bluuebunny/crossref_metadata_2025 huggingface dataset:
Focal dermal hypoplasia (Goltz Syndrome): A preterm neonate with multisystem anomalies—A case report
Authors: Mohamed Abdikarin Ahmed , Hagos Hindeya Hailu , Seyoum Dawit , Hadgu Amanuel
Published: August 2024

Goltz syndrome is a rare condition characterized by thinning of the skin, which leads to the herniation of fat and results in both skin and systemic abnormalities. The primary cause of this syndrome is the mutation of the PORCN gene, which is associated with the X chromosome. A newborn baby was admitted to the neonatal intensive care unit due to skeletal and skin abnormalities. The major findings in this patient included anophthalmia, microform cleft lip, subcutaneous fat herniation, and split foot. An abdominal ultrasound examination revealed a solitary right kidney and an echocardiogram showed patent ductus arteriosus. The patient was treated for neonatal sepsis, and the family received counseling about the disease. We report this case because of its exceptional rarity.
Predicting dementia in Parkinson's disease on a small tabular dataset using hybrid LightGBM–TabPFN and SHAP
Authors: Tran Vinh Quang , Byeon Haewon
Published: August 2024

Objective

This study aims to create a robust and interpretable method for predicting dementia in Parkinson's disease (PD), especially in resource-limited settings. The model aims to be accurate even with small datasets and missing values, ultimately promoting its use in clinical practice to benefit patients and medical professionals.

Methods

Our study introduces LightGBM–TabPFN, a novel hybrid model for predicting dementia conversion in PD. Combining LightGBM's strength in handling missing values with TabPFN's ability to exploit small datasets, LightGBM–TabPFN outperforms seven existing methods, achieving outstanding accuracy and interpretability thanks to SHAP analysis. This analysis leverages data from 242 PD patients across 17 variables.

Results

Our LightGBM–TabPFN model significantly outperformed seven existing methods. Achieving an accuracy of 0.9592 and an area under the ROC curve of 0.9737.

Conclusions

The interpretable LightGBM–TabPFN with SHAP signifies a significant advancement in predictive modeling for neurodegenerative diseases. This study not only improves dementia prediction in PD but also provides clinical professionals with insights into model predictions, offering opportunities for application in clinical settings.
Unilateral decision-making powers in contract to be used by good boys or cognitive misers?
Authors: Soper Charles Haward
Published: August 2024

Modern contracts allocate material powers to contractants to take major decisions which affect the interests of counterparties. Empirical evidence, from studies and from litigated cases, tends to show that those responsible for taking decisions using powers granted to them under contracts take those decisions seriously. They give the decision some thought, and they try to be reasonable. The law, however, does not generally insist on high standards of conduct. I explore the law and the social psychology of decision making, System 1 or System 2 as Kahnemann classified it, and how to align them, as well as discuss, from legal theory, how one might define a reasonable decision. Legal argument is underpinned by an analysis which suggests that control of decision-making powers should be a matter of contract construction, the Court's question to be directed at the likely intention of the parties.
Assessing Public Perceptions of Virtual Primary Care During the COVID-19 Pandemic in the UK, Germany, Sweden, and Italy: A Topic Modeling Approach
Authors: Machleid Felix , Crespo Roberto Fernandez , Flott Kelsey , Ghafur Saira , Darzi Ara , Mayer Erik , Neves Ana Luisa
Published: August 2024

The COVID-19 pandemic has driven the transition from face-to-face visits to virtual care delivery. In this study, we explore patients’ perceptions of the benefits and challenges of using virtual primary care technologies during the pandemic, using machine learning approaches. A cross-sectional survey was conducted in August 2020 in Italy, Sweden, Germany, and the UK. Latent Dirichlet Allocation was used to identify themes of two open-ended questions. Comparisons between participant characteristics were made using Wilcoxon rank-sum test. 6,331 participants were included (51.7% female; 42.4% +55 years; 60.5% white ethnicity; 86.6% low literacy). The benefits extracted included: primary care delivery, infection control, reducing contacts, virtual care, timeliness, patient-doctor interaction, convenience, and safety. Participants from Sweden were most likely to mention “primary care delivery” (UK p = .007, IT p = .03, DE p < .001), from the UK “virtual care” (SE p < .001, IT p < .001, DE p < .001) and from Italy “patient-doctor interaction” (UK p < .001, SE p < .001, DE p < .001). The challenges included: diagnostic difficulties, physical examination, digital health risks, technical challenges, virtual care, data security and protection, and lack of personal contact. “Diagnostic difficulties” was most significantly mentioned in Sweden (UK p = .009, IT p < .001, DE p < .001), “virtual care” in the UK (IT p = .02, SE p = .001, DE p < .001), and “data security and protection” in Germany (UK p < .001, IT p = .019, SE p < .001). Our study reinforces the feasibility of using machine learning to explore large qualitative datasets. Our findings contribute to a better identification of the lessons learned during the pandemic and inform improvements in policy and practice.
A Panel Analysis of the Impact of EBITDA, Equity Book Values, Growth, Risk and Negative Earnings on Share Price Variations
Authors: Nhleko Ronald , Schutte Daniel
Published: August 2024

This study was motivated by the recent prevalence of valuation professionals utilizing EBITDA measures as part of their equity valuation strategies. To examine the impact of such valuation measures on share price variations, we developed a variant of the Ohlson valuation model that relates EBITDA, equity book values, growth, risk and negative earnings to share prices. We validated this relationship by utilizing the complete time-series data of the largest companies listed on the Johannesburg Stock Exchange from 1994 to 2017. We found that our model specification accounted for over 87% of the variance in the logarithmic-transformed share prices. Furthermore, the response coefficients for each explanatory variable were statistically significant, regardless of whether companies or sectors were incorporated as cross-sections. These findings have several significant empirical implications. Firstly, they demonstrate that EBITDA and equity book value variables significantly impact share price variations. Secondly, they lend credence to the hypotheses that growth and risk factors impact share price variations, and that negative earnings are value relevant. Ultimately, these findings constitute conclusive evidence of the empirical validity of the model specification we posit.

JEL classification codes: G10, G12, G14, G11, G32, M41.
Linking Responsible Leadership to Organizational Citizenship Behavior for the Environment: Examining the Role of Employees Harmonious Environmental Passion and Environmental Transformational Leadership
Authors: Alwheshi Ahmed , Alzubi Ahmad , Iyiola Kolawole
Published: August 2024

Firms are increasingly expected to exhibit social responsibility and contribute to sustainability goals. Emerging studies have highlighted the importance of responsible leaders who stimulate their employees, which then results in employee voluntary behavior toward the environmental practices, referred to as organizational citizenship behavior for the environment (OCBE). Drawing from social learning theory, the current study explores the impact of responsible leadership (RL) on OCBE using data obtained from employees of Turkish manufacturing firms. Additionally, employee harmonious environmental passion and environmental transformational leadership (ETL) were examined as mediator and moderator respectively. The results indicated that RL has a positive effect on OCBE. RL has a positive effect on employee harmonious environmental passion. Employee harmonious environmental passion has a positive effect on OCE. The relationship between RL and OCBE was mediated by employee harmonious environmental passion. Also, it was discovered that high level of ETL, the link between RL and OCBE is stronger for firms’ whose employees perceived high ETL. Based on the findings, implications for practice and research were discussed.
Aging With Grace: The Quest for Integrated, Compassionate Care for Older Adults
Authors: Romem Anat , Zalcman Beth G. , Katz Emilia , Prager Tal
Published: August 2024

Introduction

This Practice Update discusses the potential for implementation of the 4M model for care of older adults in Israel, to complement the medical-centric model that exists today. The older adult population in Israel is increasing. However, efficient and sufficient care that takes patient's wishes into consideration is lacking.

Purpose

Care of older adults, particularly palliative patients, is complex and requires multidisciplinary efforts. There are numerous challenges to caring for older adults. These include fragmentation of care, unclear boundaries between palliative and geriatric care, and the preservation of patient autonomy, indicating a need to adopt new care frameworks.

Conclusion

The authors suggest implementing the 4M model as a new care framework in addition to the current medical-centric model. This framework considers important care aspects during discussions of care: what matters to the patient, medication, mentation, and mobility. Implementation of this model can promote better-integrated care, thus improving the quality of life for older adults.
Sleep Disorders’ Prevalence and Impact on Academic Performance among Undergraduate Nursing Students in a Selected University, United Arab Emirates
Authors: Ibrahim Fatma M , Salmi Rahma Nemer , Saif Malak Anes , Mohammed Amani
Published: August 2024

Introduction

Throughout their academic pursuits, students may encounter various sleep-related issues, including insomnia, sleep apnea, hypersomnia, or sleep terror disorder. These disorders can profoundly impact their well-being, emotional state, and academic achievements.

Objective

This study, of significant relevance to the field of nursing and sleep disorders, aimed to investigate the prevalence of sleep disorders and their impact on academic performance among undergraduate nursing students in the United Arab Emirates.

Methods

A cross-sectional research method was implemented among 177 undergraduate nursing students. Two tools were used: Too I consisted of two parts: sociodemographic and academic performance classifications, whereas Tool II comprised the SLEEP-50 questionnaire.

Results

Our findings revealed that 30.6% of nursing students had one or more sleep disorders. Insomnia was the most prevalent among the nursing students (37.5%), followed by circadian rhythm (33.3%), narcolepsy (26.6%), sleep apnea and restless leg syndrome (25%), nightmares (22.2%), and sleepwalking (11.11%). There was a significant relation between restless leg syndrome and academic performance, while in linear regression analysis, it was found that the variable that most affects sleep is gender.

Conclusion

The implications of this study's findings are clear-nursing schools must intensify their efforts to raise awareness about the detrimental effects of sleep problems on academic performance. Furthermore, subsequent research is crucial to evaluate the execution of interventions aimed at preventing such disorders.
Development and Implementation of a Microlearning Curriculum of Physiology Formulas for Postgraduate Clinical Fellows in Pediatric Critical Care Medicine
Authors: Murtha Tanya D. , Geneslaw Andrew S. , Scott Baird J. , Wilson Patrick T.
Published: August 2024

Postgraduate medical education in clinical settings poses many challenges secondary to the large volume of knowledge to be acquired, competing clinical responsibilities, and fatigue. To address these challenges, a microlearning curriculum using flipped classroom methodologies was created to facilitate the mastering of fundamental physiology formulas by pediatric critical care medicine fellows. Forty physiology formulas were distilled into 5-minute microlearning sessions. Fellows were provided the weekly formula and encouraged to self-study prior to the face-to-face learning. The 5-minute session took place at the beginning of a regularly scheduled clinical care conference where normal values, explanatory diagrams, and board-like questions were discussed. A faculty or fellow facilitator then provided a more in-depth explanation and shared clinical pearls related to the formula. Following the session, an e-mail summarizing the learning points was sent. The curriculum was well received by fellows and faculty. Over 5 years, the curriculum evolved through phases of active development, implementation, minor modifications, transition to a virtual platform, shift to senior fellow-led instruction, and harmonization with other curricular activities. Engagement and sustainability were addressed with a fully flipped classroom, where senior fellows served as teachers to junior fellows. Microlearning in a multimodal manner is an excellent method for teaching busy postgraduate clinical trainees fundamental physiology formulas that underpin pediatric critical care decision-making. The gradual transition from individual learning to a flipped classroom taught by peers with faculty support was well tolerated and consistent with adult learning theories. The transition was essential to ensure the sustainability of the curriculum.
Bridge to Practice: A Qualitative Evaluation of Joint Medical Program (JMP) International Medical Graduates Perceived Preparedness for Professional Practice
Authors: Foot Michelle , Vashum Khanrin , Ballal Pavana , Lampe Lisa
Published: August 2024

OBJECTIVES

This study sought to examine the views of international graduates regarding how they perceived the Joint Medical Program Bachelor of Medicine (JMP BMed) undergraduate training prepared them to practice in a health system different from that in which they had studied. Eighteen international graduates of the JMP between 2010 and 2017 inclusive agreed to be interviewed face-to-face.

METHODS

JMP BMed international graduates were interviewed using 18 standardized questions to elicit perceptions of their preparedness to practice and reflections on their training experience. The interview data were qualitatively analyzed, and the main themes were identified and categorized.

RESULTS

Overall, the international graduates of the JMP BMed curriculum felt well-prepared for tasks associated with communication, self-directed learning, and approaching mental health issues. Conversely, they perceived the level of clinical exposure and experience as inadequate in preparing them for the expected level of medical knowledge and responsibility. They also felt underprepared for navigating a different health system.

CONCLUSIONS

The strengths and weaknesses identified in the JMP BMed program in its preparation of international graduates, particularly those who chose to practice in their country of origin, are of relevance for all medical schools that enrol international students. Greater awareness of the needs of international medical students returning home to practice may be of value for future curriculum planning purposes to ensure that medical schools optimally prepare their graduates to practice with confidence in a range of healthcare systems.
Locked Stem Reverse Total Shoulder Arthroplasty for Complex Proximal Humerus Fracture in the Elderly: Clinical and Radiological Short-Term Results
Authors: Rivera Alberto R. , Cardona Victor
Published: August 2024

Purpose

To evaluate both the short-term clinical and radiological results of reverse shoulder arthroplasty (RSA) with uncemented locked stem in the management of a proximal humerus fracture (PHFs) in the elderly.

Methods

Retrospective study including 40 consecutive 3–4 part proximal humerus fractures treated with reverse shoulder arthroplasty with a minimum of 24 months follow-up. In all the cases, the greater tuberosity (GT) was reattached with a standardized suture technique and a local horseshoe bone graft. All the patients were assessed at the 24-month follow-up with Constant-Murley Score (CMS) and Visual Analog Score (VAS). Radiographic healing of the greater tuberosity was noted in addition to stem locking screws radiographic changes. Complications and revision rates were reported.

Results

Mean final CMS for this cohort was 80 points. The greater tuberosity healed in the anatomic position in 90% of the cases (N = 36), obtaining an average CMS of 80 in these patients. Healing of the greater tuberosity did not occur in 10% of the cases (N = 4), obtaining an average CMS of 60. All patients scored above 100° in forward elevation with a mean of 140°. Mean active external rotation was 30°. Low-grade scapular notching was reported in <1% of the cases. Major complications were reported in one patient with an acromial fracture. No complications or loosening of stem locking screws were noted. There were no reoperations.

Conclusion

In the elderly population, reverse shoulder arthroplasty utilizing a fracture-specific locking stem, low-profile metaphysis, suture-friendly groove, meticulous suture technique, and local bone grafting allows adequate fixation, variable prosthesis height adjustment, and enhances greater tuberosity healing. This approach yields positive short-term clinical outcomes without complications related to the stem's locking screws.

Level of Evidence

Level IV Retrospective Case Series
Retrograde colon imaging through colonic transendoscopic enteral tubing helps to confirm the cause of difficult colonoscopy: a case report
Authors: Jiang Xiaomeng , Wang Runqing , Sun Haibo , Zhang Faming
Published: August 2024

Numerous factors can contribute to a difficult colonoscopy, potentially leading to an incomplete procedure and overlooked lesions. Alternative strategies for handling difficult and incomplete colonoscopies should be considered. We present the case of an 85-year-old male who underwent a difficult colonoscopy, during which two expert endoscopists spent 1.5 h attempting various techniques but failed to intubate the cecum. Subsequently, colonic transendoscopic enteral tubing (TET) was performed. Abdominal plain film revealed tortuosity of the TET tube in the left abdomen corresponding to the distribution of the descending colon. Retrograde colon imaging was conducted by injecting a mixture of contrast medium and air into the colon via the TET tube. X-ray demonstrated well-developed visualization of the entire colon and terminal ileum. And evident elongation and tortuosity of the descending colon resembled an N-type folding pattern. The final diagnosis was determined as descending colon redundancy. Colonic TET combined with retrograde colon imaging through the TET tube may serve as an effective supplementary approach for identifying causes of difficult colonoscopy and improving diagnostic accuracy for bowel diseases when complete visualization is not achieved.
Manufacturing of automotive mat using recycled carbon fiber: Obtaining strong physical properties through isotropic fiber orientation and improved adhesion of epoxy resin
Authors: Yoon Manseok , Lee Jaewoong , Kang Chankyu
Published: August 2024

With the rise in carbon fiber-reinforced plastic (CFRP) usage, there is a growing occurrence of waste disposal, prompting the exploration of different recycling methods. The primary methods of recycling include separating carbon fibers and resin from discarded CFRP products or reusing scraps generated during CFRP production, such as dry fabric or prepreg. Recycling leftover dry fabric is essential for waste management in the automotive industry. Current research is centered on utilizing recycled materials to produce anisotropic mats, presenting difficulties in managing variations in properties. Moreover, isotropic mats are the preferred choice for practical automotive component design. Our research aimed to solve this problem by creating recycled carbon fiber (rCF) mats with isotropic characteristics through a wet method to enhance even fiber spreading. Conditions to minimize property changes in the fabric based on direction were identified, and the mats were tailored accordingly. Then, the resin was impregnated into the mats using compression resin transfer molding to form CFRP. The static properties of the CFRP specimens produced were evaluated to identify conditions that maximize isotropy. Furthermore, observations of oil injection into rCF mats showed that resin track formation was reduced when CFRP was fabricated using isotropic mats.
A Randomized Controlled Trial of a Culturally Adapted, Community-Based, Remotely Delivered Mindfulness Program for Latinx Patients With Breast Cancer is Acceptable and Feasible While Reducing Anxiety
Authors: Juarez-Reyes Maria , Martinez Erica , Xiao Lan , Goldman Rosas Lisa
Published: August 2024

Background/Objective

Few Spanish mindfulness interventions have been evaluated in Latinx patients with cancer. We culturally adapted a mindfulness intervention for Spanish speaking Latinx patients. The objective was to measure feasibility and acceptability as primary outcomes, with changes in anxiety, depression, and sleep as secondary outcomes.

Method

Spanish-speaking Latinx patients with breast cancer (n = 31) were randomized, between April 2021 and May 2022 to either intervention or wait-list control groups. The mindfulness intervention consisted of 6-weekly 1.5-hour sessions remotely delivered by a novice facilitator. Cultural adaptations included language, metaphor, goal, concept, trauma informed, and acknowledgement of spirituality. Feasibility was benchmarked as 75% of participants attending their first session, 75% of participants completing 4 of 6 sessions, and scoring ≥ 4 on a 5-point Likert feasability scale measuring ability to implement changes after 6-weeks. Acceptability was measured as scoring ≥ 4 on a 5-point Likert scale measuring usefulness and relevance of the mindfulness intervention for each session. An intention-to-treat, linear mixed model with repeated measures analysis examined changes in anxiety, depression, and sleep at week 6 and 18 (3 months post intervention).

Results

All three feasibility benchmarks were met with 75% of first session attendance, 96% of participants completing 4 of 6 sessions, and 94% scoring ≥ 4, on the feasibility scale (Mean (SD) = 4.3 (0.6)). Acceptability scores for both usefulness and relevance questions were ≥ 4 across all 6 sessions. Anxiety was significantly reduced at 3 months (−3.6 (CI -6.9, −0.2), P = .04), but is of unclear clinical significance given the small change. Depression scores declined, but not significantly, and there were no changes in sleep.

Conclusion

This culturally adapted, remotely delivered mindfulness intervention using a novice facilitator was acceptable and feasible and demonstrated associated reductions in anxiety amongst Spanish speaking Latinx patients with breast cancer.

Trial Registration

ClinicalTrials.gov ID# NCT04834154.
Development of Preliminary Integrated Health Care Clinical Competencies for United States Doctor of Chiropractic Programs: A Modified Delphi Consensus Process
Authors: Daniels Clinton J , Cupler Zachary A , Napuli Jason G , Walsh Robert W , Ziegler Anna-Marie L , Meyer Kevin W , Knieper Matthew J , Walters Sheryl A , Salsbury Stacie A , Trager Robert J , Gliedt Jordan A , Young Morgan D , Anderson Kristian R , Kirk Eric J , Mooring Scott A , Battaglia Patrick J , Paris David J , Brown Amanda G , Goehl Justin M , Hawk Cheryl
Published: August 2024

Background

There has been rapid growth of chiropractors pursuing career opportunities in both public and private hospitals and other integrated care settings. Chiropractors that prosper in integrated care settings deliver patient-centered care, focus on the institutional mission, understand and adhere to organizational rules, and are proficient in navigating complex systems. The Council on Chiropractic Education Accreditation Standards do not outline specific meta-competencies for integrated care clinical training.

Objective

The purpose of this study was to develop preliminary integrated health care competencies for DC programs to guide the advancement of clinical chiropractic education.

Methods

A systematic literature search was performed. Articles were screened for eligibility and extracted in duplicate. Domains and seed statements were generated from this literature, piloted at a conference workshop, and evaluated via a modified Delphi consensus process. Of 42 invited, 36 chiropractors participated as panelists. Public comment period yielded 20 comments, none resulting in substantive changes to the competencies.

Results

Of 1718 citations, 23 articles met eligibility criteria. After 2 modified Delphi rounds, consensus was reached on all competency statements. A total of 78 competency statements were agreed upon, which encompassed 4 domains and 11 subdomains. The 4 domains were: 1) Collaboration, (2) Clinical Excellence, (3) Communication, and (4) Systems Administration.

Conclusion

We identified 78 preliminary competencies appropriate for preparing DC students and early career chiropractors for clinical practice in integrated healthcare settings. Educational programs may consider these competencies for curricular design and reform to strengthen DC program graduates for integrated practice, advanced training, and employment.
Qualitative Insights Regarding the Use of Tai Chi for Pain Management Among Adults With HIV
Authors: Dunne Eugene M , Mitchell Christina , McTigue Georgiana , Rosen Rochelle K , Yeh Gloria Y , Carey Michael P
Published: August 2024

Background

Approximately one-half of all adults with HIV experience chronic pain. Needed are nonpharmacological approaches to improve pain management in this population.

Methods

For this study, we conducted in-depth qualitative interviews (n = 20) with thirteen adults with HIV and 7 HIV care providers regarding their perceptions of Tai Chi for chronic pain management. The interviews were audio recorded, transcribed, double-coded, and analyzed using applied thematic analysis.

Results

HIV patients had limited prior exposure to Tai Chi and had not previously considered this practice for pain management. However, after viewing a brief video demonstration of Tai Chi, patients recognized potential benefits, including relaxation, stress reduction, and pain lessening. Patients were surprised by the gentle nature of Tai Chi and expressed enthusiasm to learn more about Tai Chi. HIV healthcare providers similarly had limited knowledge of Tai Chi for pain management. HIV care providers shared several helpful insights on the potential implementation of Tai Chi with this population.

Conclusions

Adults with HIV and healthcare providers were optimistic that Tai Chi would reduce stress and ease chronic pain. These data suggest that Tai Chi would be of interest to HIV patients and care providers as a novel pain management strategy.
The burdens attributable to headache disorders in Cameroon: national estimates from a population-based door-to-door survey, including a headache-care needs assessment
Authors: Kuate Tegueu Callixte , Dzudie Tamdja Anastase , Kom Franklin , Forgwa Barche Blaise , Ebasone Peter , Magnerou Mélanie , Mbonda Paul , Fogang Yannick , Massi Gams Daniel , Doumbe Jacques , Husøy Andreas , Steiner Timothy J.
Published: August 2024

Background

We have previously shown headache to be highly prevalent in Cameroon. Here we present the attributed burden. We also perform a headache-care needs assessment.

Methods

This was a cross-sectional survey among adults (18–65 years) in the general population. Multistage cluster-sampling in four regions (Centre, Littoral, West and Adamawa), home to almost half the country’s population, generated a representative sample. We used the standardised methodology of the Global Campaign against Headache, including the HARDSHIP questionnaire, with diagnostic questions based on ICHD-3 and enquiries into symptom burden, impaired participation (lost productivity and disengagement from social activity), quality of life (QoL) using WHOQoL-8, and willingness to pay (WTP) for effective care. We defined headache care “need” in terms of likelihood of benefit, counting all those with probable medication-overuse headache (pMOH) or other headache on ≥ 15 days/month (H15 +), with migraine on ≥ 3 days/month, or with migraine or tension-type headache (TTH) and meeting either of two criteria: a) proportion of time in ictal state (pTIS) > 3.3% and intensity ≥ 2 (moderate-to-severe); or b) ≥ 3 lost days from paid and/or household work in the preceding 3 months.

Results

Among 3,100 participants, mean frequency of any headache was 6.7 days/month, mean duration 13.0 h and mean intensity 2.3 (moderate). Mean pTIS was 9.8%, which (with prevalence factored in) diluted to 6.1–7.4% of all time in the population. Most time was spent with H15 + (5.3% of all time), followed by TTH (1.0%) and migraine (0.8%). For all headache, mean lost days/3 months were 3.4 from paid work, 3.0 from household work and 0.6 from social/leisure activities, diluting to 2.5, 2.2 and 0.6 days/3 months in the population. QoL (no headache: 27.9/40) was adversely impacted by pMOH (25.0) and other H15 + (26.0) but not by migraine (28.0) or TTH (28.0). WTP (maximally XAF 4,462.40 [USD 7.65] per month) was not significantly different between headache types. An estimated 37.0% of adult Cameroonians need headache care.

Conclusion

Headache disorders in Cameroon are not only prevalent but also associated with high attributed burden, with heavily impaired participation. Headache-care needs are very high, but so are the economic costs of not providing care.
Potential and goal conflicts in reverse auction design for bioenergy with carbon capture and storage (BECCS)
Authors: Fridahl Mathias , Möllersten Kenneth , Lundberg Liv , Rickels Wilfried
Published: August 2024

Bioenergy with carbon capture and storage (BECCS) is considered as a future key technology to provide baseload electricity, heat, pulp, paper, and biofuels, while also enabling atmospheric carbon dioxide removal (CDR). Sweden seeks to lead the way in bringing this technology up to scale, introducing a EUR 3.6 billion reverse auction scheme to facilitate market entry of companies producing BECCS. We explore instrument design preferences among politicians, regulators, and prospective BECCS operators to identify trade-offs and explore feasible policy design. Based on 35 interviews with experts in the latent BECCS sector in Sweden, we identify under which circumstances prospective operators would be willing to place bids and discuss how actor preferences both align with and challenge auction theory. The analysis concludes that at least four dilemmas need attention. These concerns how to: (1) balance the state’s demand for BECCS to be implemented already in 2030 against the prospective BECCS operators’ fear of the winner’s curse, i.e., a fear of bidding for a contract that turns out to be too costly to implement; (2) allocate contracts at the margin of the auctioneer’s demand for BECCS without driving up costs; (3) design compliance mechanism to achieve effectiveness without undermining efficiency, and; 4) integrate the auction with the voluntary carbon market—if at all—in a manner that safeguards the environmental integrity of the auctions.
2024 joint BMC Ecology and Evolution and BMC Zoology image competition: the winning images
Authors: Harman Jennifer , Nödl Marie-Therese , Fenton Brock , Hipsley Christy A. , Liberles David A. , Narayan Edward , Settele Josef , Traulsen Arne
Published: August 2024

In 2024, researchers from around the world entered the joint BMC Ecology and Evolution and BMC Zoology image competition. The photos, a celebration of the wonders and mysteries of the natural world, emphasise the importance of protecting life on our planet. This editorial announces the winning images chosen by the Editors and senior members of the journal’s editorial boards.
MicroRNA levels in patients with chronic hepatitis B virus and HIV coinfection in a high-prevalence setting; KwaZulu-Natal, South Africa
Authors: Mthethwa Lulama , Parboosing Raveen , Msomi Nokukhanya
Published: August 2024

Background

Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) co-infection are significant public health issues, despite the availability of an effective HBV vaccine for nearly three decades and the great progress that has been made in preventing and treating HIV. HBV and HIV both modulate micro-ribonucleic acids (microRNA) expression to support viral replication. The aim of this study was to describe the pattern of microRNA expression in patients coinfected with chronic HBV and HIV with varying disease severity, as indicated by Hepatitis B e antigen (HBeAg) status, HBV viral load, alanine transaminase (ALT) levels, and HIV viral load.

Methods

Plasma microRNAs, specific to HBV, were measured by quantitative real-time polymerase chain reaction (qRT-PCR) in HBV and HIV-negative healthy controls (n = 23) and patients coinfected with chronic HBV-HIV (n = 50). MicroRNA expression levels were compared between patients with high vs low HBV viral load, HBeAg positive vs HBeAg negative, high vs low ALT levels, and high vs low HIV viral load. Additionally, HBV viral load, ALT levels, and HIV viral load were correlated with microRNA expression levels.

Results

Significantly higher expression levels of selected microRNAs were observed in chronic HBV-HIV coinfected patients compared to healthy controls. Significantly higher expression levels of hsa-miR-122-5p, hsa-miR-192-5p, and hsa-miR-193b-3p were observed in patients with high HBV viral load compared with low HBV viral load patients, and the levels of these microRNAs were correlated with HBV viral load levels. Significantly higher levels of hsa-miR-15b-5p and hsa-miR-181b-5p were observed in HBeAg-negative patients.

Conclusion

This study demonstrates the potential use of hsa-miR-15b-5p, hsa-miR-122-5p, hsa-miR-181b-5p, hsa-miR-192-5p and hsa-miR-193b-3p as additional diagnostic biomarkers in chronic HBV disease progression.
Association of weight loss strategies with all-cause and specific-cause mortality: a prospective cohort study
Authors: Diao Zhiquan , Zhu Yilin , Huang Wenqi , Wen Huiyan , Li Jiaxin , Qiu Jiamin , Niu Yingying , Yan Haoyu , Zhong Jianfeng , Bai Xuerui , Xu Zhitong , Liang Xiaofeng , Liu Dan
Published: August 2024

Background

The health effects of different weight loss strategies vary greatly, and the relationship between weight loss strategies, especially the combination of multiple strategies, and death is still unclear. We aimed to examine the associations of various numbers and combinations of weight loss strategies with all-cause and specific-cause mortality and to further evaluate the associations of different total weight loss volumes with mortality.

Methods

Using data from NHANES (1999–2018) with 48,430 participants aged 20 and above, we collected fourteen self-reported weight loss strategies and identified five clusters using latent class analysis. Cox proportional hazards models were used to examine the association between the amounts and clusters of weight loss strategies and mortality.

Results

During a median follow-up of 9.1 years of 48,430 participants, 7,539 deaths were recorded (including 1,941 CVDs and 1,714 cancer). Participants who adopted 2, 3–4, and ≥ 5 weight loss strategies had a lower risk of all-cause mortality, with HRs of 0.88 (95% CI, 0.81 to 0.97), 0.89 (95% CI, 0.81 to 0.96) and 0.71 (95% CI, 0.61 to 0.82). Regardless of weight loss or weight gain categories, there was a significant trend toward reduced mortality as the number of weight loss strategies increased (P trend < 0.05). Participants who adopted cluster-1 (four strategies), cluster-2 (five strategies) and cluster-3 (three strategies) had a significantly lower risk of all-cause mortality, with HRs of 0.71 (95% CI, 0.60 to 0.84), 0.70 (95% CI, 0.55 to 0.89) and 0.81 (95% CI, 0.70 to 0.94). Among them, cluster-1 and cluster-2 are both characterized by eating less food, exercising, drinking plenty of water, lowering calories and eating less fat. Conversely, cluster-4 (five strategies) and cluster-5 (four strategies) had marginally significant effects, and they both had actual higher total energy intakes. Similar associations were observed for CVDs and cancer mortality.

Conclusions

Employing two or more weight loss strategies was associated with a lower risk of death, even among those who gained weight. Eating less food, exercising, drinking plenty of water, lowering calories and eating less fat is a better combination of strategies. On this basis, limiting the actual intake of total energy is necessary.
Longitudinal assessment of the impact of COVID-19 infection on mask-wearing behaviors
Authors: Pham Danielle , Lomeli Angel , Goldhaber Nicole H. , Valentine Holly D. , Knight Rob , Longhurst Christopher A. , Laurent Louise C. , Jacobs Marni B.
Published: August 2024

Background

Wearing a mask was a crucial component in slowing the COVID-19 pandemic. However, little is known about the intersectionality between mask usage, risk perception, and infection. The purpose of this study was to investigate whether risk perceptions and masking behaviors are associated with contracting SARS-CoV-2 and how contracting SARS-CoV-2 subsequently changes masking behaviors in specific situations.

Methods

This cohort study utilized survey data from the UC San Diego ZAP COVID-19 study (n = 1,230) to evaluate the risk of contracting SARS-CoV-2 in relation to baseline risk perceptions and masking behaviors in various situations and how contracting SARS-CoV-2 affects subsequent masking behavior.

Results

We found that more consistent self-reported mask use in indoor public spaces (p = 0.03) and in other people’s houses (p = 0.002) was associated with remaining free of SARS-CoV-2 infection. We also found that contracting SARS-CoV-2 was associated with a subsequent increase in mask use in other people’s houses (p = 0.01).

Conclusions

Our findings suggest that consistent mask use is correlated with decreased infection and that contracting SARS-CoV-2 may modify mask use behaviors in high-risk situations. These findings may help inform future public health messaging for infectious disease prevention.

Trial registration

This study has not been previously registered as it is an observational study. There was no pre-registration of the analytic plan for the present study.
Cross-sectional survey and analysis of factors influencing the prevalence of dental caries among older individuals aged 65-74 in Guangdong Province in 2021
Authors: Tian Tao , Yang Zijing , Li Simin , Fan Weihua , Wu Linmei , Li Jianbo , Huang Shaohong
Published: August 2024

Background

The prevalence of oral diseases is subject to change over time. In 2021, Guangdong Province conducted its fourth survey assessing the oral health status of individuals aged 65–74.

Materials and methods

Evaluation criteria and potential influencing factors were identified. A sample of residents aged 65–74 from 13 designated monitoring sites in Guangdong Province was randomly selected for the study. Spearman correlation analysis was employed to investigate the clinical correlation between influencing factors and evaluation criteria. Negative binomial and zero-inflated negative binomial regression models were utilized to examine the factors influencing caries prevalence. In contrast, logistic regression was employed to identify the risk factors for caries occurrence. A p-value of ≤0.05 was considered statistically significant.

Results

The prevalence of caries rate of crowns, roots, and teeth were 76.36%, 52.25%, and 79.2%, respectively. Individuals with periodontal pockets exhibited a significantly higher risk of root caries. The presence of dental calculus significantly exacerbated the occurrence of crown, root, and dental caries, and increased the risk of crown and dental caries. Consuming sweet foods once or more a week notably increased the average root decayed score (D of roots), the prevalence rate of root caries, and the D score of the Decayed, Missing, and Filled teeth [DMFT] index in individuals already afflicted with this condition. Similarly, the consumption of sweetened drinks significantly elevated the risk of crown and root caries, exacerbating overall caries progression. Frequencies of manual toothbrush and toothpick cleaning showed a negative correlation with average tooth missing score (MT). In contrast, the frequency of manual/electric toothbrush and toothpick cleaning was negatively correlated with the DMFT index. Engaging in dental diagnosis and treatment behaviors significantly increased the number of filled crowns (F), MT, and DMFT scores while reducing the prevalence of dental caries.

Conclusions

In Guangdong Province, caries prevalence among older individuals aged 65–74 remains substantial. Relevant professionals and institutions must provide comprehensive guidance and assistance to the older population, emphasizing the importance of reducing the consumption of sweets and sweetened beverages, adopting correct tooth brushing techniques and frequency (at least twice daily), timely treatment of periodontal diseases, conducting regular epidemiological caries surveys, and addressing economic barriers to accessing caries diagnosis and treatment services.
Screening of broad-host expression promoters for shuttle expression vectors in non-conventional yeasts and bacteria
Authors: Ji Liyun , Xu Shuo , Zhang Yue , Cheng Hairong
Published: August 2024

Background

Non-conventional yeasts and bacteria gain significance in synthetic biology for their unique metabolic capabilities in converting low-cost renewable feedstocks into valuable products. Improving metabolic pathways and increasing bioproduct yields remain dependent on the strategically use of various promoters in these microbes. The development of broad-spectrum promoter libraries with varying strengths for different hosts is attractive for biosynthetic engineers.

Results

In this study, five Yarrowia lipolytica constitutive promoters (yl.hp4d, yl.FBA1in, yl.TEF1, yl.TDH1, yl.EXP1) and five Kluyveromyces marxianus constitutive promoters (km.PDC1, km.FBA1, km.TEF1, km.TDH3, km.ENO1) were selected to construct promoter-reporter vectors, utilizing α-amylase and red fluorescent protein (RFP) as reporter genes. The promoters' strengths were systematically characterized across Y. lipolytica, K. marxianus, Pichia pastoris, Escherichia coli, and Corynebacterium glutamicum. We discovered that five K. marxianus promoters can all express genes in Y. lipolytica and that five Y. lipolytica promoters can all express genes in K. marxianus with variable expression strengths. Significantly, the yl.TEF1 and km.TEF1 yeast promoters exhibited their adaptability in P. pastoris, E. coli, and C. glutamicum. In yeast P. pastoris, the yl.TEF1 promoter exhibited substantial expression of both amylase and RFP. In bacteria E. coli and C. glutamicum, the eukaryotic km.TEF1 promoter demonstrated robust expression of RFP. Significantly, in E. coli, The RFP expression strength of the km.TEF1 promoter reached ∼20% of the T7 promoter.

Conclusion

Non-conventional yeast promoters with diverse and cross-domain applicability have great potential for developing innovative and dynamic regulated systems that can effectively manage carbon flux and enhance target bioproduct synthesis across diverse microbial hosts.

Graphical Abstract
StaVia: spatially and temporally aware cartography with higher-order random walks for cell atlases
Authors: Stassen Shobana V. , Kobashi Minato , Lam Edmund Y. , Huang Yuanhua , Ho Joshua W. K. , Tsia Kevin K.
Published: August 2024

Single-cell atlases pose daunting computational challenges pertaining to the integration of spatial and temporal information and the visualization of trajectories across large atlases. We introduce StaVia, a computational framework that synergizes multi-faceted single-cell data with higher-order random walks that leverage the memory of cells’ past states, fused with a cartographic Atlas View that offers intuitive graph visualization. This spatially aware cartography captures relationships between cell populations based on their spatial location as well as their gene expression and developmental stage. We demonstrate this using zebrafish gastrulation data, underscoring its potential to dissect complex biological landscapes in both spatial and temporal contexts.
Hydrothermal conditioning of oleaginous yeast cells to enable recovery of lipids as potential drop-in fuel precursors
Authors: Banerjee Shivali , Dien Bruce S. , Singh Vijay
Published: August 2024

Background

Lipids produced using oleaginous yeast cells are an emerging feedstock to manufacture commercially valuable oleochemicals ranging from pharmaceuticals to lipid-derived biofuels. Production of biofuels using oleaginous yeast is a multistep procedure that requires yeast cultivation and harvesting, lipid recovery, and conversion of the lipids to biofuels. The quantitative recovery of the total intracellular lipid from the yeast cells is a critical step during the development of a bioprocess. Their rigid cell walls often make them resistant to lysis. The existing methods include mechanical, chemical, biological and thermochemical lysis of yeast cell walls followed by solvent extraction. In this study, an aqueous thermal pretreatment was explored as a method for lysing the cell wall of the oleaginous yeast Rhodotorula toruloides for lipid recovery.

Results

Hydrothermal pretreatment for 60 min at 121 °C with a dry cell weight of 7% (w/v) in the yeast slurry led to a recovery of 84.6 ± 3.2% (w/w) of the total lipids when extracted with organic solvents. The conventional sonication and acid-assisted thermal cell lysis led to a lipid recovery yield of 99.8 ± 0.03% (w/w) and 109.5 ± 1.9% (w/w), respectively. The fatty acid profiles of the hydrothermally pretreated cells and freeze-dried control were similar, suggesting that the thermal lysis of the cells did not degrade the lipids.

Conclusion

This work demonstrates that hydrothermal pretreatment of yeast cell slurry at 121 °C for 60 min is a robust and sustainable method for cell conditioning to extract intracellular microbial lipids for biofuel production and provides a baseline for further scale-up and process integration.

Graphical abstract
A hybrid yang transform adomian decomposition method for solving time-fractional nonlinear partial differential equation
Authors: Bekela Alemu Senbeta , Deresse Alemayehu Tamirie
Published: August 2024

Nonlinear time-fractional partial differential equations (NTFPDEs) play a great role in the mathematical modeling of real-world phenomena like traffic models, the design of earthquakes, fractional stochastic systems, diffusion processes, and control processing. Solving such problems is reasonably challenging, and the nonlinear part and fractional operator make them more problematic. Thus, developing suitable numerical methods is an active area of research. In this paper, we develop a new numerical method called Yang transform Adomian decomposition method (YTADM) by mixing the Yang transform and the Adomian decomposition method for solving NTFPDEs. The derivative of the problem is considered in sense of Caputo fractional order. The stability and convergence of the developed method are discussed in the Banach space sense. The effectiveness, validity, and practicability of the method are demonstrated by solving four examples of NTFPEs. The findings suggest that the proposed method gives a better solution than other compared numerical methods. Additionally, the proposed scheme achieves an accurate solution with a few numbers of iteration, and thus the method is suitable for handling a wide class of NTFPDEs arising in the application of nonlinear phenomena.