bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Reasoning: A 38-Year-Old Woman Presenting With Acute Hyperkinetic Movements of Her Right Arm
Authors: Ryan Dylan , Mushannen Tasnim , Le Scott
Published: March 2024

We present a case report of a 38-year-old woman who presented to the hospital with acute onset high amplitude, non-rhythmic, hyperkinetic movements of the right upper extremity, abnormal sensation of the right upper extremity from the elbow to the hand, and the inability to recognize her hand without visual input. This case discusses the differential diagnoses of acute hyperkinetic movement disorders and concurrent alien-limb in a patient presenting within the time window for vascular intervention. Readers are led through the reasoning behind acute interventional decision-making in a patient with a rare presentation. Workup reveals the eventual diagnosis.
Understanding teachers’ usage of YouTube as a pedagogical tool: A qualitative case study of basic school teachers in Ghana
Authors: Adu-Marfo Ama Otwiwah , Kwapong Olivia Adwoa Tiwaah Frimpong , Oheneba-Sakyi Yaw , Miller-Young Janice
Published: March 2024

YouTube has been widely considered as a pedagogical tool over the last few decades. Recent findings from research portray YouTube videos as an instructional part of learning that contributes to best practices in teaching. Much of the studies have focused on usage by teachers and students at the tertiary level without much attention given to basic school teachers. Using an exploratory qualitative case study design and the ICT Pedagogical Beliefs Classification framework, we explored teachers’ usage of YouTube as a pedagogical tool. We drew on the experiences of 18 teachers in 3 private schools in Ghana to find out how Youtube was used in instruction. Four dominant ways of usage were identified. YouTube was used as a teaching tool, a means of enhancing specific topics, a means of learning new and varied ways of teaching, and as a means of developing teachers’ professional competence. Findings showed that whilst some of the ways of usage align with constructivist methods of teaching others still fall within traditional and teacher centred approaches to teaching. We argue that for teachers to enact meaningful pedagogies with technology through a more student-centred model, their knowledge and skills need to be developed alongside the reshaping of their motives and reasons and subsequently the ways in which they use technology for teaching. We recommend the planning and reinforcement of innovative instructional design of technological integration for teachers through informed policy and the use of training interventions to build new skills geared towards constructive and creative teaching suited to developing a net generation of students.
A typology of artificial intelligence data work
Authors: Muldoon James , Cant Callum , Wu Boxi , Graham Mark
Published: March 2024

This article provides a new typology for understanding human labour integrated into the production of artificial intelligence systems through data preparation and model evaluation. We call these forms of labour ‘AI data work’ and show how they are an important and necessary element of the artificial intelligence production process. We draw on fieldwork with an artificial intelligence data business process outsourcing centre specialising in computer vision data, alongside a decade of fieldwork with microwork platforms, business process outsourcing, and artificial intelligence companies to help dispel confusion around the multiple concepts and frames that encompass artificial intelligence data work including ‘ghost work’, ‘microwork’, ‘crowdwork’ and ‘cloudwork’. We argue that these different frames of reference obscure important differences between how this labour is organised in different contexts. The article provides a conceptual division between the different types of artificial intelligence data work institutions and the different stages of what we call the artificial intelligence data pipeline. This article thus contributes to our understanding of how the practices of workers become a valuable commodity integrated into global artificial intelligence production networks.
Just public algorithms: Mapping public engagement with the use of algorithms in UK public services
Authors: Pallett Helen , Price Catherine , Chilvers Jason , Burall Simon
Published: March 2024

This paper proposes and models a novel approach to public engagement with the use of algorithms in public services. Algorithms pose significant risks which need to be anticipated and mitigated through democratic governance, including public engagement. We argue that as the challenge of creating responsible algorithms within a dynamic innovation system is one that will never definitively be accomplished – and as public engagement is not singular or pre-given but is always constructed through performance and in relation to other processes and events – public engagement with algorithms needs to be conducted and conceptualised as relational, systemic, and ongoing. We use a systemic mapping approach to map and analyse 77 cases of public engagement with the use of algorithms in public services in the UK 2013–2020 and synthesise the potential benefits and risks of these approaches articulated across the cases. The mapping shows there was already a diversity of public engagement on this topic in the UK by 2020, involving a wide range of different policy areas, framings of the problem, affordances of algorithms, publics, and formats of public engagement. While many of the cases anticipate benefits from the adoption of these technologies, they also raise a range of concerns which mirror much of the critical literature and highlight how algorithmic approaches may sometimes foreclose alternative options for policy delivery. The paper concludes by considering how this approach could be adopted on an ongoing basis to ensure the responsible governance of algorithms in public services, through a ‘public engagement observatory’.
Participatory action research in critical data studies: Interrogating AI from a South–North approach
Authors: Medrado Andrea , Verdegem Pieter
Published: March 2024

In this article, we draw inspiration from participatory action research (PAR) and the work of Latin American thinkers such as Freire and Fals Borda to interrogate artificial intelligence (AI). We propose a South-North flow by utilising PAR approaches that stem from Latin America, challenging how the North's centrality is taken for granted regarding AI epistemologies, experiences, and understandings. Conducting workshops in London with a diverse group of students, tech workers and activists, we argue that PAR can not only empower marginalised communities in the Global South; we can also learn more from its application in the Global North, in contexts where people deal with different struggles. Our analysis delves into three specific concepts around AI and data (in)justice: autonomy, empathy and dialogue. First, inspired by PAR principles, participants started to problematise what they called an empty interpretation of empathy, establishing parallels with transnational dynamics of data capitalism, which disadvantage marginalised communities in the Global South. Second, PAR offered a critical lens to analyse issues of AI and autonomy in ways that are less individualistic and more collective and politically engaged. Third, PAR's dialogical spirit enabled participants to locate various intersections between AI and dialogue. Critiquing the idea of a superior AI, participants were reminded of the possibilities offered by human intelligence and the combination of thinking, making and feeling or what Fals Borda (2003. Ante la crisis del país: I deas acción para el cambio, 1st. Ed. Bogotá: Panamericana) calls our sentipensante nature.
Shared concerns versus ideological preferences: The New York Times’ coverage of two Olympics games held in the global health crisis
Authors: He Renyi , Huang Xiaoyun
Published: March 2024

The Olympic Games are often framed by the U.S. media as political events, with the media’s preference for democratic political systems, while global health crises are often framed in a similar way, demonstrating shared concerns about human interests. When the Olympics occur during a global health crisis, a tension emerges between the ideological framing of the Olympics and the shared concern for human interests in media coverage. By analyzing New York Times coverage of the Tokyo 2020 Summer Olympics and the Beijing 2022 Winter Olympics, this study aims to show how ideological preferences in Olympic coverage interact with shared concerns about health crises. Furthermore, the analysis of this interaction leads to a rethinking of traditional journalistic norms that view journalists as detached observers.
Courageous Conversations: Preparing Students to Lead in a Politically Polarized Business Environment
Authors: Schlobohm Allison , Johnson James H.
Published: March 2024

We describe an experimental curriculum innovation that creates a safe space for students to engage in courageous conversations —to openly share diverse thoughts and opinions as well as vigorously debate politically charged issues of critical business importance. Course evaluations and online surveys of student experiences and reactions strongly suggest that the courageous conversation model is an excellent way to prepare the next generation of successful business leaders. In a world where politically polarizing issues embedded in America’s culture wars increasingly impact business viability, profitability, and competitiveness, such leaders are both highly coveted and key to organizational success.
Trends of the Delay and Variance of Childbirth Timing by Completed Number of Children
Authors: Mogi Ryohei , Yoda Shohei
Published: March 2024

The timing of childbirth has undergone significant changes in the past decades. However, it may not be feasible for individuals with many children to further delay the timing of each childbirth given the biological constraints on fecundability and social age deadline for childbirth. Thus, the delay in having children and the increasing heterogeneity in its timing may present different trends when analyzed retrospectively by completed number of children. This study investigates the age at childbirth by birth order among women age 40+ in 17 European countries and Canada based on the number of children they have. Our findings show that individuals having more children tend to have each child at earlier ages, with less variation in timing, compared to the counterparts with fewer children. This suggests that changes in the timing of childbirth are more pronounced among individuals having fewer children and less so among those with having more children.
A Scoping Review of Personalized, Interactive, Web-Based Clinical Decision Tools Available for Breast Cancer Prevention and Screening in the United States
Authors: Kamil Dalya , Wojcik Kaitlyn M. , Smith Laney , Zhang Julia , Wilson Oliver W. A. , Butera Gisela , Jayasekera Jinani
Published: March 2024

Introduction. Personalized web-based clinical decision tools for breast cancer prevention and screening could address knowledge gaps, enhance patient autonomy in shared decision-making, and promote equitable care. The purpose of this review was to present evidence on the availability, usability, feasibility, acceptability, quality, and uptake of breast cancer prevention and screening tools to support their integration into clinical care. Methods. We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist to conduct this review. We searched 6 databases to identify literature on the development, validation, usability, feasibility, acceptability testing, and uptake of the tools into practice settings. Quality assessment for each tool was conducted using the International Patient Decision Aid Standard instrument, with quality scores ranging from 0 to 63 (lowest-highest). Results. We identified 10 tools for breast cancer prevention and 9 tools for screening. The tools included individual (e.g., age), clinical (e.g., genomic risk factors), and health behavior (e.g., alcohol use) characteristics. Fourteen tools included race/ethnicity, but no tool incorporated contextual factors (e.g., insurance, access) associated with breast cancer. All tools were internally or externally validated. Six tools had undergone usability testing in samples including White (median, 71%; range, 9%–96%), insured (99%; 97%–100%) women, with college education or higher (60%; 27%–100%). All of the tools were developed and tested in academic settings. Seven (37%) tools showed potential evidence of uptake in clinical practice. The tools had an average quality assessment score of 21 (range, 9–39). Conclusions. There is limited evidence on testing and uptake of breast cancer prevention and screening tools in diverse clinical settings. The development, testing, and integration of tools in academic and nonacademic settings could potentially improve uptake and equitable access to these tools.

Highlights

There were 19 personalized, interactive, Web-based decision tools for breast cancer prevention and screening. Breast cancer outcomes were personalized based on individual clinical characteristics (e.g., age, medical history), genomic risk factors (e.g., BRCA1/2), race and ethnicity, and health behaviors (e.g., smoking). The tools did not include contextual factors (e.g., insurance status, access to screening facilities) that could potentially contribute to breast cancer outcomes. Validation, usability, acceptability, and feasibility testing were conducted mostly among White and/or insured patients with some college education (or higher) in academic settings. There was limited evidence on testing and uptake of the tools in nonacademic clinical settings.
The coming twilight of a petro-state? Traumatic decarbonization as a driver of political transformation in Iraq
Authors: Al Kli Shahla , Miller Jared , de Waal Alex
Published: March 2024

Iraq is a compelling example of a state highly dependent on a singular source of rent, namely oil revenue. Since 2003, Iraq has also been characterized by a fractured, rivalrous elite without central control over organized violence. This formula represents a “rentier political marketplace” in which state funds for salaries and contracts are the essential lubricant of the political system. During 2014–2021, successive shocks to national oil revenues represented a partial and temporary, but traumatic, decarbonization of Iraq’s government and political finance. In turn, this triggered a series of governance and political reconfigurations including a nominal decentralization process and fracturing of sectarian power, followed by a nationwide civic movement demanding transformational change. This paper traces these changes and the abrupt return to business as usual when oil prices rebounded. In doing so, the paper further investigates the nexus between oil and democracy in Iraq and addresses the unanswered question of how Iraq can decarbonize and democratize in the future.
A lineage-specific STAT5BN642H mouse model to study NK-cell leukemia
Authors: Klein Klara , Kollmann Sebastian , Hiesinger Angela , List Julia , Kendler Jonatan , Klampfl Thorsten , Rhandawa Mehak , Trifinopoulos Jana , Maurer Barbara , Grausenburger Reinhard , Betram Christof A. , Moriggl Richard , Rülicke Thomas , Mullighan Charles G. , Witalisz-Siepracka Agnieszka , Walter Wencke , Hoermann Gregor , Sexl Veronika , Gotthardt Dagmar
Published: March 2024

Patients with T- and natural killer (NK)-cell neoplasms frequently have somatic STAT5B gain-of-function mutations. The most frequent STAT5B mutation is STAT5BN642H, which is known to drive murine T-cell leukemia, although its role in NK-cell malignancies is unclear. Introduction of the STAT5BN642H mutation into human NK-cell lines enhances their potential to induce leukemia in mice. We have generated a mouse model that enables tissue-specific expression of STAT5BN642H and have selectively expressed the mutated STAT5B in hematopoietic cells (N642Hvav/+) or exclusively in NK cells (N642HNK/NK). All N642Hvav/+ mice rapidly develop an aggressive T/NKT-cell leukemia, whereas N642HNK/NK mice display an indolent NK-large granular lymphocytic leukemia (NK-LGLL) that progresses to an aggressive leukemia with age. Samples from patients with NK-cell leukemia have a distinctive transcriptional signature driven by mutant STAT5B, which overlaps with that of murine leukemic N642HNK/NK NK cells. To our knowledge, we have generated the first reliable STAT5BN642H-driven preclinical mouse model that displays an indolent NK-LGLL progressing to aggressive NK-cell leukemia. This novel in vivo tool will enable us to explore the transition from an indolent to an aggressive disease and will thus permit the study of prevention and treatment options for NK-cell malignancies.
Interactions between integrin α9β1 and VCAM-1 promote neutrophil hyperactivation and mediate poststroke DVT
Authors: Pandey Nilesh , Kaur Harpreet , Chorawala Mehul R. , Anand Sumit Kumar , Chandaluri Lakshmi , Butler Megan E. , Aishwarya Richa , Gaddam Shiva J. , Shen Xinggui , Alfaidi Mabruka , Wang Jian , Zhang Xiaolu , Beedupalli Kavitha , Bhuiyan Md. Shenuarin , Bhuiyan Mohammad Alfrad Nobel , Buchhanolla Prabandh , Rai Prashant , Shah Rahul , Chokhawala Himanshu , Jordan J. Dedrick , Magdy Tarek , Orr A. Wayne , Stokes Karen Y. , Rom Oren , Dhanesha Nirav
Published: March 2024

Venous thromboembolic events are significant contributors to morbidity and mortality in patients with stroke. Neutrophils are among the first cells in the blood to respond to stroke and are known to promote deep vein thrombosis (DVT). Integrin α9 is a transmembrane glycoprotein highly expressed on neutrophils and stabilizes neutrophil adhesion to activated endothelium via vascular cell adhesion molecule 1 (VCAM-1). Nevertheless, the causative role of neutrophil integrin α9 in poststroke DVT remains unknown. Here, we found higher neutrophil integrin α9 and plasma VCAM-1 levels in humans and mice with stroke. Using mice with embolic stroke, we observed enhanced DVT severity in a novel model of poststroke DVT. Neutrophil-specific integrin α9–deficient mice (α9fl/flMrp8Cre+/−) exhibited a significant reduction in poststroke DVT severity along with decreased neutrophils and citrullinated histone H3 in thrombi. Unbiased transcriptomics indicated that α9/VCAM-1 interactions induced pathways related to neutrophil inflammation, exocytosis, NF-κB signaling, and chemotaxis. Mechanistic studies revealed that integrin α9/VCAM-1 interactions mediate neutrophil adhesion at the venous shear rate, promote neutrophil hyperactivation, increase phosphorylation of extracellular signal-regulated kinase, and induce endothelial cell apoptosis. Using pharmacogenomic profiling, virtual screening, and in vitro assays, we identified macitentan as a potent inhibitor of integrin α9/VCAM-1 interactions and neutrophil adhesion to activated endothelial cells. Macitentan reduced DVT severity in control mice with and without stroke, but not in α9fl/flMrp8Cre+/− mice, suggesting that macitentan improves DVT outcomes by inhibiting neutrophil integrin α9. Collectively, we uncovered a previously unrecognized and critical pathway involving the α9/VCAM-1 axis in neutrophil hyperactivation and DVT.
Unveiling heterogeneity of hysteresis in perovskite thin films
Authors: Zou Zhouyiao , Qiu Haian , Shao Zhibin
Published: March 2024

The phenomenon of current–voltage hysteresis observed in perovskite-based optoelectronic devices is a critical issue that complicates the accurate assessment of device parameters, thereby impacting performance and applicability. Despite extensive research efforts aimed at deciphering the origins of hysteresis, its underlying causes remain a subject of considerable debate. By employing nanoscale investigations to elucidate the relationship between hysteresis and morphological characteristics, this study offers a detailed exploration of photocurrent–voltage hysteresis at the nanoscale within perovskite optoelectronic devices. Through the meticulous analysis of localized I–V curve arrays, our research identifies two principal hysteresis descriptors, uncovering a predominantly inverted hysteresis pattern in 87% of the locations examined. This pattern is primarily attributed to the energetic barrier encountered at the interface between the probe and the perovskite material. Our findings underscore the pronounced heterogeneity and grain-dependent variability inherent in hysteresis behavior, evidenced by an average Hysteresis Index value of 0.24. The investigation suggests that the localized hysteresis phenomena cannot be exclusively attributed to either photocharge collection processes or organic cation migration at grain boundaries. Instead, it appears significantly influenced by localized surface trap states, which play a pivotal role in modulating electron and hole current dynamics. By identifying the key factors contributing to hysteresis, such as localized surface trap states and their influence on electron and hole current dynamics, our findings pave the way for targeted strategies to mitigate these effects. This includes the development of novel materials and device architectures designed to minimize energy barriers and enhance charge carrier mobility, thereby improving device performance and longevity. This breakthrough in understanding the microscale mechanisms of hysteresis underscores the critical importance of surface/interface defect trap passivation in mitigating hysteretic effects, offering new pathways for enhancing the performance of perovskite solar cells.
Solid waste characteristics and management strategies at ST Theresa (STT) and Holy Cross (HC) hospitals in Chirumanzu rural District, Zimbabwe
Authors: Shabani Takunda , Mutekwa Timothy Vurayayi , Shabani Tapiwa
Published: March 2024

Management of solid waste from rural hospitals is among major problems affecting developing countries. This is mostly attributed to inadequate data related to quantity and quality of hospital solid waste. Similarly, information related to rural hospital solid waste characteristics and management is limited in Zimbabwe. However, SDGs complemented by Zimbabwe Vision 2030, NDS 1 advocates for sustainable solid waste management. Hence, enough data related to characteristics of solid waste from rural hospitals are required to attain sustainability. This research focuses on hospital solid waste characteristics and management strategies at STT and HC rural hospitals. Descriptive cross sectional research design which triangulates qualitative and quantitative paradigms was utilized. Interviews, observations, questionnaires were used to collect data. Quantitative data were analyzed using Statistical Package for Social Sciences whereas qualitative data were subjected to content analysis. Solid waste generated at STT encompasses non-hazardous (77.35%), hazardous waste (22.65%). At HC solid waste consists of non-hazardous (79%) and hazardous waste (21%). Respondents at STT (70.4%) and HC (72.7%) noted that solid waste was increasing. Solid waste was increasing due to various factors namely high use of disposable materials at HC (35.1%), STT (42.5%) and increase of patients at HC (30%) and STT (29.7%). Solid waste was indiscriminately stored in various types of containers although pedal operated bins and sharp containers were highly used at STT (72.4%) and HC (69.1%). Waste receptacles were transported to disposal sites using wheelbarrows and manual handling. Open pits and burning were among disposal strategies but incineration was regarded as the golden approach at STT (44.8%) and HC (41.8%). Inappropriate hospital solid waste management was due to shortage of finance at STT (38.1%) and HC (30.9%) and unawareness among health workers. Although it was worsened by lack of all stakeholder participation at STT (79.0%) and HC (76.4%). Consequently, the study recommended application of strategies which support circular economy, integrated approach, raising awareness of health workers and provision of enough resources to rural hospitals.
Long-term push–pull cropping system shifts soil and maize-root microbiome diversity paving way to resilient farming system
Authors: Jalloh Abdul A. , Khamis Fathiya Mbarak , Yusuf Abdullahi Ahmed , Subramanian Sevgan , Mutyambai Daniel Munyao
Published: March 2024

Background

The soil biota consists of a complex assembly of microbial communities and other organisms that vary significantly across farming systems, impacting soil health and plant productivity. Despite its importance, there has been limited exploration of how different cropping systems influence soil and plant root microbiomes. In this study, we investigated soil physicochemical properties, along with soil and maize-root microbiomes, in an agroecological cereal-legume companion cropping system known as push–pull technology (PPT). This system has been used in agriculture for over two decades for insect-pest management, soil health improvement, and weed control in sub-Saharan Africa. We compared the results with those obtained from maize-monoculture (Mono) cropping system.

Results

The PPT cropping system changed the composition and diversity of soil and maize-root microbial communities, and led to notable improvements in soil physicochemical characteristics compared to that of the Mono cropping system. Distinct bacterial and fungal genera played a crucial role in influencing the variation in microbial diversity within these cropping systems. The relative abundance of fungal genera Trichoderma, Mortierella, and Bionectria and bacterial genera Streptomyces, RB41, and Nitrospira were more enriched in PPT. These microbial communities are associated with essential ecosystem services such as plant protection, decomposition, carbon utilization, bioinsecticides production, nitrogen fixation, nematode suppression, phytohormone production, and bioremediation. Conversely, pathogenic associated bacterial genus including Bryobacter were more enriched in Mono-root. Additionally, the Mono system exhibited a high relative abundance of fungal genera such as Gibberella, Neocosmospora, and Aspergillus, which are linked to plant diseases and food contamination. Significant differences were observed in the relative abundance of the inferred metabiome functional protein pathways including syringate degradation, L-methionine biosynthesis I, and inosine 5'-phosphate degradation.

Conclusion

Push–pull cropping system positively influences soil and maize-root microbiomes and enhances soil physicochemical properties. This highlights its potential for agricultural and environmental sustainability. These findings contribute to our understanding of the diverse ecosystem services offered by this cropping system where it is practiced regarding the system's resilience and functional redundancy. Future research should focus on whether PPT affects the soil and maize-root microbial communities through the release of plant metabolites from the intercrop root exudates or through the alteration of the soil's nutritional status, which affects microbial enzymatic activities.
Feasibility and repeatability of ultrasound-guided surface electroenterography to measure colonic slow wave motility in healthy adults
Authors: Rolleman Nick H. , Visser Iris M. , Klein Willemijn M. , Van Putten Michel J.A.M. , De Blaauw Ivo , Botden Sanne M.B.I.
Published: March 2024

Surface electroenterography is a potential non-invasive alternative to current diagnostics of colonic motility disorders. However, electrode positioning in electroenterography is often based on general anatomy and may lack generalizability. Furthermore, the repeatability of electroenterography measurements is unknown. This study aimed to evaluate ultrasound-guided electrode positioning for electroenterography measurements and to determine the repeatability of those measurements. In ten healthy adults, two electroenterography procedures were performed, consisting of fasting, ultrasound-guided electrode localization and two 20-minute electroenterography recordings separated by a meal. The dominant frequency, the mean power density (magnitude of colonic motility) and the power percent difference (relative pre- to postprandial increase in magnitude) were determined. Repeatability was determined by Lin’s concordance correlation coefficient. The results demonstrated that the dominant frequency did not differ between pre- and postprandial recordings and was 3 cpm, characteristic of colonic motility. The mean power density increased between the pre- and postprandial measurements, with an average difference of over 200%. The repeatability of both the dominant frequency and power density was poor to moderate, whereas the correlation coefficient of the power percent difference was poor. Concluding, ultrasound-guided surface electroenterography seems able to measure the gastrocolic reflex, but the dissatisfactory repeatability necessitates optimization of the measurement protocol.
The impact of pension on the health behavior of elderly rural residents: evidence from China
Authors: Li Rui , Gao Duanyang , Yang Yuying
Published: March 2024

Background

Unhealthy behavior is an important factor threatening the health of older rural residents in China. We examine the effects of receiving pension on elderly rural residents’ health behavior (namely conscious control of sugar, salt, and edible oil intake, as well as learning health or wellness knowledge), also including effect heterogeneity by income level and gender.

Methods

Using China Rural Revitalization Survey (CRRS) in 2020, we used the policy rule of the China’s New Rural Pension Scheme that only those people who are over 60 years old can have access to pension as the natural experiment, and explore the causal effect of receiving pensions on the health behaviors by using regression discontinuity design method.

Results

Having access to pension can improve the health behavior of rural elderly residents, including increasing the probability of rural residents’ conscious control of sugar (p < 0.1) and conscious control of salt intake (p < 0.1), which is still valid after a series of robustness tests. Heterogeneity analysis finds that access to pensions is more likely to improve the health behavior of low-income families and male rural elderly residents.

Conclusions

The research has expanded the discussion on the correlation between the pension and the health of rural elderly residents, and the conclusion provides important policy implications for optimizing the rural elderly insurance system and leveraging pension to improve the health behavior of rural elderly residents.
Predictors of attitudes towards aging in elderly living in community care
Authors: Bužgová Radka , Kozáková Radka , Bobčíková Katka
Published: March 2024

Background

Due to the aging of the population, the promotion of healthy aging is an important part of public health. Healthy aging of the population can be influenced by the attitudes of the elderly themselves towards old age and aging. The aim of this cross-sectional study was to find out the attitudes of older people living in a community environment toward old age and the predictors that influence these attitudes.

Methods

The evaluation of attitudes towards old age using the WHO AAQ (Attitudes to Aging Questionnaire) questionnaire involved 1,174 elderly people living in the community. Age, sex, marital status, education, subjective health assessment, social support, depression (GDS-15), anxiety (GAI), sense of coherence (SOC-13) and self-esteem (RSES) were used to evaluate related factors.

Results

As part of the exploratory factor analysis, a three-factor model (Psychosocial Loss, Physical Change, and Psychological Growth) was confirmed. The Cronbach alpha was found to be acceptable (α = 0.835). The predictors of better AAQ in the Psychological Loss domain were: subjective health, age, quality of life, self-esteem, sense of coherence, life satisfaction, anxiety, and social support; in the Physical Change domain: subjective health, quality of life, self-esteem, life satisfaction, cohabitation, and depression; and in the Psychological Growth domain: age, self-esteem, sense of coherence, life satisfaction, and social support.

Conclusion

Preventive and policy measures should aim to increase the satisfaction and self-assessment of the elderly, which can help them evaluate the period of old age more positively. It is also important to create a positive perspective of ageing and elderly in society.
Effects of oral oligopeptide preparation and exercise intervention in older people with sarcopenia: a randomized controlled trial
Authors: Liao Xinyi , Cheng Daomei , Li Jingjing , Zhu Lin , Zhang Suqiong , Jing Xiaofan , Shi Lei
Published: March 2024

Background

Nutrition and exercise are important interventions for sarcopenia. There were few studies on oral oligopeptide nutrition preparations combined with exercise to intervene in the older people with sarcopenia. The aim of this study was to verify the effectiveness of oligopeptide nutrition preparation combined with exercise intervention on the older people with sarcopenia in community.

Methods

A total of 219 subjects aged 65 years or older with sarcopenia were randomly divided into 4 groups. The nutrition group (n = 58) was given individualized nutrition education and oral oligopeptide nutrition preparation. The exercise group (n = 50) received exercise intervention. The combined group (n = 52) received both oral nutrition preparation and exercise interventions. The control group (n = 59) only received individualized nutrition education. The nutrition preparation can provide energy 185kcal and protein 24.2g per day. The exercise intervention including warm-up exercise, resistance exercise and aerobic exercise, the training time was 60min for 5 times every week. The intervention lasted for 16 weeks. Hand grip strength, gait speed, body composition and hematology parameters were measured before and after intervention.

Results

A total of 159 subjects completed the study. Compared with baseline, the left grip strength and 6-m walking speed of the subjects in nutrition group increased significantly after the intervention, and the grip strength of both hands in exercise group and combined group increased significantly. The body weight of the subjects in nutrition group, exercise group and combined group increased significantly after intervention, but no increase in soft lean mass (SLM) and skeletal muscle mass (SMM) was observed in any of the four groups. The fat-free mass (FFM) of the legs of the control group, exercise group and nutrition group decreased after intervention, and only the FFM of the legs of the combined group maintained the level before the intervention.

Conclusion

Both oral peptide nutrition and exercise interventions can improve the muscle strength or function of the older people with sarcopenia. However, there were no increases in muscle mass observed.

Trial registration

ChiCTR, ChiCTR2100052135. Registered 20 October 2021, https://www.chictr.org.cn/showproj.html?proj=135743
Validity and test–retest reliability of the Swedish version of the Geriatric Depression Scale among very old adults
Authors: Snellman Sandra , Hörnsten Carl , Olofsson Birgitta , Gustafson Yngve , Lövheim Hugo , Niklasson Johan
Published: March 2024

Background

The Geriatric Depression Scale (GDS) has shown good validity and reliability, but few studies have examined the GDS among very old adults or the Swedish translation.

Objectives

Evaluate the validity and reliability of the Swedish version of GDS-15 among very old adults.

Methods

In the Umeå85 + /GErontological Regional DAtabase (GERDA) study, 387 participants were assessed with both the GDS-15 and the Montgomery-Åsberg Depression Rating Scale (MADRS). The mean age was 91 years. Concurrent validity between the scales was calculated using Spearman's correlation. We used the Diagnostic and Statistical Manual of Mental Disorders (DSM) V symptom criteria for depression based on MADRS item scores to define depression. We calculated the Area Under the Curve (AUC) and found an optimal cut-off.

A convenience sample with 60 individuals was used to calculate test–retest reliability with Cohen’s kappa and Intraclass Correlation Coefficient (ICC).

Results

Spearman's correlation coefficients between total scores for GDS-15 and MADRS were 0.60. Cronbach's alpha for the whole scale was 0.73. The AUC was 0.90 for distinguishing major depression, and the recommended cut-off of ≥ 5 showed a sensitivity of 95.2% and specificity of 65.8%. The test–retest showed that Cohen’s kappa was substantial (0.71) and the ICC was excellent (0.95).

Conclusions

The Swedish version of the GDS-15 showed good validity and reliability among very old adults. The generally recommended cut-off of ≥ 5 seems reasonable to use with the Swedish version and among very old adults.
Altered trends of local brain function in classical trigeminal neuralgia patients after a single trigger pain
Authors: Yan Juncheng , Wang Luoyu , Pan Lei , Ye Haiqi , Zhu Xiaofen , Feng Qi , Wang Haibin , Ding Zhongxiang , Ge Xiuhong
Published: March 2024

Objective

To investigate the altered trends of regional homogeneity (ReHo) based on time and frequency, and clarify the time-frequency characteristics of ReHo in 48 classical trigeminal neuralgia (CTN) patients after a single pain stimulate.

Methods

All patients underwent three times resting-state functional MRI (before stimulation (baseline), after stimulation within 5 s (triggering-5 s), and in the 30th min of stimulation (triggering-30 min)). The spontaneous brain activity was investigated by static ReHo (sReHo) in five different frequency bands and dynamic ReHo (dReHo) methods.

Results

In the five frequency bands, the number of brain regions which the sReHo value changed in classical frequency band were most, followed by slow 4 frequency band. The left superior occipital gyrus was only found in slow 2 frequency band and the left superior parietal gyrus was only found in slow 3 frequency band. The dReHo values were changed in midbrain, left thalamus, right putamen, and anterior cingulate cortex, which were all different from the brain regions that the sReHo value altered. There were four altered trends of the sReHo and dReHo, which dominated by decreased at triggering-5 s and increased at triggering-30 min.

Conclusions

The duration of brain function changed was more than 30 min after a single pain stimulate, although the pain of CTN was transient. The localized functional homogeneity has time-frequency characteristic in CTN patients after a single pain stimulate, and the changed brain regions of the sReHo in five frequency bands and dReHo complemented to each other. Which provided a certain theoretical basis for exploring the pathophysiology of CTN.
Clinicopathological characteristics and predictors of outcome of rapidly progressive glomerulonephritis: a retrospective study
Authors: Mohamed Osama Nady , Ibrahim Sharehan Abdelrahman , Saleh Rabeh Khairy , Issa Ahmed S. , Setouhi Amr , Rabou Ayman Ahmed Abd , Mohamed Mahmoud Ragab , Kamel Shaimaa F.
Published: March 2024

Background

Globally, there are regional and time-based variations in the prevalence, etiology, and prognosis of rapidly progressive glomerulonephritis (RPGN). Prognosis of RPGN is poor, with a higher risk of death and end stage renal disease (ESRD) even with immunosuppressive medications. In the Middle East and North Africa, the studies on this disease are very limited. Therefore, we determined the predictors of outcome of RPGN.

Methods

We retrospectively assessed 101 adult patients over age of 18, diagnosed with RPGN based on renal biopsy illustrating crescents in ≥ 50% of the glomeruli. Patients who had crescents in their renal biopsies that were < 50% and those who refused to consent to a renal biopsy were excluded. We categorized the patients into 3 groups based on immunohistochemistry; type I, type II and type III. Then, depending on renal loss, we divided them into ESRD and non-ESRD groups. The clinical history and physical examination were retrieved. Additionally, 24-hour urine protein, urine analysis, renal function tests, serum albumin, complete blood count, antinuclear antibodies, anti-double stranded DNA antibodies, ANCA antibodies and serum complement levels were checked. Each patient underwent a kidney biopsy for immunohistochemistry and light microscopy. The percentage of crescentic glomeruli, number of sclerosed glomeruli, tertiary lymphoid organ (TLO), neutrophil infiltration, endocapillary or mesangial hypercellularity, interstitial fibrosis with tubular atrophy (IFTA) were analyzed. Primary outcomes (remission, ESRD and mortality) and secondary outcomes were assessed.

Results

Type II was the most frequent cause of RPGN (47.5%), followed by type III (32.7%) and type I (19.8%). 32 patients (31.7%) died during follow up, whereas 60 patients (59.4%) developed ESRD. In 41 patients (40.6%), remission occurred. Oliguria, serum creatinine, and need for HD at presentation were significantly increased in ESRD group compared to non-ESRD group (P < 0.001 for each). Mesangial proliferation, IFTA, TLO formation, sclerotic glomeruli and fibrous crescents were also significantly increased in ESRD group in comparison to non-ESRD group (P < 0.001 for each). Glomerulosclerosis (P = 0.036), and IFTA (P = 0.008) were predictors of ESRD. Infections (P = 0.02), respiratory failure (P < 0.001), and heart failure (P = 0.004) were mortality risk factors.

Conclusion

Type II RPGN was the most common. Infection was the most frequent secondary outcome. Oliguria, glomerulosclerosis, the requirement for hemodialysis at presentation, IFTA and TLO formation were predictors of ESRD. Respiratory failure, heart failure and infections were significant predictors of mortality.
HPV related p16INK4A and HSV in benign and potentially malignant oral mucosa pathologies
Authors: Duś-Ilnicka Irena , Hałoń Agnieszka , Perra Andrea , Radwan-Oczko Małgorzata
Published: March 2024

Background

The association of Human Papilloma Virus (HPV) and Human Syncytial Virus (HSV) infection with inflammatory and potentially malignant disorders of the oral cavity (OPMD) is unknown. The aim of this cross-sectional study was to stablish the expression of the p16INK4A and HSV proteins, to test potential correlation between those parameters in biopsies from clinically diagnosed oral lesions.

Methods

Immunochemical analysis of 211 formalin-fixed, paraffin-embedded (FFPE) blocks from 211 individuals was provided. The clinical diagnosis included in the research were Oral lichen planus (N = 30), Oral Leukoplakia (N = 13) Mucocele (N = 25), Erosion/ulceration/ inflammation of mucosa (N = 8), Overgrowth of mucosa (N = 135).

Results

Two hundred eleven analyzed FFPE samples resulted with the median age of 58.5 years (the average age 54.0 years and SD ± 17 years). The female/male ratio was 2.3 (69.7% vs 30.3% respectively). All the samples positive for HSV also expressed p16INK4A (p = 0.000), that’s showed various levels of association with the diverse clinical diagnosis reaching the higher level in OM 49.1% (29 positive samples) and OLP 30.5% (18). p16INK4A was associated with OLP at 30.5% (18), and fibroma 30.5%. HSV expression was mostly present in fibroma at 47.6% (10 positive samples).

Conclusion

HSV and p16INK4A positivity in relation to diagnosis of the biopsies showed statistically most often p16INK4A in OLP and fibroma. The results of co-expression of p16INK4A and HSV in mucocele and fibroma in oral mucosa suggest a cooperation between the molecular alterations induced by these two viruses. Squamous papilloma samples positive for p16INK4A were also positive for HSV, suggesting that the putative pro-oncogenic action of HSV could be an early event.
AI-Dentify: deep learning for proximal caries detection on bitewing x-ray - HUNT4 Oral Health Study
Authors: Pérez de Frutos Javier , Holden Helland Ragnhild , Desai Shreya , Nymoen Line Cathrine , Langø Thomas , Remman Theodor , Sen Abhijit
Published: March 2024

Background

Dental caries diagnosis requires the manual inspection of diagnostic bitewing images of the patient, followed by a visual inspection and probing of the identified dental pieces with potential lesions. Yet the use of artificial intelligence, and in particular deep-learning, has the potential to aid in the diagnosis by providing a quick and informative analysis of the bitewing images.

Methods

A dataset of 13,887 bitewings from the HUNT4 Oral Health Study were annotated individually by six different experts, and used to train three different object detection deep-learning architectures: RetinaNet (ResNet50), YOLOv5 (M size), and EfficientDet (D0 and D1 sizes). A consensus dataset of 197 images, annotated jointly by the same six dental clinicians, was used for evaluation. A five-fold cross validation scheme was used to evaluate the performance of the AI models.

Results

The trained models show an increase in average precision and F1-score, and decrease of false negative rate, with respect to the dental clinicians. When compared against the dental clinicians, the YOLOv5 model shows the largest improvement, reporting 0.647 mean average precision, 0.548 mean F1-score, and 0.149 mean false negative rate. Whereas the best annotators on each of these metrics reported 0.299, 0.495, and 0.164 respectively.

Conclusion

Deep-learning models have shown the potential to assist dental professionals in the diagnosis of caries. Yet, the task remains challenging due to the artifacts natural to the bitewing images.
Handling the desire to die– evaluation of an elective course for medical students
Authors: Schallenburger M , Schwartz J , Batzler Yann-Nicolas , Meier St , Küppers R , Tenge Th , Doll A , Kremeike K , Wetzchewald D , Neukirchen M
Published: March 2024

Background

The desire to die can occur in palliative care patients with a prevalence of up to 22%. Not every desire to die is accompanied by a pressure to act, but usually by a burden that can arise from various factors. To address this burden appropriately, health care workers should be trained. Based on an evaluated course on handling the desire to die, an elective course for medical students was developed and evaluated. In order to identify the impact of the elective course’s content, a comparison of attitudes towards assisted dying with two other participant groups was conducted. Therefore, three questions from the evaluation of the elective course were used.

Method

Online evaluation of the elective and questions addressing attitude were assessed using a five-point Likert scale. The specific outcome-based assessment was determined using the Comparative Self-Assessment Gain. The main participant group (group 1) were students who took the elective. The additional survey on attitudes towards assisted dying included undergraduate medical students who had taken compulsory palliative care courses (group 2) and physicians who had taken an introductory course in intensive care or emergency medicine (group 3).

Results

Group 1 (n = 13, response rate rr = 86.7%) was very satisfied with the blended learning format (100%) and the course itself (100%). They were able to deepen their knowledge (81.0%) and train skills (71.2%) through the course. In the additional surveys, there were 37 students in group 2 (rr = 66.1%) and 258 physicians in group 3 (rr = 73.6%). Willingness to assist with or accompany the various options for assisted dying varied according to the type of assistance. Among the participants, it can be summarised that the highest willingness was shown by the students of group 2 followed by the physicians of group 3 and the students of group 1.

Conclusions

A course on handling the desire to die of palliative patients can deepen knowledge and train communication skills and thus support self-confidence. Dealing with the background of the desire to die, knowledge about assisted dying, but also one’s own attitudes and responsibilities can influence the attitude towards assisted dying.