bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a serious game-based cognitive rehabilitation system for patients with brain injury
Authors: Rahmani-Katigari Meysam , Mohammadian Fatemeh , Shahmoradi Leila
Published: November 2023

Background

Traumatic brain injury (TBI) resulting from a forceful impact to the head can cause severe functional disabilities, with cognitive impairment being a major hindrance to patients' return to daily life. Encouraging patients to engage in rehabilitation programs consistently poses a significant challenge for therapists. To address this issue, gamification has gained momentum as an effective approach. This study aims to develop a serious game-based cognitive rehabilitation system tailored for patients with brain injury.

Methods

The study included four stages. Initially, the requirements were analyzed through focus groups. Then the system structure and game content were discussed and was agreed as a conceptual model. In second stage, the system design was drawn using various modeling diagrams. In third stage, a system prototype was developed using the Unity game engine and C# programming. Finally, a heuristic evaluation method was employed to assess usability.

Results

Based on the focus group meetings with seven participants, a conceptual model of the system structure and game content was designed. Game's interface was developed for both the therapist and patient versions. The focus groups determined a 2D casual gaming genre with a postman character and 10 missions on the smartphone platform. For example, in the first mission, the postman must move from mailboxes 1 to 10 and pick up the letters. This is according to Trail Making Test task. The 16 tasks in different subcategories of attention were selected to make these missions. The usability evaluation highlighted privacy, help and documentation, and aesthetic and minimalist design as the areas with the highest percentage of problems.

Conclusions

Cognitive rehabilitation is vital in facilitating patients' faster return to daily routines and enhancing their quality-of-life following brain injury. Incorporating a game-based system provides patients with increased motivation to engage in various cognitive exercises. Additionally, continuous monitoring by specialists ensures effective patient management. The game-based system offers different game stages to strengthen and rehabilitate attention in patients with brain injury. In the next step, the clinical effects of this system will be evaluated.
Association between light at night and the risk of child death in sub-saharan Africa: a cross-sectional analysis based on DHS data
Authors: Li Xinyue , Bachwenkizi Jovine , Chen Renjie , Kan Haidong , Meng Xia
Published: November 2023

Background

The high under-five mortality rate (U5MR) in Africa is a significant public health concern. Previous studies have found that satellite retrieved light at night (LAN) data with long-term and global coverage can be used as a proxy for socio-economic development and urbanization. Currently, few studies on the effects of LAN on child mortality have been conducted in Africa, a region with varying levels of urbanization between countries.

Objective

To quantify the correlation between risk of child mortality and LAN as an indicator of urbanization and economic development in Africa.

Methods

Using data from the Demographic and Health Survey (DHS) database conducted in 15 African countries out of 46 countries from 2005 to 2013, this study estimated LAN levels for children based on their year of birth and residential addresses. This study used Cox proportional hazards models to assess the association between LAN and the risk of child mortality in Africa.

Results

The mean U5MR was 95 per 1,000 livebirths among the 15 African countries during 2005–2013. After adjusting for covariates, each 10-unit increment in LAN was associated with a 5.3% reduction in the risk of U5MR. The effect estimates were more pronounced in areas with lower LAN.

Conclusion

In Africa, the risk of U5MR decreased with increasing LAN, especially in areas with lower LAN. The results suggest that the development of urbanization and socio-economic conditions may be beneficial to child health, especially in regions with low LAN. The use of LAN as a proxy may offer an intriguing approach for identifying areas requiring targeted development in urbanization and socio-economic conditions.
Application of “immersive contextualization based-learning teaching” mode in the orthopaedic musculoskeletal disorder module of clinical medicine education
Authors: Cai Wufeng , You Mingke , Li Jian , Li Qi , Wang Duan , Wang Haoyang
Published: November 2023

Objective

To evaluate the effect and influence of the “immersive contextualization-based learning” teaching mode (ICBLT) in the orthopaedic musculoskeletal disorder module of clinical medicine education.

Methods

Undergraduate students in five consecutive semesters of clinical medicine in West China Hospital, Sichuan University were enrolled in this study. During the teaching process in each semester, a cross-over design was applied, and students were randomly divided into two classes (Class A and Class B) to receive the designated experimental courses with different routes. After they took the final exams, the scores of the selected chapters (sports injury chapter and osteoarthritis chapter) were extracted to conduct Tests of Between-Subjects Effects. Q-Q plot was drawn to test whether the distribution of the scores follows normal distribution. The part of the feedback questionnaires to assess these two teaching modes were also extracted for comparison.

Results

A total of 441 students were enrolled in this study, among which, Class A teaching route was implemented to 222 students and Class B to the rest 219. The results of Tests of Between-Subjects Effects showed that ICBLT mode could lead to better scores compared to the Lecturing-based learning teaching (LBLT) mode (p < 0.0001). In terms of mastery of practical skills, help to deepen the memory of knowledge and satisfaction with the teaching mode, the ICBLT mode showed better results (p < 0.0001).

Conclusion

ICBLT mode had better potential in helping mastery of practical skills and deepening the memory of knowledge.
Can gamified surgical sets improve surgical instrument recognition and student performance retention in the operating room? A multi-institutional experimental crossover study
Authors: Masoumian Hosseini Mohsen , Sadat Manzari Zahra , Gazerani Azam , Masoumian Hosseini Seyedeh Toktam , Gazerani Akram , Rohaninasab Mehrdad
Published: November 2023

Introduction

Surgery requires a high degree of precision, speed, and concentration. Owing to the complexity of the modern world, traditional methods cannot meet these requirements. Therefore, in this study, we investigated students’ diagnostic skills in the Operating Room in the context of surgical instruments by using gamification of surgical instruments and a crossover design.

Method

The study design was a multi-institutional quasi-experimental crossover and involved a three-arm intervention (with gender-specific block randomisation: Group A, B, and C) with a pre-test and three post-tests. A total of 90 students fell into three groups of 30 participants each. The surgical sets were learned for one semester through game-based instruction and traditional teaching, and then three OSCE tests were administered with time and location differences. Using one-way ANOVA, OSCE results were compared in the game, traditional, and control groups. The effectiveness of the intervention was tested in each group by repeated measures.

Result

The pretest scores of all three groups did not differ significantly. In the OSCE tests, both groups, A and B, performed similarly. However, these tests showed a significant difference in grouping between training through games and training in the traditional way. There was no significant difference between OSCE tests 2 and 3 in the game-based training group, indicating that what was learned was retained, while in the traditional method training group, OSCE 3 test scores declined significantly. Furthermore, repeated measures showed the effectiveness of game-based training.

Conclusion

In this study, gamification has turned out to be very effective in helping learners learn practical skills and leading to more sustainable learning.
Use of a hybrid digital training approach for hormonal IUD providers in Nigeria: results from a mixed method study
Authors: Little Kristen M. , Nwala Anthony A. , Demise Eden , Archie Samantha , Nwokoma Ezechukwu I. , Onyezobi Chinedu , Anyasi Helen , Afolabi Kayode , OlaOlorun Funmilola M. , Rademacher Kate H. , Danna Kendal , Lorenzetti Lara , Anyanti Jennifer , Plotkin Marya
Published: November 2023

Background

In Nigeria, in-service trainings for new family planning (FP) methods have typically been conducted using a combination of classroom-based learning, skills labs, and supervised practicums. This mixed-methods study evaluated the feasibility, acceptability, provider competency, and costs associated with a hybrid digital and in-person training model for the hormonal intrauterine device (IUD).

Methods

The study was conducted in Enugu, Kano, and Oyo states, Nigeria, and enrolled FP providers previously trained on non-hormonal IUDs. Participants completed a digital didactic training, an in-person model-based practicum with an Objective Structured Clinical Examination (OSCE), followed by supervised provision of service to clients. Provider knowledge gains and clinical competency were assessed and described descriptively. Data on the feasibility, acceptability, and scalability of the approach were gathered from participating providers, clinical supervisors, and key stakeholders. Training costs were captured using an activity-based approach and used to calculate a cost per provider trained. All analyses were descriptive.

Results

Sixty-two providers took the hybrid digital training, of whom 60 (91%) were included in the study (n = 36 from public sector, n = 15 from private sector, and n = 9 both public/private). The average knowledge score increased from 62 to 86% pre- and post-training. Clinical competency was overall very high (mean: 94%), and all providers achieved certification. Providers liked that the digital training could be done at the time/place of their choosing (84%), was self-paced (79%), and reduced risk of COVID-19 exposure (75%). Clinical supervisors and Ministry of Health stakeholders also had positive impressions of the training and its scalability. The hybrid training package cost $316 per provider trained.

Conclusions

We found that a hybrid digital training approach to hormonal IUD service provision in Nigeria was acceptable and feasible. Providers demonstrated increases in knowledge following the training and achieved high levels of clinical competency. Both providers and clinical supervisors felt that the digital training content was of high quality and an acceptable (sometimes preferable) alternative to classroom-based, in-person training. This study provided insights into a hybrid digital training model for a long-acting contraceptive, relevant to scale-up in Nigeria and similar settings.
Cisplatin exposure alters tRNA-derived small RNAs but does not affect epimutations in C. elegans
Authors: Fallet Manon , Wilson Rachel , Sarkies Peter
Published: November 2023

Background

The individual lifestyle and environment of an organism can influence its phenotype and potentially the phenotype of its offspring. The different genetic and non-genetic components of the inheritance system and their mutual interactions are key mechanisms to generate inherited phenotypic changes. Epigenetic changes can be transmitted between generations independently from changes in DNA sequence. In Caenorhabditis elegans, epigenetic differences, i.e. epimutations, mediated by small non-coding RNAs, particularly 22G-RNAs, as well as chromatin have been identified, and their average persistence is three to five generations. In addition, previous research showed that some epimutations had a longer duration and concerned genes that were enriched for multiple components of xenobiotic response pathways. These results raise the possibility that environmental stresses might change the rate at which epimutations occur, with potential significance for adaptation.

Results

In this work, we explore this question by propagating C. elegans lines either in control conditions or in moderate or high doses of cisplatin, which introduces genotoxic stress by damaging DNA. Our results show that cisplatin has a limited effect on global small non-coding RNA epimutations and epimutations in gene expression levels. However, cisplatin exposure leads to increased fluctuations in the levels of small non-coding RNAs derived from tRNA cleavage. We show that changes in tRNA-derived small RNAs may be associated with gene expression changes.

Conclusions

Our work shows that epimutations are not substantially altered by cisplatin exposure but identifies transient changes in tRNA-derived small RNAs as a potential source of variation induced by genotoxic stress.
Maternal glycemic status during pregnancy and mid-childhood plasma amino acid profiles: findings from a multi-ethnic Asian birth cohort
Authors: Liu Mengjiao , Chan Shiao-Yng , Eriksson Johan G. , Chong Yap Seng , Lee Yung Seng , Yap Fabian , Chong Mary Foong-Fong , Tint Mya Thway , Yang Jiaxi , Burgner David , Zhang Cuilin , Li Ling-Jun
Published: November 2023

Background

Increasing maternal glycaemia across the continuum during pregnancy may predispose offspring to subsequent cardiometabolic risk later in life. However, evidence of long-term impacts of maternal glycemic status on offspring amino acid (AA) profiles is scarce. We aimed to investigate the association between maternal antenatal glycaemia and offspring mid-childhood amino acid (AA) profiles, which are emerging cardiometabolic biomarkers.

Methods

Data were drawn from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study, a multi-ethnic Asian birth cohort. A subset of 422 mother–child dyads from the GUSTO study, who was followed from early pregnancy to mid-childhood, was included. Mothers underwent an oral glucose tolerance test (OGTT) at 26–28 weeks gestation, with fasting and 2-h plasma glucose concentrations measured and gestational diabetes mellitus (GDM) diagnosed per WHO 1999 guidelines. Offspring fasting plasma samples were collected at mean age 6.1 years, from which AA profiles of nine AAs, alanine, glutamine, glycine, histidine, isoleucine, leucine, valine, phenylalanine, and tyrosine were measured. Total branched-chain amino acids (BCAAs) were calculated as the sum of isoleucine, leucine, and valine concentrations. Multi-variable linear regression was used to estimate the association of maternal glycemic status and offspring mid-childhood AA profiles adjusting for maternal age, ethnicity, maternal education, parity, family history of diabetes, ppBMI, child sex, age and BMIz-scores.

Results

Approximately 20% of mothers were diagnosed with GDM. Increasing maternal fasting glucose was significantly associated with higher offspring plasma valine and total BCAAs, whereas higher 2-h glucose was significantly associated with higher histidine, isoleucine, valine, and total BCAAs. Offspring born to mothers with GDM had higher valine (standardized mean difference 0.27 SD; 95% CI: 0.01, 0.52), leucine (0.28 SD; 0.02, 0.53), and total BCAAs (0.26 SD; 0.01, 0.52) than their counterparts. Inconsistent associations were found between maternal GDM and other amino acids among offspring during mid-childhood.

Conclusions

Increasing maternal fasting and post-OGTT glucose concentrations at 26–28 weeks gestation were significantly associated with mid-childhood individual and total BCAAs concentrations. The findings suggest that elevated maternal glycaemia throughout pregnancy, especially GDM, may have persistent programming effects on offspring AA metabolism which were strongly associated with adverse cardiometabolic profiles at mid-childhood.
A cross-sectional study to ascertain malaria prevalence among asymptomatic travellers arriving on the Lihir Group of Islands, Papua New Guinea: implications for elimination efforts
Authors: Millat-Martínez Pere , Baro Bàrbara , Kasian Bernadine , Lorry Lina , Sanz Sergi , Wali Chilaka , Raulo Sylvia , Elizah Arthur , Koleala Tamarah , Kaius-Ome Maria , Karl Stephan , Mitjà Oriol , Laman Moses , Pomat William , Bassat Quique
Published: November 2023

Background

The Lihir Islands of Papua New Guinea host a mining operation that has resulted in a mine-impacted zone (MIZ) with reduced malaria transmission and a substantial influx of mine employees, informal cross-country traders, returning locals, and visitors. Prevalence of malaria parasites was assessed in travellers arriving on the Lihir Group of Islands to evaluate the risk of parasite importation.

Methods

In 2018, a cross-sectional study at the airport and main wharf was conducted, targeting asymptomatic travellers who had been away from Lihir for at least 12 days. Microscopy, rapid diagnostic tests (RDTs), and quantitative PCR (qPCR) were used to determine Plasmodium parasite prevalence, employing logistic regression models to identify factors associated with qPCR positivity.

Results

398 travellers arriving by plane and 402 arriving by boat were included. Both cohorts were significantly different. Mean age among travellers arriving by plane was 40.1 years (SD ± 10.1), 93% were male and 96% were employed at the mine. In contrast, among travellers arriving by boat, the mean age was 31.7 years (SD ± 14.0), 68% were male and 36% were employed at the mine. The prevalence of malaria infection among travellers arriving by plane was 1% by RDT and microscopy, and increased to 5% by qPCR. In contrast, those arriving by boat showed a prevalence of 8% by RDT and microscopy, and 17% by qPCR. Risk factors for infection were arriving by boat (OR 4.2; 95%CI 2.45,7.21), arriving from nearby provinces with high malaria incidence (OR 5.02; 95%CI 1.80, 14.01), and having been away from Lihir for 91 days or more (OR 4.15; 95%CI 2.58, 6.66). Being mine worker staying at the mine accommodation was related with less infection risk (OR 0.24; 95% CI 0.14, 0.43); while Lihirian residents returning from a trip, VFRs, or people with trading unrelated to mining had higher risks (p = 0.0066).

Conclusions

Travellers arriving by boat faced increased risk of malaria infection than those arriving by plane. This subpopulation poses an import risk to the MIZ and the rest of Lihir Islands. Screening of high-risk groups at wharfs, and collaboration with nearby Islands, could sustain reduced transmission and facilitate malaria elimination strategies.
Advanced application of nanotechnology in active constituents of Traditional Chinese Medicines
Authors: Qiu Chong , Zhang Jun Zhe , Wu Bo , Xu Cheng Chao , Pang Huan Huan , Tu Qing Chao , Lu Yu Qian , Guo Qiu Yan , Xia Fei , Wang Ji Gang
Published: November 2023

Traditional Chinese Medicines (TCMs) have been used for centuries for the treatment and management of various diseases. However, their effective delivery to targeted sites may be a major challenge due to their poor water solubility, low bioavailability, and potential toxicity. Nanocarriers, such as liposomes, polymeric nanoparticles, inorganic nanoparticles and organic/inorganic nanohybrids based on active constituents from TCMs have been extensively studied as a promising strategy to improve the delivery of active constituents from TCMs to achieve a higher therapeutic effect with fewer side effects compared to conventional formulations. This review summarizes the recent advances in nanocarrier-based delivery systems for various types of active constituents of TCMs, including terpenoids, polyphenols, alkaloids, flavonoids, and quinones, from different natural sources. This review covers the design and preparation of nanocarriers, their characterization, and in vitro/vivo evaluations. Additionally, this review highlights the challenges and opportunities in the field and suggests future directions for research. Nanocarrier-based delivery systems have shown great potential in improving the therapeutic efficacy of TCMs, and this review may serve as a comprehensive resource to researchers in this field.

Graphical abstract
Visualization of microRNA therapy in cancers delivered by small extracellular vesicles
Authors: Fu Peiwen , Guo Yumeng , Luo Yanan , Mak Michael , Zhang Jianguo , Xu Wenrong , Qian Hui , Tao Zhimin
Published: November 2023

MicroRNA (miRNA) delivery by extracellular vesicles (EVs) has recently inspired tremendous developments in cancer treatments. However, hybridization between miRNA and its target mRNA is still difficult to be imaged in vivo to assess the therapeutic effects in time. Herein we design a nano-scale fluorescent “off–on” complex encapsulated by small extracellular vesicles (sEVs) for real-time visualization and evaluation of gene therapy efficiency in human gastric cancer cells and murine xenograft tumor models. The complex is formed by π–π stacking between graphene quantum dots (GQDs) and tumor suppressor miR-193a-3p conjugated fluorescent tag whose signals remain off when binding to GQDs. Loaded into sEVs using tunable sonication techniques, the GQDs/Cy5-miR particles enter the tumor cells and promote miR-193a-3p escape from endosomes. The miR-193a-3p in GQDs/Cy5-miR is unleashed to pair the specific target oncogene cyclin D1 (CCND1), therefore turning on the fluorescence of miRNA tags. We find out that GQDs/Cy5-miR@sEVs can activate the “turn-on” fluorescent signal and exhibit the longest retention time in vivo, which suggests a minimized degradation of miR-193a-3p in dynamic processes of miRNA-mRNA binding. More importantly, GQDs/Cy5-miR@sEVs significantly promote cancer apoptosis in vitro and in vivo via the enhanced cellular uptake. Our study demonstrates that GQDs/Cy5-miR@sEVs represent an efficient and refined theranostic platform for gene therapy in cancers.

Graphical Abstract
SHED-derived exosomes attenuate trigeminal neuralgia after CCI of the infraorbital nerve in mice via the miR-24-3p/IL-1R1/p-p38 MAPK pathway
Authors: Guo Rong , Fang Yuxin , Zhang Yuyao , Liu Liu , Li Na , Wu Jintao , Yan Ming , Li Zehan , Yu Jinhua
Published: November 2023

Background

Microglial activation in the spinal trigeminal nucleus (STN) plays a crucial role in the development of trigeminal neuralgia (TN). The involvement of adenosine monophosphate-activated protein kinase (AMPK) and N-methyl-D-aspartate receptor 1 (NMDAR1, NR1) in TN has been established. Initial evidence suggests that stem cells from human exfoliated deciduous teeth (SHED) have a potential therapeutic effect in attenuating TN. In this study, we propose that SHED-derived exosomes (SHED-Exos) may alleviate TN by inhibiting microglial activation. This study sought to assess the curative effect of SHED-Exos administrated through the tail vein on a unilateral infraorbital nerve chronic constriction injury (CCI-ION) model in mice to reveal the role of SHED-Exos in TN and further clarify the potential mechanism.

Results

Animals subjected to CCI-ION were administered SHED-Exos extracted by differential ultracentrifugation. SHED-Exos significantly alleviated TN in CCI mice (increasing the mechanical threshold and reducing p-NR1) and suppressed microglial activation (indicated by the levels of TNF-α, IL-1β and IBA-1, as well as p-AMPK) in vivo and in vitro. Notably, SHED-Exos worked in a concentration dependent manner. Mechanistically, miR-24-3p-upregulated SHED-Exos exerted a more significant effect, while miR-24-3p-inhibited SHED-Exos had a weakened effect. Bioinformatics analysis and luciferase reporter assays were utilized for target gene prediction and verification between miR-24-3p and IL1R1. Moreover, miR-24-3p targeted the IL1R1/p-p38 MAPK pathway in microglia was increased in CCI mice, and participated in microglial activation in the STN.

Conclusions

miR-24-3p-encapsulated SHED-Exos attenuated TN by suppressing microglial activation in the STN of CCI mice. Mechanistically, miR-24-3p blocked p-p38 MAPK signaling by targeting IL1R1. Theoretically, targeted delivery of miR-24-3p may offer a potential strategy for TN.

Graphical Abstract
Genome characteristics of atypical porcine pestivirus from abortion cases in Shandong Province, China
Authors: Sun Xiaoyu , Zhang Qiaoya , Shan Hu , Cao Zhi , Huang Juan
Published: November 2023

Background

Atypical porcine pestivirus (APPV) is a novel, highly variable porcine pestivirus. Previous reports have suggested that the virus is associated with congenital tremor (CT) type A-II in piglets, and little information is available about the correlation between the virus and sow abortion, or on coinfection with other viruses. In China, reported APPV strains were mainly isolated from South China and Central China, and data about the APPV genome from northern China are relatively scarce.

Methods

Eleven umbilical cords, one placenta, and one aborted piglet, were collected from aborted sows of the same farm in Shandong Province of northern China. Nucleic acids were extracted from the above samples, and subsequently pooled for viral metagenomics sequencing and bioinformatics analysis. The viral coexistence status and complete genome characteristics of APPV in Shandong Province were determined.

Results

In abortion cases, APPV was present with Getah virus, porcine picobirnavirus, porcine kobuvirus, porcine sapovirus, Po-Circo-like virus, porcine serum-associated circular virus, porcine bocavirus 1, porcine parvovirus 1, porcine parvovirus 3 and porcine circovirus 3, etc. The first complete genome sequence(11,556 nt) of APPV in Shandong Province of northern China, was obtained using viral metagenomics and designated APPV-SDHY-2022. Comparison with Chinese reference strains revealed that the polyprotein of APPV-SDHY-2022 shared 82.6-84.2%, 93.2-93.6%, and 80.7-85% nucleotide identity and 91.4-92.4%, 96.4-97.7%, and 90.6-92.2% amino acid identity with those of the Clade I, Clade II and Clade III strains, respectively. Phylogenetic analysis based on the complete polyprotein CDS and NS5A sequences concluded that APPV-SDHY-2022 belongs to Clade II. Analysis of the NS5A nucleotide sequences revealed homology of greater than 94.6% for the same isoform, 84.7-94.5% for different isoforms of the same clade and 76.8-81.1% for different clades. Therefore, Clade II was further divided into three subclades, and APPV-SDHY-2022 belonged to subclade 2.3. Members of Clade II have 20 unique amino acids in individual proteins, distinguishing them from Clade I and Clade III members. The E2 protein showed the greatest diversity of putative N-glycosylation sites with 9 patterns, and APPV-SDHY-2022 along with other Chinese APPV strains shared the conserved B-cell conformational epitope residues 39E, 70R, 173R, 190K and 191N of the E2 protein.

Conclusions

We reported viral coexistence and the first complete genome sequence of APPV from abortion cases and from Shandong Province. The new APPV isolate belongs to an independent branch of Clade II. Our results increase the molecular and epidemiological understanding of APPV in China.
Development of a novel integrated isothermal amplification system for detection of bacteria-spiked blood samples
Authors: Li Jin , Shang Mei-Yun , Deng Shao-Li , Li Min , Su Ning , Ren Xiao-Dong , Sun Xian-Ge , Li Wen-Man , Li Yu-Wei , Li Ruo-Xu , Huang Qing , Lu Wei-Ping
Published: November 2023

Bloodstream infection (BSI) caused by bacteria is highly pathogenic and lethal, and easily develops whole-body inflammatory state. Immediate identification of disease-causing bacteria can improve patient prognosis. Traditional testing methods are not only time-consuming, but such tests are limited to laboratories. Recombinase polymerase amplification combined with lateral flow dipstick (RPA-LFD) holds great promise for rapid nucleic acid detection, but the uncapping operation after amplification easily contaminates laboratories. Therefore, the establishment of a more effective integrated isothermal amplification system has become an urgent problem to be solved. In this study, we designed and fabricated a hermetically sealed integrated isothermal amplification system. Combining with this system, a set of RPA-LFD assays for detecting S. aureus, K. peneumoniae, P. aeruginosa, and H. influenza in BSI were established and evaluated. The whole process could be completed in less than 15 min and the results can be visualized by the naked eye. The developed RPA-LFD assays displayed a good sensitivity, and no cross-reactivity was observed in seven similar bacterial genera. The results obtained with 60 clinical samples indicated that the developed RPA-LFD assays had high specifcity and sensitivity for identifying S. aureus, K. peneumoniae, P. aeruginosa, and H. influenza in BSI. In conclusion, our results showed that the developed RPA-LFD assay is an alternative to existing PCR-based methods for detection of S. aureus, K. peneumoniae, P. aeruginosa, and H. influenza in BSI in primary hospitals.
Role of oxygen vacancies in ferroelectric or resistive switching hafnium oxide
Authors: Lee Jaewook , Yang Kun , Kwon Ju Young , Kim Ji Eun , Han Dong In , Lee Dong Hyun , Yoon Jung Ho , Park Min Hyuk
Published: December 2023

HfO2 shows promise for emerging ferroelectric and resistive switching (RS) memory devices owing to its excellent electrical properties and compatibility with complementary metal oxide semiconductor technology based on mature fabrication processes such as atomic layer deposition. Oxygen vacancy (Vo), which is the most frequently observed intrinsic defect in HfO2-based films, determines the physical/electrical properties and device performance. Vo influences the polymorphism and the resulting ferroelectric properties of HfO2. Moreover, the switching speed and endurance of ferroelectric memories are strongly correlated to the Vo concentration and redistribution. They also strongly influence the device-to-device and cycle-to-cycle variability of integrated circuits based on ferroelectric memories. The concentration, migration, and agglomeration of Vo form the main mechanism behind the RS behavior observed in HfO2, suggesting that the device performance and reliability in terms of the operating voltage, switching speed, on/off ratio, analog conductance modulation, endurance, and retention are sensitive to Vo. Therefore, the mechanism of Vo formation and its effects on the chemical, physical, and electrical properties in ferroelectric and RS HfO2 should be understood. This study comprehensively reviews the literature on Vo in HfO2 from the formation and influencing mechanism to material properties and device performance. This review contributes to the synergetic advances of current knowledge and technology in emerging HfO2-based semiconductor devices.

Graphical Abstract
Age-related changes in geometry and transparency of human crystalline lens revealed by optical signal discontinuity zones in swept-source OCT images
Authors: Gupta Ashish , Ruminski Daniel , Villar Alfonso Jimenez , Toledo Raúl Duarte , Gondek Grzegorz , Pierscionek Barbara , Artal Pablo , Grulkowski Ireneusz
Published: December 2023

Background

The shape and microstructure of the human crystalline lens alter with ageing, and this has an effect on the optical properties of the eye. The aim of this study was to characterise the age-related differences in the morphology and transparency of the eye lenses of healthy subjects through the optical signal discontinuity (OSD) zones in optical coherence tomography (OCT) images. We also investigated the association of those changes with the optical quality of the eye and visual function.

Methods

OCT images of the anterior segment of 49 eyes of subjects (9–78 years) were acquired, and the OSD zones (nucleus, C1–C4 cortical zones) were identified. Central thickness, curvature and optical density were measured. The eye’s optical quality was evaluated by the objective scatter index (OSI). Contrast sensitivity and visual acuity tests were performed. The correlation between extracted parameters and age was assessed.

Results

The increase in lens thickness with age was dominated by the thickening of the cortical zone C3 (0.0146 mm/year). The curvature radii of the anterior lens surface and both anterior and posterior nucleo-cortical interfaces decreased with age (− 0.053 mm/year, − 0.013 mm/year and − 0.006 mm/year, respectively), and no change was observed for the posterior lens radius. OCT-based densitometry revealed significant correlations with age for all zones except for C1β, and the highest increase in density was in the C2–C4 zones (R = 0.45, 0.74, 0.56, respectively, P < 0.001). Increase in OSI was associated with the degradation of visual function.

Conclusions

OCT enables the identification of OSD zones of the crystalline lens. The most significant age-related changes occur in the C3 zone as it thickens with age at a faster rate and becomes more opaque than other OSD zones. The changes are associated with optical quality deterioration and reduction of visual performance. These findings contribute to a better understanding of the structure–function relationship of the ageing lens and offer insights into both pathological and aging alterations.
Difference in marginal bone loss around implants between short implant-supported partial fixed prostheses with and without cantilever: a retrospective clinical study
Authors: Al-Kilani Josef , Al-Kilani Sedef , Chrcanovic Bruno Ramos
Published: December 2023

Purpose

To investigate the influence of cantilever prosthetic arm on the marginal bone loss (MBL) over time around dental implants supporting short fixed partial dentures (FPDs), in a record-based retrospective study.

Methods

All cases of 3-unit implant-supported FPDs, supported by 2–3 implants, from the database of cases treated at one specialist clinic were considered for inclusion. Only implants with a minimum of 36 months of radiological follow-up were considered. Univariate linear regression models were used to compare MBL over time between 12 clinical covariates, after which a linear mixed-effects model was built.

Results

One-hundred-thirty-nine patients (64 men, 75 women) with 164 3-unit implant-supported FPDs (333 implants supporting non-cantilevered FPDs, 94 supporting cantilevered FPDs) were included in the study. The patients were followed up clinically and radiographically for a mean of 154.1 ± 78.0 (min–max, 37.3–364.6) and 132.9 ± 77.3 months (min–max, 36.8–329.9), respectively. The total number of marginal bone level double measurements (mesial and distal sides of each implant) was 2909. FPDs with cantilever presented an estimated greater MBL over time compared to FPDs without cantilever. Bruxism, sex (women), implant (modified) surface, and (poor) bone quality were also associated with higher MBL over time.

Conclusions

The use of a cantilever extension is suggested to negatively affect the bone marginal level over time around implants supporting 3-unit FPDs. Due to the small difference of the estimated MBL over long periods of follow-up between the groups, it is a matter of debate if the observed negative effect may be of clinical significance.

Graphical Abstract
Gestational weight gain of multiparas and risk of primary preeclampsia: a retrospective cohort study in Shanghai
Authors: Chen Chao , Lei Zhijun , Xiong Yaoxi , Ni Meng , He Biwei , Gao Jing , Zheng Panchan , Xie Xianjing , He Chengrong , Yang Xingyu , Cheng Weiwei
Published: December 2023

Background

In all studies conducted so far, there was no report about the correlation between excessive gestational weight gain (GWG) and the risk of preeclampsia (PE) in multiparas, especially considering that multiparity is a protective factor for both excessive GWG and PE. Thus, the aim of this retrospective cohort study was to determine whether GWG of multiparas is associated with the increased risk of PE.

Methods

This was a study with 15,541 multiparous women who delivered in a maternity hospital in Shanghai from 2017 to 2021, stratified by early-pregnancy body mass index (BMI) category. Early-pregnancy body weight, height, week-specific and total gestational weight gain as well as records of antenatal care were extracted using electronic medical records, and antenatal weight gain measurements were standardized into gestational age-specific z scores.

Results

Among these 15,541 multiparous women, 534 (3.44%) developed preeclampsia. The odds of preeclampsia increased by 26% with every 1 z score increase in pregnancy weight gain among normal weight women and by 41% among overweight or obese women. For normal weight women, pregnant women with preeclampsia gained more weight than pregnant women without preeclampsia beginning at 25 weeks of gestation, while accelerated weight gain was more obvious in overweight or obese women after 25 weeks of gestation.

Conclusions

In conclusion, excessive GWG in normal weight and overweight or obese multiparas was strongly associated with the increased risk of preeclampsia. In parallel, the appropriate management and control of weight gain, especially in the second and third trimesters, may lower the risk of developing preeclampsia.

Graphical Abstract
Patient-reported experiences and outcomes of virtual care during COVID-19: a systematic review
Authors: Bajgain Bishnu , Rabi Sarah , Ahmed Sadia , Kiryanova Veronika , Fairie Paul , Santana Maria J.
Published: December 2023

Introduction

The onset of COVID-19 has caused an international upheaval of traditional in-person approaches to care delivery. Rapid system-level transitions to virtual care provision restrict the ability of healthcare professionals to evaluate care quality from the patient's perspective. This poses challenges to ensuring that patient-centered care is upheld within virtual environments. To address this, the study’s objective was to review how virtual care has impacted patient experiences and outcomes during COVID-19, through the use of patient-reported experience and outcome measures (PREMs and PROMs), respectively.

Methods

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to evaluate patient responsiveness to virtual care during COVID-19. Using an exhaustive search strategy, relevant peer-reviewed articles published between January 2020 and 2022 were pulled from MEDLINE, CINAHL, EMBASE, and PsychInfo databases. Study quality was independently assessed by two reviewers using the Mixed Methods Appraisal Tool. A patient partner was consulted throughout the study to provide feedback and co-conduct the review.

Results

After removing duplicates, 6048 articles underwent title and abstract review, from which 644 studies were included in the full-text review stage. Following this, 102 articles were included in the study. Studies were published in 20 different countries, were predominantly cross-sectional, and reported on the delivery of virtual care in specialized adult outpatient settings. This review identified 29 validated PREMs and 43 PROMs. Several advantages to virtual care were identified, with patients citing greater convenience, (such as saving travel time and cost, less waiting experienced to see care providers) and increased protection from viral spread. Some studies also reported challenges patients and caregivers faced with virtual care, including feeling rushed during the virtual care appointment, lack of physical contact or examination presenting barriers, difficulty with communicating symptoms, and technology issues.

Conclusion

This review provides supportive evidence of virtual care experiences during the COVID-19 pandemic from patient and caregiver perspectives. This research provides a comprehensive overview of what patient-reported measures can be used to record virtual care quality amid and following the pandemic. Further research into healthcare professionals’ perspectives would offer a supportive lens toward a strong person-centered healthcare system.
Exploring educational traditions and experiences of block residents engaging in urban food self-production: a case study of Urban Living Lab
Authors: Duda Ewa , Korwin-Szymanowska Adamina
Published: December 2023

Food self-production offers a promising solution to many urbanization problems in cities. However, despite the advanced technology, the acceptance and involvement of local residents (its users) are required for implementation. The study presented here aims to gain a deeper understanding of the educational characteristics of future or current users of urban gardens, especially those oriented towards their own food production. The research will explore urban dwellers' traditional understanding and knowledge of the food growing process acquired over the course of their lives. We conducted in-depth interviews with residents of a selected block of flats in Łódź, who expressed their willingness to participate in an Urban Living Lab. As part of it, they would grow food for a year using hydroponic installation located in the corridors of their block. As a result of our analyses, we have identified the dominant traditions and social culture associated with growing food among the future participants of the Urban Living Lab, focusing primarily on the educational aspects. This is because we assume that effective educational interventions are an essential tool in the process of shaping the pro-environmental behaviour of city dwellers. The results obtained will be relevant for those involved in the urban education process, including city authorities, urban educators, pro-environmental associations, and grassroots activists.
Exploring the influence of collaborative data-based decision making among teachers in professional learning communities on teaching practice
Authors: O’Connor Blair , Park Mihwa
Published: December 2023

Educational policies such as the No Child Left Behind Act in 2001 and Every Student Succeeds Act in 2015 have emphasized the need for hard evidence such as standardized test data to make educational decisions. Therefore, teachers have been expected to use student assessment data to make informed curricular decisions and adjustments in teaching practice. This has led school districts to turn to data-based decision-making (DBDM) to create an effective process of student assessment data analysis, and reflection during professional learning communities (PLCs). The study explored teachers’ collaboration on the DBDM when teachers were analyzing student assessment data from common, district, and state assessments, as well as its influence on their instructional decisions. Participating teachers’ department and PLC meetings were recorded, and individual teachers’ classrooms were also observed. Teacher interview data and their lesson plans were also included and analyzed qualitatively. Results revealed that the purpose of collaboration determined types of data used, modes of analysis, and the impact on their teaching. Furthermore, teachers used varied assessment data to plan and adjust their instruction. Their motivation to enhance their teaching practices was also increased by exchanging ideas and insights rooted in the data.
A de-noising algorithm for bridge cable force monitoring data based on mathematical morphology
Authors: Deng Chao , Li Yi , Zou Wei , Ren Yuan , Peng Ying , Han Zhuo’er
Published: December 2023

A mathematical morphological filter-based de-noising method is developed in this study for bridge cable force monitoring data. Structure elements, one of the most important parameters in the mathematical morphology, dominate de-noising effects. The de-noising effects subject to single structure element and multi-structure element filters are discussed based on the simulation signals. The results indicate that the de-noising effects by using the spherical structure element are better than using the straight line or rhombic structure element. Moreover, the multi-structure element filter outperforms the single one. Through simulation analysis, the de-noising performance of the low-pass filter, wavelet filter and morphological filter is compared. The results show that the performance of the wavelet and morphological filters is better than that of the low-pass filter. For low signal-to-noise signals, the performance of the wavelet filter is superior. With the increase of signal-to-noise ratio, the morphological filters show more advantages. Taking the cable force monitoring data of the 3rd Nanjing Yangtze River Bridge as an example, the de-noising performance of the wavelet and morphological filters is discussed. The results show that both the wavelet filters and morphological filters have satisfactory de-noising effects. The mathematical morphology method can provide an optional and effective de-nosing choice, which enriches the means of de-noising for bridge monitoring data.
Joint associations of leisure-time physical activity and sitting time with emotional wellbeing, physical functioning and work ability: an occupational study among young and early midlife Finnish municipal employees
Authors: Lahti Jouni , Salmela Jatta , Kouvonen Anne , Rahkonen Ossi , Lallukka Tea
Published: December 2023

Background

Physical inactivity and sedentary behaviour are major public health problems. We examined the individual and joint associations of leisure-time physical activity (LTPA) and total sitting time with emotional wellbeing, physical functioning and work ability in young and early midlife employees.

Methods

Cross-sectional questionnaire survey data were collected in 2017 among 19–39-year-old employees of the City of Helsinki (response rate 51.5%). LTPA (including commuting PA) was converted into a metabolic equivalent (MET) index. We classified the participants into four groups according to PA recommendations and participation in vigorous intensity activities. Total sitting time was classified into three groups using tertile cut-points (5.5 and 8.5 h/day). For joint analyses, we truncated LTPA into three groups and sitting time into two groups yielding a six-category variable. Emotional wellbeing and physical functioning were measured using the RAND-36 questionnaire and work ability with a scale ranging from 0 to 100. Linear regression analysis was used to estimate adjusted means and their 95% confidence intervals (CIs). The analytical sample included 4544 participants (80% females).

Results

Adjusting for age and sex, high sitting time (> 8.5 h/day) was associated only with poorer emotional wellbeing. LTPA, especially vigorous activity, showed clear positive associations with emotional wellbeing, physical functioning and work ability. For emotional wellbeing, the low activity groups with low (70.51, 95% CI 69.1–71.9) and high (67.5, 65.5–69.5) sitting time and the moderate activity groups with low (72.5, 71.3–73.7) and high (70.4, 68.6–72.1) sitting time had statistically significantly lower mean scores than the corresponding vigorous activity groups with low (74.9, 74.2–75.7) and high (72.7, 71.6–73.9) sitting time. For physical functioning, the vigorous activity groups with low (96.3, 95.8–96.7) and high (96.2, 95.5–96.9) sitting time had significantly higher scores than the other groups. For work ability, the vigorous activity groups with low (82.0, 81.3–82.6) and high (80.8, 79.8–81.8) sitting time had significantly higher scores than the other groups. Adjusting for covariates only slightly attenuated these associations.

Conclusions

Promoting PA among employees can contribute to better physical and mental health as well as better work ability.