scale (MTS), Dyskinesia Impairment Scale (DIS), and Selective Control Assessment of the Lower Extremity (SCALE). All the participants demonstrated improvements larger than the minimal clinical important difference (MCID) or the smallest detectable difference (SDD), as applicable.
Conclusions: Evidence of changes in the stretch reflex responses in these four cases of mixed CP was observed. The observed variability in the stretch reflex responses may be due to the dyskinetic component of the mixed CP presentations. More studies with a larger sample size and longer duration of learning and practice of ballet technique are necessary to establish the extent of possible modulation and adaptation of the stretch reflex response as a neurophysiological basis for observed improvements in clinical measures. This study was registered in the Clinical Trials Protocol Registration and Results System (NCT04237506, January 17, 2020).
A Study on The Clinical Medical Students' Awareness of Cardiopulmonary Resuscitation- A Comparative Study Between Syrian Private University and Damascus University
Authors: Abdullah Nour Alhouda Mahmoud , Rhibani Lubna Mohamad Hassan , Rekmani Najwa fajr
Published: April 2024

Background:
The importance of this research lies in that it sheds light on a significant medical issue, that is clinical medical students’ awareness of cardiopulmonary resuscitation, as well as comparing this awareness between two major universities in Syria, namely Damascus university and Syrian Private university (SPU). The purposes of this research are to determine the knowledge score on this issue, indicate its importance in practical life, reveal the weak cognitive points, and compare this awareness between the two universities, in an attempt to correct the defect and restore the deficiency in order to achieve a healthier and safer life.
Materials and Methods:
A cross-sectional study was conducted on a sample of clinical medical students at both Damascus university and SPU, by randomly publishing a questionnaire among these students over a period of time spanning from 24/10/2023 to 7/1/2024.
Results:
The sample included 445 students, most of whom were at Damascus university with a percentage of 64% and 58.9% of the sample were female. The results have showed that knowledge score at Damascus university is higher than that at SPU, with the first recording 7.35 points out of 10 and the latter recording 4.15
Conclusion:
This study reveals the number of flaws in the awareness of cardiopulmonary resuscitation among medical students, who are supposed to be the most educated people on this extremely important medical procedure; since correct knowledge and application of it in the appropriate time can help save the lives of many people.
Cruz Prados, Alfredo. El sentido de la moral. Saber querer lo que en verdad se quiere. Pamplona: Eunsa, 2022, 170 pp. ISBN: 978-84-313-3768-1
Authors: Flores-Castro Lingán Gonzalo
Published: April 2024

Reseña: Cruz Prados, Alfredo. El sentido de la moral. Saber querer lo que en verdad se quiere. Pamplona: Eunsa, 2022, 170 pp. ISBN: 978-84-313-3768-1
En la presente obra, el profesor de filosofía política Alfredo Cruz Prados presenta una versión sintética y accesible de su magistral Deseo y verificación. La estructura fundamental de la ética (Eunsa, 2015). El haber realizado el trabajo de exponer de forma sencilla y breve las ideas tratadas en ese texto se debe a la sugerencia de colegas suyos en la Universidad de Navarra, y el autor no defrauda. Sólo esperamos que se anime a hacer lo mismo con las otras dos obras que componen su trilogía de filosofía práctica: Ethos y Polis. Bases para la reconstrucción de la filosofía política (Eunsa, 2015) y Sobre la realidad del Derecho. Filosofía jurídica (Eunsa, 2021). Por lo pronto, diremos que la presente es una obra excepcional, siendo al mismo tiempo clara y sintética, sin por ello perder un ápice del rigor que caracteriza a la obra del profesor Cruz Prados.
Non-parametric three-dimensional discrete fracture network modelling from fracture mapping data
Authors: Xu Chaoshui , Dowd Peter , Nguyen Nathan , Wang Wenjie
Published: April 2024

Rock masses usually include discontinuities in the form of fractures or joints, which in general are critical in determining the mechanical or flow properties of the rock mass at the engineering scale. Recent advances in computing power have made it possible to represent these fractures explicitly in a rock mass model. However, in practice, three-dimensional fracture systems are impossible to measure, and the best available alternative is either to map fractures in drill cores (one-dimensional) or on exposed rock surfaces (two-dimensional). The construction of a three-dimensional fracture system that is representative of reality then becomes a very challenging inverse problem, as this is essentially a relationship of one reality corresponding to many possibilities. Most existing approaches start with assumptions about the distribution of measured features, perform a series of bias corrections and then use some further assumptions and stereological analysis to establish the three-dimensional fracture model. The usual practice is to focus on particular aspects (parameters) of the three-dimensional fracture model which can easily produce a biased representation of the real fracture system. In this paper, a non-parametric systematic optimisation framework is described which can help construct a more realistic three-dimensional fracture model that best matches the statistics of the fracture mapping data. No bias correction is necessary in this approach provided the sampling of the fracture model is consistent with that used in the data collection. The framework can also be used to assess the uncertainty of the fracture model, which is an important, but often neglected, component of modelling in existing approaches. In addition, this non-parametric approach is also flexible and can deal with data from different sources (e.g., different sampling planes at different orientations, mixtures of plane and borehole sampling). This is a significant advantage over existing approaches as different data sources often display different statistical characteristics even for the same fracture set. The Stripa Mine dataset is used to demonstrate the application of the proposed method.
Does Eta Protein Differentiate Rheumatoid Arthritis from Psoriatic Arthritis?
Authors: Kor Ahmet , Orhan Kevser , Maraş Yüksel , Oğuz Esra Fırat , Unan Mehtap Kalçık , Dilek Gamze , Erten Şükran , Nas Kemal
Published: April 2024

Aim:

The clinical symptoms and laboratory markers of Rheumatoid Arthritis
(RA) and Psoriatic Arthritis (PsA) can be very similar, so making a differential diagnosis
between these two diseases is often difficult. Serological parameters to be used in differential
diagnosis can guide the clinician. This study aimed to investigate the usability
of 14-3-3η (eta) protein as a biomarker in the differential diagnosis of PsA and RA, and
the relationships between eta protein and disease activity scores and joint erosions in
PsA and RA.

Methods:

54 PsA patients, 53 RA patients, and 56 healthy individuals were included in
this study. The ELISA (Enzyme-Linked ImunoSorbent Assay) kit was used as a quantitative
sandwich enzyme immunoassay technique to detect human eta protein levels. Receiver-
operating Characteristic (ROC) curves analysis was used to determine the sensitivity
and specificity of the eta protein.

Results:

Eta protein levels were found to be significantly higher in the RA group than in
the PsA [B: -0.341, OR (95% CI): 0.711 (0.556-0.909), p: 0.007] and control [B: -0.225,
OR (95% CI): 0.798 (0.641-0.995), p: 0.045] groups. Eta protein median values were significantly
higher in patients with joint erosion than in those without [β= 0.151, OR (95%
CI): 1.163 (1.003-1.349), p: 0.046].

Conclusion:

Eta protein levels are higher in the serum of RA patients than PsA and are
associated with joint erosion. Eta protein may be a potential biomarker in the differential
diagnosis of RA and PsA. It may represent a possible therapeutic step in the pathophysiological
pathways in the development of joint erosion.
Preparation and Physicochemical Properties of a Thermosensitive Hydrogel-based Lipopeptide Biosurfactant
Authors: Afsharipour Sepehr , Estabragh Mohammad Amin Raeisi , Namaki Amirhossein , Ohadi Mandana , Moshafi Mohammad Hassan , Banat Ibrahim M. , Dehghannoudeh Gholamreza
Published: April 2024

Background:

Temperature-sensitive (thermo-sensitive) formulations are a novel drug
delivery dosage form that shows bio-inspired behavior in various applications. The structure and
properties of a thermosensitive polymer are critical in designing an intelligent biometric polymer that
contains lipopeptide biosurfactants.

Objectives:

In this study, thermo-sensitive hydrogels with lipopeptide biosurfactants as a potential
wound dressing dosage form were formulated and examined regarding physicochemical properties.

Methods:

The lipopeptide biosurfactants were isolated from the Acinetobacter junni B6 bacterial
strain and loaded on a formulation of poloxamer 407® and carboxymethyl cellulose as a gelling
agent. Numerous experiments were carried out to evaluate the physicochemical properties of these
formulations, such as the stability, spreadability, release profile, and kinetic.

Results:

The formulation (Poloxamer 407® (19% w/v), carboxymethyl cellulose (2% w/v), lipopeptide biosurfactants (5mg/mL), benzyl alcohol (1% v/v), and 0.1mL polyethylene glycol 400) was
select as the optimum formulation. The selected formulation released 26.9% of the lipopeptide biosurfactants with anomalous transport kinetics after 10 hours.

Conclusions:

The results showed that a thermo-sensitive formulation could help achieve a sustained
release of lipopeptide biosurfactants and potentially be used as a dressing formulation for wounds in
future studies.
Adolescents' Knowledge and Attitudes about Contraception, Sexuality, Sexually Transmitted Diseases, and Pelvic Health
Authors: Erceg Ivkosic Ivana , Fures Rajko , Bojcic Ruzica , Hrgovic Zlatko , Fures Dora , Cosic Vesna , Lez Cvjetko , Stanic Zana , Bulic Luka
Published: April 2024

Background:

Sexually Transmitted Infections (STIs) can cause serious health complications, including pelvic inflammatory disease, infertility, ectopic pregnancy, adverse pregnancy outcomes, and cervical cancer. Adolescents and young adults are particularly vulnerable to STIs due to
risk-taking behaviors, multiple sexual partners, and inconsistent condom use. Our study aimed to
examine the knowledge about contraceptive methods and sexually transmitted infections, and attitudes toward sexual health education among adolescents in Croatia.

Methods:

The participants were high school students aged 16 to 18 years. The study was conducted
at Antun Gustav Matoš Gymnasium, Zabok. We obtained study data via an anonymous survey.

Results:

The study included 204 adolescents in their final years of high school. The total number of
adolescents who had sexual intercourse was 47 (23%). The percentage of sexually active female
and male adolescents was 21% and 27%, respectively. In the surveyed group of adolescents, 86%
had never heard of subcutaneous progestin implants and 72% had never heard of contraceptive
sponges. All adolescents had heard of oral contraceptives and condoms. In the surveyed group of
adolescents, 58% had never heard of trichomoniasis and 10% had never heard of HSV. All adolescents had heard of HIV and syphilis. A total of 147 (72%) of the surveyed adolescents believed it as
necessary to provide health education in schools.

Conclusion:

The initiation of sexual activity among adolescents in Croatia remains unchanged
when compared to previous studies. Their current knowledge of sexually transmitted diseases and
contraceptive methods should be improved through continuous, well-designed, and comprehensive
sexual health education.
Validating the Distinctiveness of the Omicron Lineage within the SARS-CoV-2 based on Protein Language Models
Authors: Dong Ke , Gao Jingyang
Published: April 2024

Introduction:

Variants of concern were identified in severe acute respiratory syndrome
coronavirus 2, namely Alpha, Beta, Gamma, Delta, and Omicron. This study explores the mutations
of the Omicron lineage and its differences from other lineages through a protein language model.

Methods:

By inputting the severe acute respiratory syndrome coronavirus 2 wild-type sequence into
the protein language model evolving pre-trained models-1v, this study obtained the score for each
position mutating to other amino acids and calculated the overall trend of a new variant of concern
mutation scores.

Results:

It is found that when the proportion of unobserved mutations to observed mutations is 4:15,
Omicron still generates a large number of newly emerging mutations. It was found that the overall
score for the Omicron family is low, and the overall ranking for the Omicron family is low.

Conclusion:

Mutations in the Omicron lineage are different from amino acid mutations in other lineages.
The findings of this paper deepen the understanding of the spatial distribution of spike protein
amino acid mutations and overall trends of newly emerging mutations corresponding to different
variants of concern. This also provides insights into simulating the evolution of the Omicron lineage.
Nanocarrier-based Drug Delivery of Brinzolamide for Ocular Diseases: A Mini-Review
Authors: Maurya Rashmi , Vikal Akash , Patel Preeti , Narang Raj Kumar , Kurmi Balak Das
Published: April 2024

Brinzolamide (BRZ) represents a significant advancement in glaucoma treatment as a
topically active carbonic anhydrase inhibitor (CAI). It exhibits selectivity and potent inhibitory activity
for carbonic anhydrase type II isozyme (CA-II), which is crucial in aqueous humor secretion.
With excellent ocular bioavailability and a formulation optimized for physiologic pH, brinzolamide
effectively lowers intraocular pressure by inhibiting CA-II in ciliary processes. Its superior
ocular comfort profile enhances patient compliance. Preclinical evaluations confirm its specific
CA inhibition without notable side effects, and its low systemic absorption minimizes systemic
CA inhibition-related issues. BRZ's prolonged tissue half-life in the eye ensures sustained IOP reduction,
supported by clinical trials demonstrating comparable efficacy with reduced dosing frequency.
Challenges in ocular disease treatment arise from physiological, anatomical, and dynamic
barriers hindering effective drug delivery to the eye. Nanocarriers, such as micelles, nanoparticles,
liposomes, niosomes, and dendrimers, offer promising solutions by improving permeation, targeting
specific sites, and overcoming the limitations of conventional forms. This review explores diverse
nanomedicines, detailing their applications, advantages, and disadvantages in ophthalmic
drug delivery. It also includes recent research findings for a comprehensive overview of the current
landscape.
Development of Maternal Adaptation Scale for the Primipara Women
Authors: Ko Jungmi , Song Ju-Eun
Published: April 2024

Purpose: The purpose of this study was to develop and evaluate a maternal adaptation scale for primipara in Korea.Method: The theoretical framework of this study was developed based on Roy adaptation model, a literature review, and in-depth interviews with primipara who gave birth within 6 months. Data were collected using a selfreport questionnaire at obstetrics, gynecology, and pediatric hospitals. A total of 321 primiparas who had given birth within 6 months were included in this study.Results: An exploratory factor analysis demonstrated that the maternal adaptation scale for primipara consisted of 6 factors reflected in a total of 28 questions. A criterion validity assessment confirmed that a significant correlation was present between the developed scale and Lederman tool measuring maternal adaptation (r=0.54, p<0.001). The known-group validity was also established demonstrating that the normal group had higher scores of maternal adaptation than those of the depressed group (F=44.53, p<0.001). Cronbach α for the total scale was 0.87 and the subscales ranged from 0.73 to 0.84, establishing the scale's reliability.Conclusion: The study concluded that this newly developed scale of maternal adaptation is a reliable and valid instrument through empirical data verification. Therefore, the scale is recommended for active use in evaluating the level of maternal adaptation of new mothers within clinical settings, and future studies investigating the phenomenon.
Obstetricians’ Utilization of Risk Factors for High-Risk Pregnancy to Predict Complicated Pregnancies: How Are Obstetricians Using Risk Factors for High-Risk Pregnancy?
Authors: Hwang Jong Yun
Published: April 2024

Purpose: The aim of this study was to analyze how obstetricians use risk factors for high-risk pregnancies to predict complicated pregnancies.Methods: Twenty-four obstetricians were surveyed using a questionnaire that included 75 high-risk pregnancy factors identified by the Korean Society of Obstetrics and Gynecology. These factors are used to predict 11 types of complicated pregnancies: preterm labor, preterm premature rupture of membranes, incompetent internal os of the cervix, placenta previa, placenta abruptio, postpartum hemorrhage, preeclampsia/eclampsia, oligohydramnios, polyhydramnios, gestational diabetes mellitus, and intrauterine growth restriction.Results: Obstetricians utilized 65 of the 75 identified high-risk factors to predict 11 types of pregnancy complications. They identified twin pregnancy as the most significant risk factor, followed by chronic hypertension, a history of preterm birth, pregestational diabetes mellitus, advanced maternal age over 40, and a history of preeclampsia and eclampsia. Twin pregnancies were associated with all 11 complicated pregnancies. Ten of the 75 risk factors were not used for predicting complications.Conclusion: This study demonstrated that obstetricians recognized twin pregnancy as a strong risk factor associated with complications of pregnancy. Based on the results of this paper, we expect prediction models for complicated pregnancies to be developed in the future.
Comparing Attitudes Toward Different Consent Mediums: Semistructured Qualitative Study (Preprint)
Authors: Doan Xengie , Rossi Arianna , Botes Marietjie , Selzer Annika
Published: April 2024

BACKGROUND

As consent for data sharing evolves with the digital age, plain-text consent is not the only format in which information can be presented. However, designing a good consent form is highly challenging. The addition of graphics, video, and other mediums to use can vary widely in effectiveness; and improper use can be detrimental to users.

OBJECTIVE

This study aims to explore the expectations and experiences of adults toward consent given in infographic, video, text, newsletter, and comic forms in a health data sharing scenario to better understand the appropriateness of different mediums and identify elements of each medium that most affect engagement with the content.

METHODS

We designed mock consent forms in infographic, video, text, newsletter, and comic versions. Semistructured interviews were conducted with adults who were interviewed about their expectations for consent and were then shown each consent medium and asked about engaging elements across mediums, preferences for consent mediums, and the value of document quality criteria. We transcribed and qualitatively co-coded to identify themes and perform analyses.

RESULTS

We interviewed 24 users and identified different thematic archetypes based on participant goals, such as the Trust Seeker, who considered their own understanding and trust in organizations when making decisions. The infographic was ranked first for enhancing understanding, prioritizing information, and maintaining the proper audience fit for serious consent in health data sharing scenarios. In addition, specific elements such as structure, step-by-step organization, and readability were preferred engaging elements.

CONCLUSIONS

We identified archetypes to better understand user needs and elements that can be targeted to enhance user engagement with consent forms; this can help inform the design of more effective consent in the future. Overall, preferences for mediums are highly contextual, and more research should be done.
Digital Food Frequency Questionnaire Assessing Adherence to the Norwegian Food–Based Dietary Guidelines and Other National Lifestyle Recommendations: Instrument Validation Study (Preprint)
Authors: Henriksen Hege Berg , Knudsen Markus Dines , Hjartåker Anette , Blomhoff Rune , Carlsen Monica Hauger
Published: April 2024

BACKGROUND

Valid assessment tools are needed when investigating adherence to national dietary and lifestyle guidelines.

OBJECTIVE

The relative validity of the new digital food frequency questionnaire, the DIGIKOST-FFQ, against 7-day weighed food records and activity sensors was investigated.

METHODS

In total, 77 participants were included in the validation study and completed the DIGIKOST-FFQ and the weighed food record, and of these, 56 (73%) also used the activity sensors. The DIGIKOST-FFQ estimates the intake of foods according to the Norwegian food–based dietary guidelines (FBDGs) in addition to lifestyle factors.

RESULTS

At the group level, the DIGIKOST-FFQ showed good validity in estimating intakes according to the Norwegian FBDG. The median differences were small and well below portion sizes for all foods except “water” (median difference 230 g/day). The DIGIKOST-FFQ was able to rank individual intakes for all foods (r=0.2-0.7). However, ranking estimates of vegetable intakes should be interpreted with caution. Between 69% and 88% of the participants were classified into the same or adjacent quartile for foods and between 71% and 82% for different activity intensities. The Bland-Altman plots showed acceptable agreements between DIGIKOST-FFQ and the reference methods. The absolute amount of time in “moderate to vigorous intensity” was underestimated with the DIGIKOST-FFQ. However, estimated time in “moderate to vigorous intensity,” “vigorous intensity,” and “sedentary time” showed acceptable correlations and good agreement between the methods. The DIGIKOST-FFQ was able to identify adherence to the Norwegian FBDG and physical activity recommendations.

CONCLUSIONS

The DIGIKOST-FFQ gave valid estimates of dietary intakes and was able to identify individuals with different degrees of adherence to the Norwegian FBDG and physical activity recommendations. Moderate physical activity was underreported, water was overreported, and vegetables showed poor correlation, which are important to consider when interpreting the data. Good agreement was observed between the methods in estimating dietary intakes and time in “moderate to vigorous physical activity,” “sedentary time,” and “sleep.”
COVID-19 Vaccine Hesitancy: Umbrella Review of Systematic Reviews and Meta-Analysis (Preprint)
Authors: Rahbeni Tahani Al , Satapathy Prakasini , Itumalla Ramaiah , Marzo Roy Rillera , Mugheed Khalid A L , Khatib Mahalaqua Nazli , Gaidhane Shilpa , Zahiruddin Quazi Syed , Rabaan Ali A , Alrasheed Hayam A , Al-Subaie Maha F , Al Kaabil Nawal A , Alissa Mohammed , Ibrahim Amani Ahmed A L , Alsaif Hussain Abdulkhaliq , Naser Israa Habeeb , Rustagi Sarvesh , Kukreti Neelima , Dziedzic Arkadiusz
Published: April 2024

BACKGROUND

The unprecedented emergence of the COVID-19 pandemic necessitated the development and global distribution of vaccines, making the understanding of global vaccine acceptance and hesitancy crucial to overcoming barriers to vaccination and achieving widespread immunization.

OBJECTIVE

This umbrella review synthesizes findings from systematic reviews and meta-analyses to provide insights into global perceptions on COVID-19 vaccine acceptance and hesitancy across diverse populations and regions.

METHODS

We conducted a literature search across major databases to identify systematic reviews and meta-analysis that reported COVID-19 vaccine acceptance and hesitancy. The AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) criteria were used to assess the methodological quality of included systematic reviews. Meta-analysis was performed using STATA 17 with a random effect model. The data synthesis is presented in a table format and via a narrative.

RESULTS

Our inclusion criteria were met by 78 meta-analyses published between 2021 and 2023. Our analysis revealed a moderate vaccine acceptance rate of 63% (95% CI 0.60%-0.67%) in the general population, with significant heterogeneity (I2 = 97.59%). Higher acceptance rates were observed among health care workers and individuals with chronic diseases, at 64% (95% CI 0.57%-0.71%) and 69% (95% CI 0.61%-0.76%), respectively. However, lower acceptance was noted among pregnant women, at 48% (95% CI 0.42%-0.53%), and parents consenting for their children, at 61.29% (95% CI 0.56%-0.67%). The pooled vaccine hesitancy rate was 32% (95% CI 0.25%-0.39%) in the general population. The quality assessment revealed 19 high-quality, 38 moderate-quality, 15 low-quality, and 6 critically low-quality meta-analyses.

CONCLUSIONS

This review revealed the presence of vaccine hesitancy globally, emphasizing the necessity for population-specific, culturally sensitive interventions and clear, credible information dissemination to foster vaccine acceptance. The observed disparities accentuate the need for continuous research to understand evolving vaccine perceptions and to address the unique concerns and needs of diverse populations, thereby aiding in the formulation of effective and inclusive vaccination strategies.

CLINICALTRIAL

PROSPERO CRD42023468363; https://tinyurl.com/2p9kv9cr
Correction: Detecting Anomalies in Daily Activity Routines of Older Persons in Single Resident Smart Homes: Proof-of-Concept Study (Preprint)
Authors: Shahid Zahraa Khais , Saguna Saguna , Åhlund Christer
Published: April 2024

UNSTRUCTURED

One of the main challenges of health monitoring systems is the support of older persons in living independently in their homes and with relatives. Smart homes equipped with internet of things devices can allow older persons to live longer in their homes. Previous surveys used to identify sensor-based data sets in human activity recognition systems have been limited by the use of public data set characteristics, data collected in a controlled environment, and a limited number of older participants. The objective of our study is to build a model that can learn the daily routines of older persons, detect deviations in daily living behavior, and notify these anomalies in near real-time to relatives. We extracted features from large-scale sensor data by calculating the time duration and frequency of visits. Anomalies were detected using a parametric statistical approach, unusually short or long durations being detected by estimating the mean (μ) and standard deviation (σ) over hourly time windows (80 to 355 days) for different apartments. The confidence level is at least 75% of the tested values within two (σ) from the mean. An anomaly was triggered where the actual duration was outside the limits of 2 standard deviations (μ−2σ, μ+2σ), activity nonoccurrence, or absence of activity. The patterns detected from sensor data matched the routines self-reported by users. Our system observed approximately 1000 meals and bathroom activities and notifications sent to 9 apartments between July and August 2020. A service evaluation of received notifications showed a positive user experience, an average score of 4 being received on a 1 to 5 Likert-like scale. One was poor, two fair, three good, four very good, and five excellent. Our approach considered more than 75% of the observed meal activities were normal. This figure, in reality, was 93%, normal observed meal activities of all participants falling within 2 standard deviations of the mean. In this research, we developed, implemented, and evaluated a real-time monitoring system of older participants in an uncontrolled environment, with off-the-shelf sensors and internet of things devices being used in the homes of older persons. We also developed an SMS-based notification service and conducted user evaluations. This service acts as an extension of the health/social care services operated by the municipality of Skellefteå provided to older persons and relatives.
The development of a tablet-based outpatient care for people with dementia – A feasibility study (Preprint)
Authors: Supplieth Juliana , Lech Sonia , O’Sullivan Julie L. , Spang Robert , Voigt-Antons Jan‐Niklas , Schuster Johanna
Published: April 2024

BACKGROUND

Dementia presents a significant challenge for individuals affected by it, as well as their families, caregivers, and healthcare providers.

OBJECTIVE

This paper outlines the process of developing and assessing the feasibility of a tablet application aimed at addressing this challenge. It underscores the importance of incorporating input from general practitioners, stakeholders, and the needs of affected families to create a supportive healthcare app.

METHODS

A qualitative approach was chosen, consisting of three interviews and an expert workshop. Both were recorded, transcribed and the qualitative content analysis was carried out according to the methodology described by Kuckartz with the support of MAXQDA. During the development phases of the app, team meetings and discussions took place bi-weekly.

RESULTS

This paper emphasizes the necessity of considering multiple perspectives to ensure the high-quality development of supportive healthcare apps. General practitioners and relatives play pivotal roles in the treatment and care of Persons with Dementia, often expressing specific preferences and suggestions regarding supportive assistive technologies. Moreover, successful development of a useful tablet application requires robust scientific, multidisciplinary discussions, and teamwork within the healthcare community.

CONCLUSIONS

The collaboration among medical disciplines, social and technical sciences, as well as supporting organizations is essential to integrate relevant knowledge and expertise into the design and development of practical products tailored to the daily needs for healthcare of end users. Furthermore, adopting a spiral development approach inclusive of feedback loops is imperative for iterative refinement and enhancement of the application.

CLINICALTRIAL

ISRCTN 36542

INTERNATIONAL REGISTERED REPORT

RR2-10.1024/1662-9647/a000210