bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Artificial Intelligence–Based Cyberbullying Interventions From Youth Perspective
Authors: Milosevic Tijana , Verma Kanishk , Carter Michael , Vigil Samantha , Laffan Derek , Davis Brian , O’Higgins Norman James
Published: January 2023

Cyberbullying on social media continues to pose a significant problem for children and young people, and platforms increasingly rely on artificial intelligence (AI) to address it. Nonetheless, little is known about children’s views as to the effectiveness of AI-based interventions; and how these interventions impact their rights to protection, privacy, and freedom of expression, as afforded to them in the United Nations Convention on the Rights of the Child (UNCRC), which applies in a digital environment. This study is the first to ask children about their perceptions as to how AI-based proactive content moderation of cyberbullying impacts their rights. We have designed a set of AI-based interventions into cyberbullying that build on proactive content take-down, based on social learning and social norm theories; we solicited children’s views via focus groups and in-depth interviews as to their perceived effectiveness and impact of such interventions on children’s rights (children from Ireland, age 12–17, N = 59). We discuss how youth social norms can limit the effectiveness of the interventions and the need to involve youth in platform decisions regarding AI design.
Forecasting Bitcoin Futures: A Lasso-BMA Two-Step Predictor Selection for Investment and Hedging Strategies
Authors: Huang Weige , Gao Xiang
Published: January 2023

After Bitcoin futures were introduced by the Chicago Mercantile Exchange in December 2017, their trading volume has stayed in an uptrend due to speculation, though the scale is still small compared to other traditional futures. As increasing trading indicates more attention and the presence of institutional traders, there exists a need for reliable return and variance forecasts of Bitcoin futures contracts. Therefore, this paper first applies LASSO to pick out best-fitting predictors by shrinking the dimension of a universe of potential determinants sourced from intraday Bitcoin spot trades and daily futures variables. Then, a second round of predictor selection is conducted via Bayesian model averaging so that the modeling uncertainty can be mitigated. We find that factors standing out from this two-step procedure possess a strong predictive power for Bitcoin futures return and volatility in different time horizons. It is further demonstrated that the investment and hedging strategies established based on our forecasts perform well in out-of-sample validations.
Examining User Verification Schemes, Safety and Secrecy Issues Affecting M-Banking: Systematic Literature Review
Authors: Cavus Nadire , Mohammed Yakubu Bala , Bulama Mohammed , Isah Muhammad Lamir
Published: January 2023

Expediency and suppleness were the main reasons for customers’ patronage of m-banking apps. However, data stored or transmitted in these apps are susceptible to different attacks, threats, and risks. Thus, the need for robust safety mechanisms to cope with these security and privacy challenges. The purpose of this research is to examine the different components of m-banking security that merit investigation, and the vulnerability of present authentication methods in order to propose a more robust verification technique. PRISMA preferred items reporting for Systematic Review and Meta-Analyses approach was used in this study. Six databases were utilized; IEEE-Explore, Scopus, EBSCOhost, Taylor & Francis, ScienceDirect, and Web of Science. About 1,149 articles were extracted from these databases out of which 38 articles met the review selection criteria, thus included in the review. Findings of the study highlight the efficacy of PRISMA method with regard to items reporting and identification of research gaps compared to the usual literature review. Also, the results of the study found intrusion via other apps stored on mobile devices, and device lost or theft were the main safety and privacy issues. Furthermore, the study findings discovered that the present authentication schemes used by banks are becoming weak and open to various attacks due to an increase in online fraud. Based on the review findings, an Artificial Intelligence-based user authentication and anomalies detection model was proposed which may provide direction for upcoming studies. Also, banks and other financial institutions can use the review results to improve m-banking security.
Novel AI-Based Algorithm for the Automated Computation of Coronal Parameters in Adolescent Idiopathic Scoliosis Patients: A Validation Study on 100 Preoperative Full Spine X-Rays
Authors: Berlin Clara , Adomeit Sonja , Grover Priyanka , Dreischarf Marcel , Halm Henry , Dürr Oliver , Obid Peter
Published: January 2023

Study design

Retrospective, mono-centric cohort research study.

Objectives

The purpose of this study is to validate a novel artificial intelligence (AI)-based algorithm against human-generated ground truth for radiographic parameters of adolescent idiopathic scoliosis (AIS).

Methods

An AI-algorithm was developed that is capable of detecting anatomical structures of interest (clavicles, cervical, thoracic, lumbar spine and sacrum) and calculate essential radiographic parameters in AP spine X-rays fully automatically. The evaluated parameters included T1-tilt, clavicle angle (CA), coronal balance (CB), lumbar modifier, and Cobb angles in the proximal thoracic (C-PT), thoracic, and thoracolumbar regions. Measurements from 2 experienced physicians on 100 preoperative AP full spine X-rays of AIS patients were used as ground truth and to evaluate inter-rater and intra-rater reliability. The agreement between human raters and AI was compared by means of single measure Intra-class Correlation Coefficients (ICC; absolute agreement; >.75 rated as excellent), mean error and additional statistical metrics.

Results

The comparison between human raters resulted in excellent ICC values for intra- (range: .97-1) and inter-rater (.85-.99) reliability. The algorithm was able to determine all parameters in 100% of images with excellent ICC values (.78-.98). Consistently with the human raters, ICC values were typically smallest for C-PT (eg, rater 1A vs AI: .78, mean error: 4.7°) and largest for CB (.96, -.5 mm) as well as CA (.98, .2°).

Conclusions

The AI-algorithm shows excellent reliability and agreement with human raters for coronal parameters in preoperative full spine images. The reliability and speed offered by the AI-algorithm could contribute to the efficient analysis of large datasets (eg, registry studies) and measurements in clinical practice.
Changes in the content of Puerarin-PLGA nanoparticles in mice under the influence of alcohol and analysis of their antialcoholism
Authors: Qiang Siyu , Gu Lixiang , Kuang Yu , Zhao Minyao , You Yu , Han Qin
Published: January 2023

To observe the metabolic changes and antialcoholic effect of Puerarin-PLGA nanoparticles (PUE-NP) in mice. PUE-NP was prepared and characterized by particle size distribution and morphology. The mouse models with acute alcoholism were established to observe their behavioral changes after alcohol poisoning. The expressions of biologically active enzymes such as CRE, BUN, AST, ALT in serum and SOD and TLR4 in liver of mice in each group were detected, and the pathological changes in liver and kidney tissues were observed by HE staining. The PUE-NP metabolism in mice was determined by in vitro release assay and HPLC. PUE-NP nanoparticles had good morphology and structure, and the mouse models with alcohol poisoning were established successfully. Compared with alcohol group, puerarin and PUE-NP increased the disappearance latency time of righting reflex, and the recovery time of righting reflex was significantly shortened. Water maze results showed that Puerarin and PUE-NP had inhibitory effect on impaired memory. HPLC results showed that PUE-NP reached its peak in mice after 1 h, and the content percentage was twice that of puerarin preparation alone, and the distribution time of puerarin concentration in vivo was prolonged, indicating that PLGA nanoparticles had a loading and slow-release effect on puerarin and increased the bioavailability of puerarin in mice. In addition, compared with the alcohol group, Puerarin and PUE-NP improved serum ALT, AST, CRE, and BUN levels in mice, enhanced SOD activity in liver, and inhibited TLR4 expression. The effect was better in the PUE-NP group than in the Puerarin group. PUE-NP delayed the release and metabolism of Puerarin and had better effect in the treatment of the alcoholic liver and kidney injury.
Universal Pre-K and College Enrollment: Is There a Link?
Authors: Gormley William T. , Amadon Sara , Magnuson Katherine , Claessens Amy , Hummel-Price Douglas
Published: January 2023

In this study, we used data from a cohort of 4,033 Tulsa kindergarten students to investigate the relationship between pre-K enrollment and later college enrollment. Specifically, we tested whether participation in the Tulsa Public Schools universal pre-K program and the Tulsa Community Action Project (CAP) Head Start program predicted enrollment in 2- or 4-year colleges. We used propensity score weighting with multiply imputed data sets to estimate these associations. We found that college enrollment was 12 percentage points higher for Tulsa pre-K alumni compared with former students who did not attend Tulsa pre-K or Head Start. College enrollment was 7.5 percentage points higher for Head Start alumni compared to former students who did not attend Head Start or Tulsa pre-K, but this difference was only marginally significant. Tulsa pre-K attendance was associated with 2-year college enrollment among students from all racial and ethnic backgrounds, but only among Black and Hispanic students did it strongly predict 4-year college enrollment.
Identification of the Viral Pathogens in School Children With Acute Otitis Media in Central Java, Indonesia
Authors: Darmawan Anton Budhi , Dewantari Aghnianditya Kresno , Putri Hanifah Fajri Maharani , Wiyatno Ageng , Wahyono Daniel Joko , Safari Dodi
Published: January 2023

Acute otitis media (AOM) is one of the most common infectious diseases in pediatric clinical facilities and has a significant impact on health care. It is a polymicrobial disease and is usually preceded by a viral upper respiratory tract infection. Data on the spectrum of viruses that cause AOM in Indonesia are still limited. This study analyzed nasopharynx (NP) samples collected from 119 school children with AOM in Banyumas Regency, Central Java, Indonesia. Viral RNA was extracted for cDNA synthesis, followed by PCR and sequencing tools for detection of a panel of respiratory viruses using family-level primers for Coronaviridae, Enterovirus, Bocavirus, and Pneumovirinae for bocavirus. In total, 37 out of 119 NP samples (31.1%) tested positive for viruses. Human rhinovirus B was the predominant virus identified (32.4%) followed by rhinovirus C (29.7%), human rhinovirus A (27%), and human bocavirus (5.4%). Rhinovirus are predominant viral pathogens within school children with AOM in Central Java, Indonesia.
An Analysis of 30-Day Readmissions of Surgically Managed Hiatal Hernia in the United States, 2010 to 2018
Authors: Whitehorn Gregory L. , Collins Micaela L. , Mack Shale J. , Till Brian M. , Tofani Christina J. , Chojnacki Karen A. , Okusanya Olugbenga T.
Published: January 2023

Background:

Longitudinal national data on 30-day readmissions after hiatal hernia (HH) repair has not yet been fully explored.

Methods:

Data was obtained from the National Readmissions Database (NRD) for patients undergoing HH repair between 2010 and 2018. Univariable and multivariable logistic regression analyses reported with odds ratio (OR) and 95% confidence intervals (CI) were performed to identify factors associated with 30-day readmission. Interventions and procedures performed during readmission were extracted using International Classification of Disease (ICD)-9 and ICD-10 codes.

Results:

A total of 113 928 patients met inclusion criteria. Of these patients, 7492 (6.58%) were readmitted within 30 days of their initial hiatal hernia repair. Factors associated with readmission included age, diagnosis of frailty, non-elective admission for the index procedure and open approach. The median total cost of the readmission event was $29 845. On multivariable logistic regression, factors associated with 30-day readmission included frailty (OR = 1.17, P = .04), index admission status (non-elective, OR = 1.18, P < .001), Medicare (OR = 1.27, P < .001) or Medicaid insurance (OR = 1.36, P < .001), repair approach (open, OR = 1.14, P < .001), and initial length of stay (OR = 1.03, P < .001). On readmission, patients underwent a range of procedures, but only a small proportion required hiatal hernia re-repair.

Conclusion:

There are notable demographic differences between the non-readmitted and readmitted cohorts, as well as specific risk factors associated with readmission within 30 days of hiatal hernia repair. Further research is necessary determine population-specific methods to prevent readmission in the highest risk cohort.
Tribological Performance of Different Concentrations of Al2O3 Nanofluids on Minimum Quantity Lubrication Milling
Authors: Bai Xiufang , Jiang Juan , Li Changhe , Dong Lan , Ali Hafiz Muhammad , Sharma Shubham
Published: January 2023

Nanofluid minimum quantity lubrication (NMQL) is a green processing technology. Cottonseed oil is suitable as base oil because of excellent lubrication performance, low freezing temperature, and high yield. Al2O3nanoparticles improve not only the heat transfer capacity but also the lubrication performance. The physical and chemical properties of nanofluid change when Al2O3nanoparticles are added. However, the effects of the concentration of nanofluid on lubrication performance remain unknown. Furthermore, the mechanisms of interaction between Al2O3nanoparticles and cottonseed oil are unclear. In this research, nanofluid is prepared by adding different mass concentrations of Al2O3nanoparticles (0, 0.2%, 0.5%, 1%, 1.5%, and 2% wt) to cottonseed oil during minimum quantity lubrication (MQL) milling 45 steel. The tribological properties of nanofluid with different concentrations at the tool/workpiece interface are studied through macro-evaluation parameters (milling force, specific energy) and micro-evaluation parameters (surface roughness, micro morphology, contact angle). The result show that the specific energy is at the minimum (114 J/mm3), and the roughness value is the lowest (1.63 μm) when the concentration is 0.5 wt%. The surfaces of the chip and workpiece are the smoothest, and the contact angle is the lowest, indicating that the tribological properties are the best under 0.5 wt%. This research investigates the intercoupling mechanisms of Al2O3nanoparticles and cottonseed base oil, and acquires the optimal Al2O3nanofluid concentration to receive satisfactory tribological properties.
Less car, more bicycle? Generation Y as pioneers of changing everyday mobility in Germany
Authors: Konietzka Dirk , Neugebauer Lukas
Published: January 2023

Background

The paper examines whether the widespread assumption holds that younger birth cohorts (referred to as Millennials or Generation Y) act as pioneers of changing everyday mobility.

Methodology

Based on the time-series dataset "Mobility in Germany" (Mobilität in Deutschland), cohort-specific changes in everyday bicycle and car use that have occurred between 2002 and 2017 are analyzed. The empirical analyses are differentiated by age-group and settlement type. Additionally, socio-structural factors are taken into account.

Results

The results show a decline in the predominant everyday use of cars in metropolitan cities, especially among Generation Y. However, the Millennials do not emerge as pioneers of the trend toward predominant bicycle use. The results challenge the assumption that changes in everyday mobility are essentially driven by generational change.
Stochastic nuclear organization and host-dependent allele contribution in Rhizophagus irregularis
Authors: van Creij Jelle , Auxier Ben , An Jianyong , Wijfjes Raúl Y. , Bergin Claudia , Rosling Anna , Bisseling Ton , Pan Zhiyong , Limpens Erik
Published: January 2023

Background

Arbuscular mycorrhizal (AM) fungi are arguably the most important symbionts of plants, offering a range of benefits to their hosts. However, the provisioning of these benefits does not appear to be uniform among AM fungal individuals, with genetic variation between fungal symbionts having a substantial impact on plant performance. Interestingly, genetic variation has also been reported within fungal individuals, which contain millions of haploid nuclei sharing a common cytoplasm. In the model AM fungus, Rhizophagus irregularis, several isolates have been reported to be dikaryotes, containing two genetically distinct types of nuclei recognized based on their mating-type (MAT) locus identity. However, their extremely coenocytic nature and lack of a known single nucleus stage has raised questions on the origin, distribution and dynamics of this genetic variation.

Results

Here we performed DNA and RNA sequencing at the mycelial individual, single spore and single nucleus levels to gain insight into the dynamic genetic make-up of the dikaryote-like R. irregularis C3 isolate and the effect of different host plants on its genetic variation. Our analyses reveal that parallel spore and root culture batches can have widely variable ratios of two main genotypes in C3. Additionally, numerous polymorphisms were found with frequencies that deviated significantly from the general genotype ratio, indicating a diverse population of slightly different nucleotypes. Changing host plants did not show consistent host effects on nucleotype ratio’s after multiple rounds of subculturing. Instead, we found a major effect of host plant-identity on allele-specific expression in C3.

Conclusion

Our analyses indicate a highly dynamic/variable genetic organization in different isolates of R. irregularis. Seemingly random fluctuations in nucleotype ratio’s upon spore formation, recombination events, high variability of non-tandemly repeated rDNA sequences and host-dependent allele expression all add levels of variation that may contribute to the evolutionary success of these widespread symbionts.
Dysbiotic microbiome variation in colorectal cancer patients is linked to lifestyles and metabolic diseases
Authors: Hoang Tung , Kim Minjung , Park Ji Won , Jeong Seung-Yong , Lee Jeeyoo , Shin Aesun
Published: January 2023

Background

Differences in the composition and diversity of the gut microbial communities among individuals are influenced by environmental factors. However, there is limited research on factors affecting microbiome variation in colorectal cancer patients, who display lower inter-individual variations than that of healthy individuals. In this study, we examined the association between modifiable factors and the microbiome variation in colorectal cancer patients.

Methods

A total of 331 colorectal cancer patients who underwent resection surgery at the Department of Surgery, Seoul National University Hospital between October 2017 and August 2019 were included. Fecal samples from colorectal cancer patients were collected prior to the surgery. Variations in the gut microbiome among patients with different lifestyles and metabolic diseases were examined through the network analysis of inter-connected microbial abundance, the assessment of the Anna Karenina principle effect for microbial stochasticity, and the identification of the enriched bacteria using linear discrimination analysis effect size. Associations of dietary diversity with microbiome variation were investigated using the Procrustes analysis.

Results

We found stronger network connectivity of microbial communities in non-smokers, non-drinkers, obese individuals, hypertensive subjects, and individuals without diabetes than in their counterparts. The Anna Karenina principle effect was found for history of smoking, alcohol consumption, and diabetes (with significantly greater intra-sample similarity index), whereas obesity and hypertension showed the anti-Anna Karenina principle effect (with significantly lower intra-sample similarity index). We found certain bacterial taxa to be significantly enriched in patients of different categories of lifestyles and metabolic diseases using linear discrimination analysis. Diversity of food and nutrient intake did not shape the microbial diversity between individuals (pProcrustes>0.05).

Conclusions

Our findings suggested an immune dysregulation and a reduced ability of the host and its microbiome in regulating the community composition. History of smoking, alcohol consumption, and diabetes were shown to affect partial individuals in shifting new microbial communities, whereas obesity and history of hypertension appeared to affect majority of individuals and shifted to drastic reductions in microbial compositions. Understanding the contribution of modifiable factors to microbial stochasticity may provide insights into how the microbiome regulates effects of these factors on the health outcomes of colorectal cancer patients.
Activation of autophagy inhibits the activation of NLRP3 inflammasome and alleviates sevoflurane-induced cognitive dysfunction in elderly rats
Authors: Zhou Junjie , Zhang Chao , Fang Xu , Zhang Naixin , Zhang Xiaoxi , Zhu Zhaoqiong
Published: January 2023

Aims/introduction

As a common complication in elderly patients after surgery/anesthesia, postoperative cognitive dysfunction (POCD) is mainly characterized by memory, attention, motor, and intellectual retardation. Neuroinflammation is one of the most uncontroversial views in POCD. The sevoflurane-induced neurotoxicity has attracted widespread attention in recent years. However, its mechanism has not been determined. This study aimed to observe the effects of sevoflurane on cognitive function and the changes in inflammatory indices and autophagy protein expression in the prefrontal cortex in aged rats.

Method

Before the experiment, D-galactose was diluted with normal saline into a liquid with a concentration of 125 mg/kg and injected subcutaneously into the neck and back of rats for 42 days to establish the aging rat model. Morris water maze experiments were performed, including positioning navigation (5 days) and space exploration (1 day). The POCD model was established by 3.2% sevoflurane inhalation. The rats were treated with or without MCC950, a potent and selective nucleotide‐binding oligomerization domain‐like receptor protein 3 (NLRP3) inhibitor, followed by autophagy agonists and autophagy inhibitors. The expression levels of inflammasome-related protein NLRP3 and autophagy-related proteins LC3B and P62 were detected to test the behavior of rats with a water maze.

Results

We found that sevoflurane exposure affected learning and working memory ability in aged rats. We also observed microglia activation in the prefrontal cortex. NLRP3 protein expression was significantly upregulated after sevoflurane inhalation. NLRP3 inflammasome activation induced increased expression and mRNA expression of cleaved Caspase-1 and inflammatory cytokines IL-1β and IL-18, and increased secretion of peripheral proinflammatory cytokines. The inhibitor MCC950 was used to improve cognitive ability and inflammation in rats and inhibit the secretion of cytokines. In addition, we demonstrated that significant inhibition of autophagy (decreased LC3-II/I and increased P62) was accompanied by increased activation of NLRP3 inflammasomes and more severe neural cell damage. However, autophagy inhibitor rapamycin administration to activate autophagy resulted in the inhibition of NLRP3 inflammasomes, ultimately attenuating neuronal injury.

Conclusions

The activation of autophagy suppressed the formation of NLRP3 inflammasomes. It also alleviated cognitive impairment in aged rats.
Two ischemic stroke events within 48 h: a case report of an unusual presentation of thrombotic thrombocytopenic purpura
Authors: Jameie Melika , Heydari Sanaz , Ghabaee Mojdeh , Amirifard Hamed
Published: January 2023

Background

Thrombotic thrombocytopenic purpura (TTP) considers a rare cause of ischemic stroke (IS). We reported a case of a newly diagnosed patient with acquired immune-mediated TTP (iTTP), in whom two IS events developed during 48 h.

Case presentation

A 59-year-old diabetic male was presented to the hospital 24 h after symptoms onset, including left hemiparesis, dysarthria, and decreased consciousness. A brain CT scan was performed with the suspicion of acute IS, indicating infarct lesions in the right middle cerebral artery (MCA) territory. The patient was not eligible for thrombolytic therapy due to admission delay. Over the next 24 h, the patient’s neurological condition deteriorated, and the second brain CT scan showed new ischemic lesions in the left MCA territory. Initial laboratory evaluation indicated thrombocytopenia without evidence of anemia. However, in the following days, thrombocytopenia progressed, and microangiopathic hemolytic anemia (MAHA) developed. The ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) activity and inhibitors assay confirmed the diagnosis of iTTP. The patient underwent plasma exchange activity and inhibitors assay confirmed the diagnosis of iTTP. The patient underwent and pulse IV methylprednisolone. Rituximab was also added due to the refractory course of the disease. After a prolonged hospital course, he had considerable neurologic recovery and was discharged.

Conclusions

Clinicians should consider two points. First, TTP should be considered in any patient presenting with IS and having thrombocytopenia or anemia without other symptoms of TTP. Second, worsening the patient's condition during hospitalization may indicate a new stroke and should be investigated immediately.
Developing and evaluating Birthing on Country services for First Nations Australians: the Building On Our Strengths (BOOSt) prospective mixed methods birth cohort study protocol
Authors: Haora Penny , Roe Yvette , Hickey Sophie , Gao Yu , Nelson Carmel , Allen Jyai , Briggs Melanie , Worner Faye , Kruske Sue , Watego Kristie , Maidment Sarah-Jade , Hartz Donna , Sherwood Juanita , Barclay Lesley , Tracy Sally , Tracy Mark , Wilkes Liz , West Roianne , Grant Nerida , Kildea Sue
Published: January 2023

Background

With the impact of over two centuries of colonisation in Australia, First Nations families experience a disproportionate burden of adverse pregnancy and birthing outcomes. First Nations mothers are 3–5 times more likely than other mothers to experience maternal mortality; babies are 2–3 times more likely to be born preterm, low birth weight or not to survive their first year. ‘Birthing on Country’ incorporates a multiplicity of interpretations but conveys a resumption of maternity services in First Nations Communities with Community governance for the best start to life. Redesigned services offer women and families integrated, holistic care, including carer continuity from primary through tertiary services; services coordination and quality care including safe and supportive spaces. The overall aim of Building On Our Strengths (BOOSt) is to facilitate and assess Birthing on Country expansion into two settings - urban and rural; with scale-up to include First Nations-operated birth centres. This study will build on our team’s earlier work - a Birthing on Country service established and evaluated in an urban setting, that reported significant perinatal (and organisational) benefits, including a 37% reduction in preterm births, among other improvements.

Methods

Using community-based, participatory action research, we will collaborate to develop, implement and evaluate new Birthing on Country care models. We will conduct a mixed-methods, prospective birth cohort study in two settings, comparing outcomes for women having First Nations babies with historical controls. Our analysis of feasibility, acceptability, clinical and cultural safety, effectiveness and cost, will use data including (i) women’s experiences collected through longitudinal surveys (three timepoints) and yarning interviews; (ii) clinical records; (iii) staff and stakeholder views and experiences; (iv) field notes and meeting minutes; and (v) costs data. The study includes a process, impact and outcome evaluation of this complex health services innovation.

Discussion

Birthing on Country applies First Nations governance and cultural safety strategies to support optimum maternal, infant, and family health and wellbeing. Women’s experiences, perinatal outcomes, costs and other operational implications will be reported for Communities, service providers, policy advisors, and for future scale-up.

Trial registration

Australia & New Zealand Clinical Trial Registry #ACTRN12620000874910 (2 September 2020).
Pre-operative anemia and peri-operative transfusion are associated with poor oncologic outcomes in cancers of the esophagus: potential impact of patient blood management on cancer outcomes
Authors: Connor Joseph P. , Destrampe Eric , Robbins Daniel , Hess Aaron S. , McCarthy Daniel , Maloney James
Published: January 2023

Background

Both Red Blood Cell (RBC) transfusion and anemia are thought to negatively impact cancer survival. These effects have been reported with mixed findings in cancer of the esophagus. The potential impact of the application of restrictive transfusion strategies on this patient population has not been defined.

Materials and Methods

We conducted a retrospective study of esophagectomies and studied cases based on whether they were anemic or were transfused peri-operatively. Clinical characteristics and known clinicopathologic prognosticators were compared between these groups. Survival was compared by Cox proportional hazard modeling. Post-operative transfusions were assessed for compliance with restrictive transfusion thresholds.

Results

Three-hundred ninety-nine esophagectomy cases were reviewed and after exclusions 348 cases were analyzed. The median length of follow-up was 33 months (range 1–152 months). Sixty-four percent of patients were anemic pre-operatively and 22% were transfused. Transfusion and anemia were closely related to each other. Microcytic anemia was uncommon but was evaluated and treated in only 50% of cases. Most anemic patients had normocytic RBC parameters. Transfusion but not anemia was associated with a protracted/prolonged post-operative stay. Transfusion and anemia were both associated with reduced survival however only anemia was associated with decreased survival in multi-variable modeling. Sixty-eight percent of patients were transfused post-operatively and 11% were compliant with the restrictive threshold of 7 g/dL.

Conclusions

Pre-operative anemia and transfusion are closely associated, however only anemia was found to compromise survival in our esophageal cancer cohort, supporting the need for more aggressive evaluation and treatment of anemia. Adherence to restrictive transfusion guidelines offers an opportunity to reduce transfusion rates which may also improve short-term outcomes.
Does self-perceived HIV risk mediate the potential association between HIV-related symbolic stigma and sexual behaviour among young adult women in Cape Town, South Africa?
Authors: Machemedze Takwanisa
Published: January 2023

Background

Perception of risk is a central construct of models of health behaviour change as it is assumed to be an intermediate step before adoption of the related safer behaviour. In the context of HIV/AIDS, the literature suggests that psychosocial factors such as stigmatising attitudes related to stereotyping people who contract HIV may influence how people perceive their own risk of HIV infection. However, findings on the relationships between HIV-related stigma, HIV risk perception and sexual behaviour have been inconsistent. We investigated the potential mediating role of HIV risk perception on the link between HIV-related symbolic stigma and sexual behaviour.

Methods

Data used in this study are a sub-sample of 384 young adult women, aged 17–25 years, who participated in the Cape Area Panel Study conducted in Cape Town, South Africa. Study participants were asked questions relating to their demographic details, their social and economic situation, and sexual and reproductive health behaviour. The outcome measure was a composite measure of sexual behaviour derived from whether the young adult women ever had sex before, previous number of sexual partners and condom use. The mediator variable was self-perceived risk of contracting HIV. The independent variable was HIV-related symbolic stigma attitudes. Mediation analysis within the structural equation modeling (SEM) framework was used to examine if participants who held elevated stigma attitudes perceived their risk of HIV infection to be low and as a result ended up engaging in unsafe sex.

Results

Higher HIV-related symbolic stigma attitudes were associated with perception of reduced risk of contracting HIV (β = -0.248, p = 0.008, 95% CI = [-0.431, -0.066]) and perception of higher risk of contracting HIV was significantly associated with unsafe sex practices (β = 0.179, p = 0.038, 95% CI = [0.010, 0.348]). The indirect path was not significant (β = -0.044, p = 0.084, 95% CI = [-0.095, 0.006]), suggesting no mediation relationship.

Conclusions

Stigmatising attitudes towards groups of people stereotyped as at risk of HIV infection was associated with perception of invulnerability to HIV, and the question on how this relationship affects risk sexual behaviour needs further investigation.
Perceptions of livestock value chain actors (VCAs) on the risk of acquiring zoonotic diseases from their livestock in the central dry zone of Myanmar
Authors: Win Tu Tu Zaw , Campbell Angus , Soares Magalhaes Ricardo J. , Oo Kyaw Naing , Henning Joerg
Published: January 2023

Objectives

The Central Dry Zone (CDZ) is one of the most important livestock production areas of Myanmar. However, there is an eminent lack of information on the attitudes and traditional beliefs of local farmers and livestock supply chain actors in CDZ of Myanmar on the public health implications. A modified data collection instrument of the Health Belief model was developed to investigate attitudes, beliefs and barriers to the application of recommended zoonotic disease prevention.

Study design

Cross-sectional study.

Method

Data analyses were conducted considering a two-phase multilevel mixed effect binomial generalized linear models modelling approach.

Results

The availability of information about zoonosis to supply chain actors influenced their confidence to implement preventive actions (OR = 1.5,p = 0.045 for cattle diseases; OR = 1.5,p = 0.022 for village chicken diseases). Supply chain actors were more likely aware of zoonosis transmitted by cattle compared to livestock farmers (OR = 0.3,p = 0.005 for cattle farmers), while people not rearing or trading small ruminants and/or poultry were less likely to be aware of the zoonotic risk associated with these animals (p < 0.005). Information on zoonosis transmitted from small ruminants was mainly promoted through farmers (p = 0.032), while information on zoonotic diseases that can be obtained from chickens was disseminated through farmers, local authorities and the media. Nevertheless, appropriate hand hygiene measures (i.e. cleaning of hands after touching, cutting, cooking meat) (OR = 7.7,p < 0.001 for zoonotic small ruminant diseases; OR = 1.6,p = 0.073 for zoonotic village chicken diseases) and treating of sick animals (OR = 7.3,p < 0.001 for small ruminant zoonotic diseases; OR = 2.2,p = 0.031 for village chicken zoonotic diseases) increased the confidence of small ruminant and village chicken owners to prevent these zoonotic infections.

Conclusions

The findings from this study indicate that while gender and the availability of information on zoonotic risks play an important role on the perceived threat of zoonoses, the practice of prevention methods influenced the confidence of value chain actors (VCAs) on zoonoses prevention.
Sexual and reproductive health of CDC plantation camp residents: a focus on unmet need for family planning among women in union
Authors: Emeh Agbor Nathan , Hermann Ngouakam , Tanue Elvis Asangbeng , Dickson Nsagha Shey
Published: January 2023

Background

Sexual and reproductive health is crucial to a normal and healthy female life. However, little interest has been placed on this subject particularly in the resource-limited settings of Cameroon. The study assessed the sexual and reproductive health of women in union, resident in the Cameroon Development Corporation (CDC) plantation camps, Cameroon.

Methods

This was a cross-sectional study carried out from December 2019 to February 2020 in which a multi-stage sampling was applied in two purposively selected CDC plantation camps (Tiko and Penda Mboko). Out of the 16 clusters making up the camps, 8 were randomly selected using simple balloting. The main street junctions of the sampled clusters were identified and a direction of sampling randomly chosen. All houses left to the data collectors were sampled for eligible participants (one participant per household) and data were collected using validated interviewer-administered questionnaires. The number of participants per cluster was proportionate to population size of cluster. Data was analysed using SPSS 16 and statistical significance was set at p < 0.05. Regression analysis was used to determine predictors of unmet need for family planning.

Results

Out of the 414 participants included, primary education was the highest level of education for a majority (43.0%). Most of the participants (44.7%) earned between 44.5–89.0USD/month. Relatively high proportions of some sexual and reproductive indicators like early sexual contacts (before 15 years) [87(21.0%)], grand multiparity [41(9.9%)], and abortion ≥ 3 [8(1.9%)] were recorded in the study. Two hundred and seventy-eight (278) participants (67.1%) [95%CI:62.4–71.7] used contraceptives and 90 (21.7%) [95%CI:17.9–26.0] had an unmet need for family planning with 3 major reasons for non-use of contraception among them being fear of side effects, discouragement from the partner, and lack of sufficient information on contraception. Of the different predictors of unmet need for family planning assessed, nulliparity/primiparity were protective for unmet need, and this was statistically significant (AOR = 0.284[0.086–0.934]).

Conclusion

The sexual and reproductive health of CDC plantation camp residents is poor, and a health intervention is needed to improve it.
Normative reference values and predicting factors of handgrip strength for dominant and non-dominant hands among healthy Malay adults in Malaysia
Authors: Jaafar Mohd Hasni , Ismail Rosnah , Ismail Noor Hassim , Md Isa Zaleha , Mohd Tamil Azmi , Mat Nasir Nafiza , Ng Kien Keat , Ab Razak Nurul Hafiza , Zainol Abidin Najihah , Yusof Khairul Hazdi
Published: January 2023

Introduction

Handgrip strength (HGS) measures the maximum voluntary force of the hand, which has been used to assess individual health status indirectly. Although several factors related to HGS have been identified, studies among adults in Malaysia are lacking. This study aimed to provide the normative reference HGS values and determine its predictor factors among healthy adults of Malay ethnic in Malaysia.

Methodology

This study was a part of the Prospective Urban Rural Epidemiology (PURE) study carried out among adults aged between 35 to 70 years old residing in urban and rural Malaysian communities. A standardised questionnaire was used to assess the socio-demographic information and physical activity level of respondents who provided written informed consent to participate in this study. HGS was measured using Jamar’s dynamometer. A total of 3,446 healthy adults of Malay ethnic were included in this study. Descriptive data were used to derive the normative reference values for HGS using means and standard deviations stratified by age and gender. The predictors of HGS were determined using a general linear model (GLM).

Results

Mean HGS ranged from 38.48 (± 9.40) kg for the dominant hand of men aged 35–40 years to 16.53 (± 5.69) kg for the non-dominant hand of women aged 61–70 years. The ANOVA indicated that there was a significant descending trend of HGS as age increased for both genders (p < 0.05). The ANOVA also revealed that participants working in blue- or white-collar jobs had higher HGS than their counterparts who are homemakers (p < 0.05). The GLM shows that, age, occupation type, socio-economic status (SES), physical activity level and BMI significantly predicted dominant HGS among male and meanwhile, only age, SES and BMI significantly predicted dominant HGS among female.

Conclusion

HGS normative values provided herein can serve as a guide for interpreting HGS measurements obtained from healthy Asian adults especially Malay ethnic. The clinicians and researcher can use the established HGS reference values as comparison in their patients or participants. Furthermore, during a rehabilitation process, the clinicians and researchers could use the normal score ranges to document the progress of HGS and provide feedback to the patients. Further study with prospective study design is needed to determine the causal effect association of the predictors and HGS.
Risk factor analysis and a new prediction model of venous thromboembolism after pancreaticoduodenectomy
Authors: Yin Zhi-Jie , Huang Ying-Jie , Chen Qi-Long
Published: January 2023

Aim

The present study aimed to identify risk factors for venous thromboembolism (VTE) after pancreaticoduodenectomy (PD) and to develop and internally validate a predictive model for the risk of venous thrombosis.

Methods

We retrospectively collected data from 352 patients who visited our hospital to undergo PD from January 2018 to March 2022. The number of patients recruited was divided in an 8:2 ratio by using the random split method, with 80% of the patients serving as the training set and 20% as the validation set. The least absolute shrinkage and selection operator (Lasso) regression model was used to optimize feature selection for the VTE risk model. Multivariate logistic regression analysis was used to construct a prediction model by incorporating the features selected in the Lasso model. C-index, receiver operating characteristic curve, calibration plot, and decision curve were used to assess the accuracy of the model, to calibrate the model, and to determine the clinical usefulness of the model. Finally, we evaluated the prediction model for internal validation.

Results

The predictors included in the prediction nomogram were sex, age, gastrointestinal symptoms, hypertension, diabetes, operative method, intraoperative bleeding, blood transfusion, neutrophil count, prothrombin time (PT), activated partial thromboplastin time (APTT), aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AST/ALT), and total bilirubin (TBIL). The model showed good discrimination with a C-index of 0.827, had good consistency based on the calibration curve, and had an area under the ROC curve value of 0.822 (P < 0.001, 95%confidence interval:0.761–0.882). A high C-index value of 0.894 was reached in internal validation. Decision curve analysis showed that the VTE nomogram was clinically useful when intervention was decided at the VTE possibility threshold of 10%.

Conclusion

The novel model developed in this study is highly targeted and enables personalized assessment of VTE occurrence in patients who undergo PD. The predictors are easily accessible and facilitate the assessment of patients by clinical practitioners.
A prognostic model based on necroptosis-related genes for prognosis and therapy in bladder cancer
Authors: Wang Zeyi , Huang Zhengnan , Cao Xiangqian , Zhang Fang , Cai Jinming , Tang Pengfei , Yang Chenkai , Li Shengzhou , Yu Dong , Yan Yilin , Shen Bing
Published: January 2023

Bladder cancer, one of the most prevalent malignant cancers, has high rate of recurrence and metastasis. Owing to genomic instability and high-level heterogeneity of bladder cancer, chemotherapy and immunotherapy drugs sensitivity and lack of prognostic markers, the prognosis of bladder cancer is unclear. Necroptosis is a programmed modality of necrotic cell death in a caspase-independent form. Despite the fact that necroptosis plays a critical role in tumor growth, cancer metastasis, and cancer patient prognosis, necroptosis-related gene sets have rarely been studied in bladder cancer. As a result, the development of new necroptosis-related prognostic indicators for bladder cancer patients is critical. Herein, we assessed the necroptosis landscape of bladder cancer patients from The Cancer Genome Atlas database and classified them into two unique necroptosis-related patterns, using the consensus clustering. Then, using five prognosis-related genes, we constructed a prognostic model (risk score), which contained 5 genes (ANXA1, DOK7, FKBP10, MAP1B and SPOCD1). And a nomogram model was also developed to offer the clinic with a more useful prognostic indicator. We found that risk score was significantly associated with clinicopathological characteristics, TIME, and tumor mutation burden in patients with bladder cancer. Moreover, risk score was a valid guide for immunotherapy, chemotherapy, and targeted drugs. In our study, DOK7 was chosen to further verify our prognosis model, and functional assays indicated that knockdown the expression of DOK7 could prompt bladder cancer proliferation and migration. Our work demonstrated the potential role of prognostic model based on necroptosis genes in the prognosis, immune landscape and response efficacy of immunotherapy of bladder cancer.
The effect of different types of anemia on HbA1c levels in non-diabetics
Authors: Alzahrani Basil A. , Salamatullah Hassan K. , Alsharm Faisal S. , Baljoon Jamil M. , Abukhodair Abdullah O. , Ahmed Mohammed Eldigire , Malaikah Hebah , Radi Suhaib
Published: January 2023

Background

Diabetes mellitus is one of the most common diseases worldwide with significant morbidity and mortality. HbA1c remains one of the most important methods for diagnosis and monitoring of the disease. Since HbA1c is a reflection of the glucose attached to red blood cells, factors affecting hemoglobin and red blood cells’ half-life can influence HbA1c measurements.

Objective

This study aims to evaluate the effect of different types of anemia including iron deficiency anemia, sickle cell anemia, β -thalassemia trait, and megaloblastic anemia on HbA1c levels in a tertiary hospital over the past 6 years (2016–2022).

Method

This is a retrospective chart review study of 324 patients including those with one of the four types of anemia mentioned above and a control group. The control group were healthy adults with normal HbA1c and hemoglobin, who were not known to have diabetes or anemia. Patients with diabetes or prediabetes based on self-reporting or elevated fasting, random blood sugar, or 2 hours post-prandial blood glucose were excluded.

Results

The mean HbA1c levels were significantly higher in sickle cell anemia at 5.83% (95% CI = 5.39–6.28) and in iron deficiency anemia at 5.75% (95% CI = 5.68–5.82) when compared to the control group at 5.32% (95% CI = 5.22–5.41). However, the mean HbA1c levels in megaloblastic anemia were 5.38% (95% CI = 5.26–5.5) and 5.45% (95% CI = 5.21–5.69) in beta thalassemia trait, which were not significantly different when compared to the control group. HbA1c significantly decreased from 5.75 to 5.44% after treatment in the iron-deficient group with a p-value of < 0.001. Moreover, lower hemoglobin and higher red cell distribution width correlated with higher HbA1c levels in patients with sickle cell anemia.

Conclusion

This study found a significant increase in HbA1c levels in iron deficiency anemia and sickle cell disease in patients not known to have diabetes. However, there was no significant effect in those patients with β-thalassemia trait and megaloblastic anemia. Treatment of iron deficiency anemia significantly decreased the HbA1c level, bringing it back to normal.