bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on the Carbon Emission Reduction Potential of the Ports in the Yangtze River Delta of China
Authors: Wang Min , Li Huayu , Chiu Yung-ho , Deng Kexin , Deng Menghua
Published: November 2023

Green port construction has a profound impact on China’s international climate commitment to carbon neutrality by 2050. To examine the carbon emission reduction potential of 20 major ports in the Yangtze River Delta port cluster of China, this study takes the perspective of environmental efficiency and employs dynamic exogenous variable DEA in efficiency evaluation. The results show the increasing environmental efficiency of the ports in the Yangtze River Delta, rising from 0.5116 in 2013 to 0.7276 in 2019. Also, there are significant spatial differences in efficiency. After considering exogenous variable, the average efficiency has increased from 0.5537 to 0.6276, indicating that regional green development is a critical factor in port environmental efficiency evaluation. Finally, the overall efficiency of input and output have risen, the slackness of carbon emission shows a trend of decreasing, and there is great potential for reducing carbon emissions from the perspective of port environmental efficiency. The previous studies paid less attention to dynamic efficiency, exogenous variables, and carbon emission. Therefore, this paper is the first comprehensive examination on the carbon emission reduction potential of China’s Yangtze River Delta port cluster from the perspective of dynamic environmental efficiency.
Examining the Factors Related to the Technological Pedagogical and Content Knowledge Levels of Preservice Social Studies Teachers
Authors: Aksin Alpay
Published: November 2023

Technological pedagogical and content knowledge (TPACK) is a pedagogical tool that can provide teachers and preservice teachers opportunities to receive enhanced lesson input, engage in classroom interactions, and improve learning outcomes. This study aims at examining the factors related to the TPACK skills of preservice social studies teachers. Participants consisted of 368 preservice teachers studying at the social studies teacher education department of a university located in the Central Black Sea Region of Turkey. Participants completed the TPACK scale and personal information form. The data were analyzed using descriptive statistics, one-way multivariate analysis of variance, and one-way analysis of variance. The results of the study reveal that gender is associated with the preservice teachers’ technological knowledge, content knowledge, and pedagogical knowledge; education year is associated with technological knowledge and technological pedagogical knowledge; high school type is correlated with technological knowledge, technological pedagogical knowledge, technological content knowledge, and technological pedagogical and content knowledge; home computer ownership is associated with technological knowledge; and average weekly time spent using a computer is associated with technological knowledge and technological pedagogical and content knowledge. Finally, technical computer skills are correlated with technological knowledge, content knowledge, pedagogical knowledge, pedagogical content knowledge, technological pedagogical knowledge, and technological pedagogical and content knowledge. The current study may contribute to determining culturally specific and cross-cultural correlates of TPACK skills among preservice teachers.
The Historical Empathy Measurement Tool (HEMT)
Authors: Crompton Helen , Nako Katherina , Burke Diane
Published: November 2023

This study is unique in that it presents the first empirically developed framework for use as a tool for measuring historical empathy. The Historical Empathy Measurement Tool (HEMT) was developed using a design-based research method with three iterative macrocycles of design, experiment, and retrospective analysis. The study involved question responses from 276 students in grade 8 studying WWI trench warfare. The research resulted in a framework of seven levels. (0) Non-response, (1) Facts, (2) Assumptions and Deficits, (3) General Comparison of the Past and Present, (4) Emotional Comparison of the Past and Present, (5) Understanding Motives, Behaviors, Thoughts, & Emotions in the Past, and (6) Acknowledgement of Differences from those in the Past. The inter-rater reliability at the end of macrocycle three was 95%.
Activity of propolis from Mexico on the proliferation and virulence factors of Candida albicans
Authors: Rodriguez-Canales Mario , Medina-Romero Yoli Mariana , Rodriguez-Monroy Marco Aurelio , Nava-Solis Uriel , Bolaños-Cruz Sandra Isabel , Mendoza-Romero Maria Jimena , Campos Jorge E. , Hernandez-Hernandez Ana Bertha , Chirino Yolanda I. , Cruz-Sanchez Tonatiuh , Garcia-Tovar Carlos Gerardo , Canales-Martinez Maria Margarita
Published: November 2023

Background

This research evaluated the anti-Candida albicans effect of Mexican propolis from Chihuahua.

Chemical composition of the ethanolic extract of propolis was determined by GC-MS, HPLC-DAD, and HPLC-MS. The presence of anthraquinone, aromatic acid, fatty acids, flavonoids, and carbohydrates was revealed.

Results

The anti-Candida activity of propolis was determined. The inhibitions halos were between 10.0 to 11.8 mm; 25% minimum inhibitory concentration (0.5 mg/ml) was fungistatic, and 50% minimum inhibitory concentration (1.0 mg/ml) was fungicidal.

The effect of propolis on the capability of C. albicans to change its morphology was evaluated. 25% minimum inhibitory concentration inhibited to 50% of germ tube formation.

Staining with calcofluor-white and propidium iodide was performed, showing that the propolis affected the integrity of the cell membrane.

INT1 gene expression was evaluated by qRT-PCR. Propolis significantly inhibited the expression of the INT1 gene encodes an adhesin (Int1p).

Chihuahua propolis extract inhibited the proliferation of Candida albicans, the development of the germ tube, and the synthesis of adhesin INT1.

Conclusions

Given the properties demonstrated for Chihuahua propolis, we propose that it is a candidate to be considered as an ideal antifungal agent to help treat this infection since it would not have the toxic effects of conventional antifungals.
Evaluation of antibiotic resistance, toxin-antitoxin systems, virulence factors, biofilm-forming strength and genetic linkage of Escherichia coli strains isolated from bloodstream infections of leukemia patients
Authors: Roshani Mahdaneh , Taheri Mohammad , Goodarzi Alireza , Yosefimashouf Rassoul , Shokoohizadeh Leili
Published: November 2023

Background

One of the most common complications in patients with febrile neutropenia, lymphoma, leukemia, and multiple myeloma is a bloodstream infection (BSI).

Objective

This study aimed to evaluate the antibiotic resistance patterns, virulence factors, biofilm-forming strength, and genetic linkage ofEscherichia colistrains isolated from bloodstream infections (BSIs) of leukemia patients.

Methods

The study conducted in Iran from June 2021 to December 2022, isolated 67E. colistrains from leukemia patients’ bloodstream infections in hospitals in two different areas. Several techniques including disk diffusion and broth microdilution were used to identify patterns of antibiotic resistance, microtiter plate assay to measure biofilm formation, and PCR to evaluate the prevalence of different genes such as virulence factors, toxin-antitoxin systems, resistance to β-lactams and fluoroquinolone antibiotics ofE. colistrains. Additionally, the genetic linkage of the isolates was analyzed using the Enterobacterial Repeat Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR) method.

Results

The results showed that higher frequency of BSI caused byE. coliin man than female patients, and patients with acute leukemia had a higher frequency of BSI. Ampicillin and Amoxicillin-clavulanic acid showed the highest resistance, while Imipenem was identified as a suitable antibiotic for treating BSIs byE. coli. Multidrug-resistant (MDR) phenotypes were present in 22% of the isolates, while 53% of the isolates were ESBL-producing with theblaCTX-M gene as the most frequent β-lactamase gene. The fluoroquinolone resistance genesqnrB andqnrS were present in 50% and 28% of the isolates, respectively. More than 80% of the isolates showed the ability to form biofilms. ThetraT gene was more frequent than other virulence genes. The toxin-antitoxin system genes (mazF,ccdAB, andrelB) showed a comparable frequency. The genetic diversity was detected inE. coliisolates.

Conclusion

Our results demonstrate that highly diverse, resistant and pathogenicE. coliclones are circulating among leukemia patients in Iranian hospitals. More attention should be paid to the treatment and management ofE. colibloodstream infections in patients with leukemia.
Complete mitogenome assembly of Selenicereus monacanthus revealed its molecular features, genome evolution, and phylogenetic implications
Authors: Lu Guilong , Wang Wenhua , Mao Juan , Li Qing , Que Youxiong
Published: November 2023

Background

Mitochondria are the powerhouse of the cell and are critical for plant growth and development. Pitaya (Selenicereus or Hylocereus) is the most important economic crop in the family Cactaceae and is grown worldwide, however its mitogenome is unreported.

Results

This study assembled the complete mitogenome of the red skin and flesh of pitaya (Selenicereus monacanthus). It is a full-length, 2,290,019 bp circular molecule encoding 59 unique genes that only occupy 2.17% of the entire length. In addition, 4,459 pairs of dispersed repeats (≥ 50 bp) were identified, accounting for 84.78% of the total length, and three repeats (394,588, 124,827, and 13,437 bp) mediating genomic recombination were identified by long read mapping and Sanger sequencing. RNA editing events were identified in all 32 protein-coding genes (PCGs), among which four sites (nad1-2, nad4L-2, atp9-copy3-223, and ccmFC-1309) were associated with the initiation or termination of PCGs. Seventy-eight homologous fragments of the chloroplast genome were identified in the mitogenome, the longest having 4,523 bp. In addition, evolutionary analyses suggest that S. monacanthus may have undergone multiple genomic reorganization events during evolution, with the loss of at least nine PCGs (rpl2, rpl10, rps2, rps3, rps10, rps11, rps14, rps19, and sdh3).

Conclusions

This study revealed the genetic basis of the S. monacanthus mitogenome, and provided a scientific basis for further research on phenotypic traits and germplasm resource development.
Study protocol: assessment of the usefulness and practicability of a psychoeducational intervention to prevent the negative psychological impact of the COVID-19 pandemic on primary care health workers
Authors: Aragonès Enric , Rodoreda Sara , Guitart Meritxell , Garcia Eva , Berenguera Anna , Martin Francisco , Rambla Concepció , Aragonès Guillem , Calvo Antoni , Mas Ariadna , Basora Josep
Published: November 2023

Background

The COVID-19 pandemic has constituted an extraordinarily stressful situation for healthcare professionals and has led to psychological distress and an increase in various mental disorders. In the post-pandemic context, it is necessary to provide professionals with strategies and skills to manage this stressful situation and prevent or minimize its negative impact.

Methods

Aims: To assess the feasibility and clinical effects of a group psychoeducational program focused on preventing the adverse psychological and emotional effects of the pandemic on primary care workers, and to explore the experience and perceptions of participants with regard to the program from a qualitative perspective. Design: A single-arm, before-and-after study conducted in primary care. Setting: The 332 primary care centers of the Catalan Institute of Health (Catalonia, Spain) Participants: The target population of the intervention is primary care workers, including clinical profiles (e.g., nurses and doctors), and non-clinical profiles (e.g., administrative staff). The implementation strategy will also involve community psychologists, who will lead the psychoeducational groups, and the health organization promoting the implementation. Intervention: A group psychoeducational program targeting primary care workers to promote emotional well-being and the ability to cope with stressful situations. Community psychologists will deliver it in the primary care centers they are linked to. Measures: Mixed-methods evaluation, combining quantitative and qualitative research. A prospective assessment of the main outcomes (professional quality of life, psychological state, and resilience) will be performed using online questionnaires before and immediately after the intervention, and at 3 and 6 months. A qualitative study will be conducted, comprising focus groups and individual in-depth interviews with the participants in the intervention and the psychologists who provide it. Ethics: The Research Ethics Committee of the Jordi Gol Primary Care Research Institute (IDIAP) has approved the protocol (22/086-PCV).

Discussion

This project proposes an intervention to promote mental health and psychological well-being in primary care workers by learning skills and integrating them into personal and professional life. The expected results will allow us to determine the usefulness and effectiveness of this psychoeducational intervention under the conditions of real clinical practice, provide data to model and perfect it, and promote its dissemination.

Trial registration

ClinicalTrials.gov Identifier: NCT05720429; registered on 09/02/2023.
Prediction of survival and analysis of prognostic factors for hepatocellular carcinoma: a 20-year of imaging diagnosis in Upper Northern Thailand
Authors: Nakharutai Nawapon , Chitapanarux Imjai , Traisathit Patrinee , Srikummoon Pimwarat , Pojchamarnwiputh Suwalee , Inmutto Nakarin , Na Chiangmai Wittanee
Published: November 2023

Background

To evaluate survival rates of hepatocellular carcinoma (HCC), the Chiang Mai Cancer Registry provided characteristics data of 6276 HCC patients diagnosed between 1998-2020 based on evolution of imaging diagnosis. Evolution can be separated into four cohorts, namely, cohort 1 (1990-2005) when we had ultrasound (US) and single-phase computed tomography (CT), cohort 2 (2006-2009) when one multi-phase CT and one magnetic resonance imaging (MRI) were added, cohort 3 (2010-2015) when MRI with LI-RADS was added, and finally, cohort 4 (2016-2020) when two upgraded MRIs with LI-RADS were added.

Methods

Cox proportional hazard models were used to determine the relation between death and risk factors including methods of imagining diagnosis, gender, age of diagnosis, tumor stages, history of smoking and alcohol-use, while Kaplan-Meier curves were used to calculate survival rates.

Results

The median age of diagnosis was 57.0 years (IQR: 50.0-65.0) and the median survival time was 5.8 months (IQR: 1.9-26.8) during the follow-up period. In the univariable analysis, all factors were all associated with a higher risk of death in HCC patients except age of diagnosis. In a multivariable analysis, elderly age at diagnosis, regional and metastatic stages and advanced methods of imagining diagnosis during cohorts 2 and 3 were independently associated with the risk of death in HCC patients. The survival rate of patients diagnosed during cohort 4 was significantly higher than the other cohorts.

Conclusion

As a significantly increasing survival rate of HCC patients in cohort 4, advanced methods of diagnostic imaging can be a part of the recommendation to diagnose HCC.
Changes in neonatal morbidity, neonatal care practices, and length of hospital stay of surviving infants born very preterm in the Netherlands in the 1980s and in the 2000s: a comparison analysis with identical characteristics definitions
Authors: Sexty Réka E. , van der Pal Sylvia , Reijneveld Sijmen A. , Wolke Dieter , Lüchters Guido , Bakker Leonhard , van Buuren Stef , Bos Arend F. , Bartmann Peter
Published: November 2023

Background

This study evaluates changes in the neonatal morbidity, the neonatal care practices, and the length of hospital stay of surviving very preterm (VP) infants born in the Netherlands in the 1980s and in the 2000s; a period over which historical improvements were introduced into neonatal care. We, herein, also study whether these changes in neonatal morbidity, neonatal care practices and length of hospital stay are associated with sociodemographic, prenatal, and infant characteristics.

Methods

Two community-based cohorts from 1983 (POPS) and 2002−03 (LOLLIPOP) have provided the perinatal data for our study. The analysis enrolled 1,228 participants born VP (before the 32nd week of gestation) and surviving to 2 years of age without any severe congenital malformation. A rigorous harmonisation protocol ensured a precise comparison of the cohorts by using identical definitions of the perinatal characteristics.

Results

In 2003, mothers were older when giving birth, had higher multiple birth rates, and significantly more parents had received higher education. In 2003, less VP infants had severe intraventricular haemorrhage and sepsis and relatively more received continuous positive airway pressure, mechanical ventilation and caffeine therapy than in 1983. Antenatal corticosteroids and surfactant therapy were provided only in 2003. The length of the stay in the neonatal intensive care unit and in hospital had decreased in 2003 by 22 and 11 days, respectively. Differences persisted after adjustment for sociodemographic, prenatal, and infant characteristics.

Conclusions

Neonatal morbidities of the surviving VP infants in this study have not increased, and exhibit improvements for various characteristics in two cohorts born 20 years apart with comparable gestational age and birth weight. Our data suggest that the improvements found are associated with more advanced therapeutic approaches and new national protocols in place, and less so with sociodemographic changes. This analysis provides a basis for further comparative analyses of the health and the development of VP children, particularly with regard to long-term outcomes.
Concurrent features of sarcoidosis and hypersensitivity pneumonitis in two patients exposed to fungal antigens
Authors: Marruchella Almerico , Faverio Paola , Luppi Fabrizio
Published: November 2023

Background

Sarcoidosis and hypersensitivity pneumonitis (HP) are two distinct clinical entities that share granulomatous inflammation, although each of them has specific clinical, radiologic and pathologic profiles. Coexistence of the two diseases have been described, suggesting, at least in some cases, a common biologic background.

Case presentation

We describe two patients showing the concurrent diagnosis of sarcoidosis and hypersensitivity pneumonitis. Case 1: a 51-year old never smoker man had a history of occupational exposure, episodes of acute exacerbations and positive serum precipitins to Penicillium spp suggestive of HP, while the positivity of serum angiotensin converting enzyme (ACE) favored sarcoidosis. Case 2: a 42-year old non-smoker woman with occasional finding of enlarged mediastinal lymph nodes had a history of domestic exposure to molds and positive serum precipitins to Aspergillus spp suggestive of HP.

In both cases high resolution computed tomography (HRCT) together with broncoscopy findings allowed to maintain both the diagnoses: HRCT showed both enlarged hilar/mediastinal limph nodes and intersitial lung involvement typical of HP; bronchoalveolar lavage presented marked lymphocytosis and granulomatous nodal lesions were observed at transbronchial needle aspiration.

Conclusions

Sarcoidosis and HP share some clinical findings and the differential diagnosis may be difficult. Our cases suggest that a common trait may be responsible for the concurrent diagnosis of sarcoidosis and hypersensitivity pneumonitis in the same patient.
The use of mouthguards and related factors among basketball players in Indonesia
Authors: Novrinda Herry , Lambe Putri Tianda , Darwita Risqa Rina , Lee Jae-Young
Published: November 2023

Background

Basketball is a sport with a higher injury rate. Regardless, few basketball players use mouthguards, which predisposes them to injuries. The use of mouthguards (UoM) could be related to several factors. This study aims to identify factors associated with UoM and to construct a model from the factors among basketball players in Indonesia.

Methods

Through convenience sampling, a total of 286 among basketball players in Indonesia was included in this cross-sectional study. These participants filled out online a modified questionnaires regarding demographic and several factors related to UoM. The data was analyzed using chi-square test, independent-sample t-test, binary logistic regression, and structural equation modeling (SEM).

Results

There were 286 players. 127 of them were males and 159 were females. Of them, 86 (30.1%) used mouthguards. Age, duration (in year), and weekly practicing basketball (in hour) were all significantly different between mouthguards users and non-users with (p = 0.005, p = 0.036 and p = 0.035), respectively. The UoM was significantly associated with level of awareness, injury experience, social support, and oral health professional (OHP) support with (p = 0.002, p < 0.001, p < 0.001 and p < 0.001), respectively. This result was also supported by a variety of variables’ ORs, which range from 1.28 to 5.97. The coefficient of determination (R2) was 0.27.

Conclusions

The UoM among basketball players in Indonesia was related to several factors, including the level of knowledge, level of awareness, duration of basketball career, injury experiences, social support, and oral health professionals’ support which was constructed to propose a model. The model could explain 27% of the relationship between variables and UoM among Indonesian basketball players. This model will be useful for more comprehensive initiatives to promote oral health. It might be applicable for other countries as well as other sports communities / physical activities.
Three-dimensional positional relationship between impacted mandibular third molars and the mandibular canal
Authors: Yang Yun , Bao Dong-Yu , Ni Can , Li Zhen
Published: November 2023

Objective

To observe the three-dimensional positional relationship between impacted mandibular third molars (IMTMs) and mandibular canal close contacts using cone beam computed tomography (CBCT).

Methods

A total of 101 patients with IMTMs were selected who met the diagnostic criteria for 142 teeth (no bone wall imaging area between IMTMs and the mandibular canal, a high-density bone cortical imaging area only, or a ≦1 mm bone imaging area). The parameters of the rotating CBCT anode were set as follows: 110 kV, 40–50 mA; the focal point and exposure field were set as 0.3 mmh and a high-resolution zoom, respectively; the exposure time and image layer thickness were set as 5.4 s and 0.25 mm. Three-dimensional reconstruction was performed, and the position of the mandibular canal through the IMTM area was observed continuously from the coronal, horizontal and sagittal planes.

Results

We found that the mandibular canal was interrupted below the third molar (TM) in 85 cases, accounting for 59.86% of all cases. The mandibular canal was located below the buccal and lingual curvatures in 33 and 19 cases, respectively, accounting for 23.23% and 19%. In addition, a small number of mandibular canals were also located on the buccal side of the mandibular molars (2.82%). We also found one case of direct insertion of the mandibular third molar (MTM) into the mandibular canal. In addition, the mandibular canal passed through the IMTM region with 125 close contacts at the roots (88.03%); 14 mandibular canals were in contact with all teeth and 3 were in contact with the crown.

Conclusion

The use of CBCT can provide a dynamic and comprehensive understanding of the three-dimensional positional relationship of the mandibular alveolar nerve canal passing through the IMTM area, providing a high clinical reference value when extracting IMTMs and reducing the risk of injury to the inferior alveolar nerve.
Understanding the mix of services for mental health care in urban DR Congo: a qualitative descriptive study
Authors: Mukala Mayoyo Erick , Criel Bart , Sow Abdoulaye , Coppieters Yves , Chenge Faustin
Published: November 2023

Background

Mental health workers (MHWs) are exposed to conflicts of competence daily when performing tasks related to the provision of mental health services. This may be linked to a lack of understanding of their tasks as caregivers and providers. Furthermore, in most low-income settings, it is unclear how the available services are organized and coordinated to provide mental health care. To understand the above, this study aimed to identify the current mix of services for mental health care in the urban Democratic Republic of the Congo (DRC).

Methods

A qualitative descriptive study was carried out in Lubumbashi from February to April 2021. We conducted 7 focus group discussions (FGDs) with 74 key informants (family members, primary care physicians, etc.) and 13 in-depth interviews (IDIs) with key informants (traditional healers, psychiatrists, etc.). We performed a qualitative content analysis, guided by an analytical framework, that led to the development of a comprehensive inventory of MHWs from the household level to specialized facilities, exploring their tasks in care delivery, identifying existing services, and defining their current organization.

Results

Analysis of transcripts from the FGDs and IDIs showed that traditional healers and family caregivers are the leading providers in Lubumbashi. The exploration of the tasks performed by MHWs revealed that lifestyle, traditional therapies, psychotherapy, and medication are the main types of care offered/advised to patients. Active informal caregivers do not currently provide care corresponding to their competencies. The rare mental health specialists available do not presently recognize the tasks of primary care providers and informal caregivers in care delivery, and their contribution is considered marginal. We identified five types of services: informal services, traditional therapy services, social services, primary care services, and psychiatric services. Analyses pointed out an inversion of the ideal mix of these services.

Conclusions

Our findings show a suboptimal mix of services for mental health and point to a clear lack of collaboration between MHWs. There is an urgent need to clearly define the tasks of MHWs, build the capacity of nonspecialists, shift mental health-related tasks to them, and raise awareness about collaborative care approaches.
Plants and endophytes interaction: a “secret wedlock” for sustainable biosynthesis of pharmaceutically important secondary metabolites
Authors: Kumari Poonam , Deepa Nikky , Trivedi Prabodh Kumar , Singh Brajesh K. , Srivastava Vaibhav , Singh Akanksha
Published: November 2023

Many plants possess immense pharmacological properties because of the presence of various therapeutic bioactive secondary metabolites that are of great importance in many pharmaceutical industries. Therefore, to strike a balance between meeting industry demands and conserving natural habitats, medicinal plants are being cultivated on a large scale. However, to enhance the yield and simultaneously manage the various pest infestations, agrochemicals are being routinely used that have a detrimental impact on the whole ecosystem, ranging from biodiversity loss to water pollution, soil degradation, nutrient imbalance and enormous health hazards to both consumers and agricultural workers. To address the challenges, biological eco-friendly alternatives are being looked upon with high hopes where endophytes pitch in as key players due to their tight association with the host plants. The intricate interplay between plants and endophytic microorganisms has emerged as a captivating subject of scientific investigation, with profound implications for the sustainable biosynthesis of pharmaceutically important secondary metabolites. This review delves into the hidden world of the "secret wedlock" between plants and endophytes, elucidating their multifaceted interactions that underpin the synthesis of bioactive compounds with medicinal significance in their plant hosts. Here, we briefly review endophytic diversity association with medicinal plants and highlight the potential role of core endomicrobiome. We also propose that successful implementation of in situ microbiome manipulation through high-end techniques can pave the way towards a more sustainable and pharmaceutically enriched future.
Effect of COVID-19 lock down on teenage pregnancies in Northern Uganda: an interrupted time series analysis
Authors: Alunyo Jimmy Patrick , Mukunya David , Napyo Agnes , Matovu Joseph K. B. , Okia David , Benon Wanume , Okello Francis , Tuwa Ally Hassan , Wenani Daniel , Okibure Ambrose , Omara Godfrey , Olupot-Olupot Peter
Published: November 2023

Background

Pregnancy and childbirth complications are the leading cause of death among girls aged 15–19 years globally, with low- and middle-income countries (LMICs) accounting for 99% of global maternal deaths of women aged 15–49 years. Despite teenage pregnancies declining in many developing countries in recent years, the COVID-19 period intensified the problem and altered the trend for most countries. We determined the effect of the COVID-19 lockdown on the teenage pregnancy trend in Pakwach district, Uganda, to understand its magnitude in our study population.

Methods

Using interrupted time series analysis (ITS), sometimes known as quasi-experimental time series analysis. We constructed a time series of the first ANC service utilization records for girls aged 10–19 years in Pakwach district, Uganda, and conducted an interrupted series analysis. We compared the two periods of March 2019 to March 2020 and March 2020 to March 2021. We used Stata 15 to conduct our analysis, performed OLS, and plotted the results.

Results

The teenage pregnancy trend before the lockdown was decreasing by − 0.203 pregnancies per month, but in the first month after the institution of the lockdown (March 20, 2020), there was an increase in the teenage pregnancy rate of 13.9 pregnancies [95% CI: − 33.6 to 61.5], which corresponds to an increase in the monthly trend in teenage pregnancies (relative to the period before the COVID-19 lockdown trend) of 1.53 girls per month.

Conclusion

Teenage pregnancies increased during the lockdown. This slight increase depicted the impact of the pandemic on the teenage pregnancy trend associated with the COVID-19 outbreak. The government needs to focus on intervention to reduce this trend and avoid any further increases.
Acceleration of wheat breeding: enhancing efficiency and practical application of the speed breeding system
Authors: Cha Jin-Kyung , Park Hyeonjin , Choi Changhyun , Kwon Youngho , Lee So-Myeong , Oh Ki-Won , Ko Jong-Min , Kwon Soon-Wook , Lee Jong-Hee
Published: November 2023

Background

Crop breeding should be accelerated to address global warming and climate change. Wheat (Triticum aestivum L.) is a major food crop. Speed breeding (SB) and speed vernalization (SV) techniques for spring and winter wheat have recently been established. However, there are few practical examples of these strategies being used economically and efficiently in breeding programs. We aimed to establish and evaluate the performance of a breeder-friendly and energy-saving generation acceleration system by modifying the SV + SB system.

Results

In this study, a four-generation advancement system for wheat (regardless of its growth habits) was established and evaluated using an energy-efficient extended photoperiod treatment. A glasshouse with a 22-hour photoperiod that used 10 h of natural sunlight and 12 h of LED lights, and minimized temperature control during the winter season, was successful in accelerating generation. Even with one or two field tests, modified speed breeding (mSB) combined with a speed vernalization system (SV + mSB) reduced breeding time by more than half compared to traditional field-based methods. When compared to the existing SV + SB system, the SV + mSB system reduced energy use by 80% to maintain a 22-hour photoperiod. Significant correlations were found between the SV + mSB and field conditions in the number of days to heading (DTH) and culm length (CL). Genetic resources, recombinant inbred lines, and breeding materials that exhibited shorter DTH and CL values under SV + mSB conditions showed the same pattern in the field.

Conclusions

The results of our SV + mSB model, as well as its practical application in wheat breeding programs, are expected to help breeders worldwide incorporate generation acceleration systems into their conventional breeding programs.
Validating a multi-locus metabarcoding approach for characterizing mixed-pollen samples
Authors: Wizenberg Sydney B. , Newburn Laura R. , Pepinelli Mateus , Conflitti Ida M. , Richardson Rodney T. , Hoover Shelley E. R. , Currie Robert W. , Giovenazzo Pierre , Zayed Amro
Published: November 2023

Background

The mutualistic interaction between entomophilous plants and pollinators is fundamental to the structure of most terrestrial ecosystems. The sensitive nature of this relationship has been disrupted by anthropogenic modifications to natural landscapes, warranting development of new methods for exploring this trophic interaction. Characterizing the composition of pollen collected by pollinators, e.g. Apis mellifera, is a common means of exploring this relationship, but traditional methods of microscopic pollen assessment are laborious and limited in their scope. The development of pollen metabarcoding as a method of rapidly characterizing the abundance and diversity of pollen within mixed samples presents a new frontier for this type of work, but metabarcoding may have limitations, and validation is warranted before any suite of primers can be confidently used in a research program. We set out to evaluate the utility of an integrative approach, using a set of established primers (ITS2 and rbcL) versus melissopalynological analysis for characterizing 27 mixed-pollen samples from agricultural sites across Canada.

Results

Both individual markers performed well relative to melissopalynology at the family level with decreases in the strength of correlation and linear model fits at the genus level. Integrating data from both markers together via a multi-locus approach provided the best rank-based correlation between metagenetic and melissopalynological data at both the genus (ρ = 0.659; p < 0.001) and family level (ρ = 0.830; p < 0.001). Species accumulation curves indicated that, after controlling for sampling effort, melissopalynological characterization provides similar or higher species richness estimates than either marker. The higher number of plant species discovered via the metabarcoding approach simply reflects the vastly greater sampling effort in comparison to melissopalynology.

Conclusions

Pollen metabarcoding performed well at characterizing the composition of mixed pollen samples relative to a traditional melissopalynological approach. Limitations to the quantitative application of this method can be addressed by adopting a multi-locus approach that integrates information from multiple markers.
Surgical healing beyond the scalpel: exploring the impact of depressive symptoms on functional recovery in total knee arthroplasty patients
Authors: Neelaraju Harshith , Gangaiah Mahesh , Mittal Prabhat
Published: November 2023

Background

Numerous recent studies have explored the association between the mental health condition of patients before surgery and the outcomes of total knee arthroplasty. The objective of this study was to determine the prevalence of depressive symptoms among individuals undergoing total knee arthroplasty and to investigate the impact of pre-operative depressive symptoms as a significant and independent predictor on various health-related quality of life measures for patients undergoing knee surgery.

Material and methods

During the period spanning from August 2019 to May 2020, an orthopedic database was established for the purpose of assessing patients' conditions before their surgeries. The data collection process occurred at three distinct intervals: prior to the surgery, as well as at the third and sixth months following the surgical procedure. In this study, we undertook an evaluation of both pre-operative and postoperative depressive symptoms, as well as functional status, utilizing various self-report measures. These measures included the Becks Depression Scale, the Western Ontario and McMaster Universities Osteoarthritis Index, and the Knee Society Clinical Rating System.

Results

A total of 150 patients were included in the study. The proportion of patients who were severely distressed decreased from 99% (149) at the baseline assessment to 76% (114) who had mild depression and 24% (36) at borderline at 3-months of follow-up. At 6-month follow-up period, 85% (128) patients were classified as normal, with 15% (22) displaying mild distress levels.

Conclusions

Patients experiencing depression exhibited notable enhancements in various outcome measures. The findings from this study underscore a two-way relationship between mental health and surgical outcomes. Specifically, the surgical intervention yielded significant improvements in mental health status. Conversely, poorer pre-operative mental health status emerged as a predictive factor for comparatively less favorable outcomes stemming from the surgery.
CD276-CAR T cells and Dual-CAR T cells targeting CD276/FGFR4 promote rhabdomyosarcoma clearance in orthotopic mouse models
Authors: Timpanaro Andrea , Piccand Caroline , Dzhumashev Dzhangar , Anton-Joseph Stenija , Robbi Andrea , Moser Janine , Rössler Jochen , Bernasconi Michele
Published: November 2023

Background

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in childhood, whose prognosis is still poor especially for metastatic, high-grade, and relapsed RMS. New treatments are urgently needed, especially systemic therapies. Chimeric Antigen Receptor T cells (CAR Ts) are very effective against hematological malignancies, but their efficacy against solid tumors needs to be improved. CD276 (B7-H3) is a target upregulated in RMS and detected at low levels in normal tissues. FGFR4 is a very specific target for RMS. Here, we optimized CAR Ts for these two targets, alone or in combination, and tested their anti-tumor activity in vitro and in vivo.

Methods

Four different single-domain antibodies were used to select the most specific FGFR4-CAR construct. RMS cell killing and cytokine production by CD276- and FGFR4-CAR Ts expressing CD8α or CD28 HD/TM domains in combination with 4-1BB and/or CD28 co-stimulatory domains were tested in vitro. The most effective CD276- and FGFR4-CAR Ts were used to generate Dual-CAR Ts. Tumor killing was evaluated in vivo in three orthotopic RMS mouse models.

Results

CD276.V-CAR Ts (276.MG.CD28HD/TM.CD28CSD.3ζ) showed the strongest killing of RMS cells, and the highest release of IFN-γ and Granzyme B in vitro. FGFR4.V-CAR Ts (F8-FR4.CD28HD/TM.CD28CSD.3ζ) showed the most specific killing. CD276-CAR Ts successfully eradicated RD- and Rh4-derived RMS tumors in vivo, achieving complete remission in 3/5 and 5/5 mice, respectively. In CD276low JR-tumors, however, they achieved complete remission in only 1/5 mice. FGFR4 CAR Ts instead delayed Rh4 tumor growth. Dual-CAR Ts promoted Rh4-tumors clearance in 5/5 mice.

Conclusions

CD276- and CD276/FGFR4-directed CAR Ts showed effective RMS cell killing in vitro and eradication of CD276high RMS tumors in vivo. CD276low tumors escaped the therapy highlighting a correlation between antigen density and effectiveness. FGFR4-CAR Ts showed specific killing in vitro but could only delay RMS growth in vivo. Our results demonstrate that combined expression of CD276-CAR with other CAR does not reduce its benefit. Introducing immunotherapy with CD276-CAR Ts in RMS seems to be feasible and promising, although CAR constructs design and target combinations have to be further improved to eradicate tumors with low target expression.
Activities critical to success and growth of clinical trials networks. What is needed and how are we doing? An Australian and New Zealand perspective
Authors: Sanders Megan , Goulding Karen , Oakley Ed , Reidlinger Donna , Groom Katie M
Published: November 2023

Background

Clinical trial evidence underpins evidence-based medicine and the improvement of healthcare worldwide. In Australasia, a significant proportion of clinical trials are conducted by geographically dispersed and multidisciplinary clinical researchers under the auspices of Clinical Trials Networks (CTNs). These groups play an important role in contributing to evidence-based medicine, primarily by conducting investigator-initiated clinical trials. Despite their clear benefits in terms of return on investment, CTNs suffer significant challenges.

Methods

We conducted surveys and focus groups with Australian and New Zealand CTNs to identifying the activities and attributes that enable CTNs to operate successfully. Based on our findings, we then conducted further surveys of Australian and New Zealand CTNs to identify the prevalence of these success factors in existing CTNs.

Results

Our focus groups identified three key themes associated with success and growth of a CTN: engaged membership, established infrastructure, and sustainability; and thirteen critical success factors: shared vision and motivation; strong leaders, governance and succession planning; an executive officer; sustainable funding for operations; effective communication; diverse representation and consumer input; transparent processes; a strong pipeline of trials; a reputable and recognised CTN brand; innovation and adaption; an effective group of network sites with a skilled workforce; embedded trials and prioritisation of research. These key themes and the relevant key areas were presented to 30 CTNs. Two factors were almost universally present in CTNs, reflecting the importance of these attributes: the presence of an executive officer, and a strong pipeline of trials. Three factors had a particularly low prevalence: sustainable funding for operations, effective communication, and embedded trials.

Conclusions

By supporting both emerging and established CTNs to achieve critical success factors, we can improve the efficiency of CTNs to continue to contribute and expand their clinical trial activities. Particular focus needs to be on finding sustainable funding for CTNs, and raising awareness of the critical role undertaken by CTNs to improve healthcare and health outcomes.
Peer PrEP referral + HIV self-test delivery for PrEP initiation among young Kenyan women: study protocol for a hybrid cluster-randomized controlled trial
Authors: Wairimu Njeri , Malen Rachel C. , Reedy Adriana M. , Mogere Peter , Njeru Irene , Culquichicón Carlos , McGowan Maureen , Gao Fei , Baeten Jared M. , Ngure Kenneth , Ortblad Katrina F.
Published: November 2023

Background

Oral HIV pre-exposure prophylaxis (PrEP) for HIV prevention is highly effective, but uptake remains low in Africa, especially among young women who are a priority population for HIV prevention services. HIV self-testing (HIVST) has been proven to increase HIV testing in diverse populations but has been underutilized to support linkage to HIV prevention services. Most young women who initiate PrEP in Africa do so through informal peer referral. We wanted to test a model of formalized peer referral enhanced with HIVST delivery among young Kenyan women.

Methods

The Peer PrEP Trial is a two-arm hybrid effectiveness-implementation cluster-randomized controlled trial being conducted in central Kenya. Eligible participants (i.e., peer providers, n = 80) are women (≥ 16–24 years) refilling or initiating PrEP at public healthcare clinics who can identify at least four peers who could benefit from PrEP and not enrolled in another HIV study. Peer providers will be 1:1 randomized to (1) formal peer PrEP referral + HIVST delivery, where they will be encouraged to refer four peers (i.e., peer clients, ≥ 16–24 years) using educational materials and HIVST kits (two per peer client), or (2) informal peer PrEP referral, where they are encouraged to refer four peer clients using informal word-of-mouth referral. In both arms, peer providers will deliver a standard PrEP referral card with information on nearby public clinics delivering PrEP services. Peer providers will complete surveys at baseline and 3 months; peer clients will complete surveys at 3 months. Our primary outcome is PrEP initiation among peer clients, as reported by peer providers at 3 months. Secondary outcomes include PrEP continuation (any refilling), HIV testing (past 3 months), sexual behaviors (past month), and PrEP adherence (past month) among peer clients, as reported by both peer providers and clients at 3 months. Implementation outcomes will include participants’ perceived acceptability, appropriateness, and feasibility of the intervention as well assessments of the intervention’s fidelity and cost.

Discussion

Evidence from this trial will help us understand how HIVST could support health systems by facilitating linkage to PrEP services among young women who could benefit in Kenya and similar settings.

Trial registration

ClinicalTrials.gov NCT04982250. Registered on July 29, 2021.
Assessment of the performance of haematological and non-invasive fibrotic indices for the monitoring of chronic HBV infection: a pilot study in a Ghanaian population
Authors: Nyarko Eric N. Y. , Obirikorang Christian , Owiredu W. K. B. A. , Adu Evans Asamoah , Acheampong Emmanuel
Published: November 2023

Objective

Haematological and liver fibrotic markers could be appreciably utilized for effective monitoring of Chronic Hepatitis B viral (HBV) infection, thereby increasing patient’s treatment outcome. The objective of this study was to assess the applicability of complete blood count (CBC) and non-invasive liver-fibrotic indices as markers of prognostic outcome and monitoring in HBV infections.

Results

Significant differences in levels of white cell and differentials counts, red blood cell count, hemoglobin indices, and platelet indices were observed between HBV-infected patients (cases) and uninfected persons (controls). Levels of haemoglobin (Hb), total white blood cells (tWBC), neutrophils, monocytes, platelets, and Platelet Distribution width (PDW) were significantly lower (p < 0.05) in the cases compared to the controls. Total and indirect bilirubin; De-Ritis ratio, Aspartate transaminase to platelet ratio index (APRI) and RDW-to-platelet ratio (RPR) were elevated in cases compared with controls (p-value < 0.05). In a multivariate adjusted model to test the significance of markers, Hemoglobin Index (beta coefficient = − 0.876, p-value < 0.001), NLR (beta coefficient = − 0.839, p-value < 0.001), MPV_10000 (beta coefficient = − 0.333, p-value < 0.001) and Albumin (beta coefficient = − 0.059, p-value = 0.014), were associated with HBV infection status. Receiver operative characteristics curve analysis showed Hemoglobin Index (AUC = 0.744) and MPV_10000 (AUC = 0.730) as better prognostic markers for HBV-infection.