bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive framework for developing mHealth-based behavior change interventions
Authors: Rachad Taoufik , El Hafidy Abderrahim , Aabbad Meriem , Idri Ali
Published: October 2024

Background

Understanding human behaviors has been the subject of several studies. Their main goal was to inform behavior change interventions aimed at promoting positive behaviors and improving negative ones. However, as a non-expert in behavioral science, it is extremely difficult for researchers from other disciplines to design and develop evidence-based behavior change interventions. Moreover, all existing frameworks stop at the conceptual stage and do not provide instructions for developing digital-based behavior change interventions.

Objective

We present an end-to-end framework for the design and development of mHealth-based behavior change interventions by drawing on the synergy of theory, practices, and evidence from previous research.

Methods

We reconcile the frameworks most used in the literature for the design of behavior change interventions. Therefore, the authors examined the steps of each framework, and the mapping between these steps was carried out through several iterations to obtain five common steps.

Results

The proposed framework includes five steps: (1) Definition of the scope of the intervention. (2) Understanding and explanation of behavior. (3) Definition of the intervention content and strategies. (4) Implementation of the intervention. (5) Evaluation of the intervention. Each step is explained in detail, while providing researchers with examples and the necessary materials that will boost the success of their interventions.

Conclusion

This work provides a framework that will guide researchers in the design and implementation of mHealth-based behavior change interventions. It differs from its predecessors in that it goes beyond the conceptual level of intervention design by providing details about the technical implementation of mHealth solutions. Also, explanations and examples for different steps are provided to help researchers and practitioners and design, implement, and evaluate their mHealth-based behavior change interventions.
What are the Key Drivers to Promote Continuance Intention of Undergraduates in Mobile Learning? A Multi-perspective Framework
Authors: Li Li
Published: October 2024

Grounded in the expectation-confirmation theory and the D&M Information Success Model, this study investigates the factors influencing college students’ continuance intention to use mobile learning from three perspectives: educational institutions, instructors, and learners. About 421 college students were randomly selected to participate in a survey measuring their feedback on eight factors (information quality, system quality, service quality, perceived usefulness, confirmation, satisfaction, continuance intention and instructor support). The Smart-PLS method was employed for data analysis. Results indicate that CON and SEQ significantly and positively influenced PU, CON, and TES significantly and positively influenced SAT. Meanwhile, PU and SAT were significant predictors of CI, SYQ and TES significantly and positively predicted CON. The proposed model explained 83.1% of the variance in the continuance intention of mobile learning. Notably, teacher support was proven to significantly and positively impact students’ confirmation and satisfaction. Gender did not significantly moderate the relationship between perceived usefulness, satisfaction, and continuance intention. This research fills a gap in the current mobile learning literature and provides theoretical and practical implications for college students’ continuance intention toward mobile learning.
The Influence of Educational and Emotional Support on e-Learning Continuance Intention: A Two-Stage Approach PLS-SEM and ANN Analysis
Authors: Guo Min
Published: October 2024

In the context of the digital era, e-learning has become an innovative and indispensable component of the educational sector. With the continuous advancement of technology and the widespread adoption of the internet, e-learning has demonstrated its key role in maintaining educational continuity and supporting remote teaching. However, despite the extensive applications and significant advantages of e-learning, the willingness of college students to continue using e-learning platforms is not always high, presenting a challenge for educators and technology developers. Based on the Expectation Confirmation Model, this study examines the influence of perceived educational and emotional support on the continuance intention of e-learning among college students. The researchers conducted a survey using a structured questionnaire randomly among 379 university students from three universities in Henan Province to measure their self-reported responses on six constructs: perceived educational support, perceived emotional support, perceived usefulness, confirmation, satisfaction, and continuance intention. The study uses the Structural Equation Modeling—Artificial Neural Network (SEM-ANN) method to elucidate the non-compensatory and non-linear relationships between predictive factors and e-learning continuance intention. Except for the direct effects of perceived educational support and perceived emotional support on perceived usefulness, which were not significant, all other hypotheses were confirmed. Moreover, according to the normalized importance obtained from the multilayer perceptron, satisfaction (100%) was found to be the most critical predictive factor, followed by confirmation (29.8%), perceived usefulness (28.2%), perceived educational support (22.7%), and perceived emotional support (21.8%). All constructs together accounted for 62.0% of the total variance in college students’ e-learning continuance intention. This study’s adoption of a two-stage analysis approach improved the depth and accuracy of data processing and expanded the methodological scope of educational technology research. It provides direction for future in-depth studies in various environments and cultural contexts.
“The Lung Disease as an Evanescent Rainbow”: Indigenous Languages as Agency in Communicating COVID-19 in Multilingual Kham Tibetan Region in China
Authors: Puba  , Kang Dongjing
Published: October 2024

The role of language is one of the most critical elements in communicating COVID-19 public health mandates globally. This study aims to explore how Tibetans in the multilingual Kham region came to understand COVID-19 and develop health choices. To accomplish this goal, we used a culture-centered approach to examine how the words/phrases of COVID-19 influence Kham Tibetans’ agency [the ability to develop actions (or lack thereof)] to work on the infectious disease and the pandemic management policy in China. This analysis explores the interactions among social structure, culture, and agency in the creation of transformative practices for negotiating the digital biomedical environment. Based on 30 in-depth interviews with Tibetans in the Kham region, we illustrate that the dialogical praxis to co-construct languages significantly impacts Tibetans’ deliberate agency, the capacity to act that is conscious or intended, to work on COVID-19 and the pandemic-control policy.
The Influence of Perceived Teacher Support on Chinese Local College Students Engagement: The Mediating Role of Self-Efficacy
Authors: Gong Wenting , Xu Chuang
Published: October 2024

Guided by ecological systems theory, this study investigated the relationship between the perceived teacher support, perceived self-efficacy, and student engagement of Chinese local college undergraduates. Data collection was carried out by questionnaire survey, and a convenience sample of 556 Chinese local college students (Male = 260, Female = 296) participated in the study. After reliability and validity analysis and SEM analysis, results show that perceived teacher support has a positive predictive effect on student engagement through the mediating effect of self-efficacy, whereas perceived teacher autonomy support has the greatest effect on student engagement, followed by teacher emotional support and teacher academic support. After discussing these results, practical significance to improve local college students’ engagement and suggestions for future research are put forward.
Revision ACL Reconstruction Surgery: Tips and Tricks
Authors: Hardjosworo Sapto Adji
Published: October 2024

Introduction:

Since Indonesia enjoys more social and economic growth in last past years, more Indonesian especially gen Millennial and gen Z enjoy sports. So the incidence of sports injuries are increasing, among those are ACL injuries. Since the anterior cruciate ligament reconstruction (ACLR) surgeries is increasing, so is the number of revision surgeries for a failed ACLR. The spectrum of ACL failure includes symptoms of recurrent instability, pain, and/or stiffness. Although primary ACL reconstruction is a successful operation, success rates may still range from 75% to 97%. Consequently, several thousand revision ACL reconstructions are performed annually and are unfortunately associated with inferior clinical outcomes when compared with primary reconstructions. Therefore sharing and learning from each other to improve the outcome of revision ACL reconstructions among us is good and beneficial.

Discussion:

Several factors which contribute to ACL failure may be identified as patient-related, surgeon-related, and biological factors. Among these, malposition of tunnel especially femoral-tunnel and recurrent trauma are the most common causes. In planning the revision ACL surgery, it is paramount to do detailed patient assessment, imaging, and studying details of the previous surgery. Among all, possible infection has to be ruled out prior to revision and identify the need for any bony reconstructive procedure. Osseous malalignment in the coronal or sagittal planes may need correction along with or prior to revision ACL surgery. In revising ACL reconstruction surgery, we need to make decision whether it can be performed as a one-stage or two-stage procedure. Severe tunnel dilatation, infection, or arthrofibrosis necessitates a two-stage approach. Associated meniscus tears and cartilage injuries are more common in revision than in primary surgery and need to be managed appropriately. Extra-articular reconstruction for controlling anterolateral instability is frequently required as well.

Conclusion:

Though revision ACL reconstruction surgery is not a routine procedure and a complex undertaking one, an excellent result can be achieved with regard to graft stability, return to play, and functional knee instability yet are generally inferior to primary ACL reconstruction. A staged approach with autograft reconstruction is recommended in any circumstance in which a single-stage approach results in suboptimal tunnel position, graft fixation, or biological milieu for enthesis healing. Patient expectations must be tempered because functional outcomes and return to pre-injury sports are usually inferior to a primary surgery.
Meniscus Medial Posterior Root Tear Management
Authors: Parsaoran Butarbutar John Christian , Riantho Albert , Fidiasrianto Kevin , Ivander Gian
Published: October 2024

Medial meniscus posterior root tear (MMPRT) refers to the avulsion or complete radial tear occurring within a distance of 1 cm from the posterior tibial attachment of the medial meniscus. Root tears result in the extrusion of the meniscus, which subsequently leads to elevated joint contact pressures. These condition increased pressures contribute to the rapid progression of joint space narrowing and the occurrence of subchondral bone edema that were indistinguishable from total meniscectomy.

Studies have reported that MMPRT represents A substantial percentage of meniscus tears, accounting for approximately 10 to 20% of all meniscus tears diagnosed. MMPRT frequency was reportedly 21.5% in all arthroscopic surgeries for meniscus medial tear. Nevertheless, despite the significant role that these injuries play in the development of degenerative joint disease, they frequently remain undetected during the initial evaluation. MMPRT are relatively common among middle-aged adults, female sex, and higher BMI with clear onset of significant injury. This might be attributed to aging associated degenerative alteration that makes the meniscus more susceptible to root detachment.

The primary objective of managing MMPRT is to mitigate the progression of osteoarthritis by reinstating optimal joint contact pressures and kinematics. Given the unfavourable results observed with conservative treatment, surgical repair is currently regarded as the preferred choice. This approach has demonstrated encouraging clinical outcomes specifically in patients who meet the appropriate indications. Patients undergoing medial meniscus root repair have better functional scores, less osteoarthritis progression, and less conversion to total knee replacement compared to meniscectomy. The most common repair method for MMPRT is using transtibial pull-out repair at anatomic footprint of the meniscus root. Nevertheless, the pull-out suture method exhibits a vulnerability at the location of meniscus suturing, where cuts frequently occur during cyclical loading. Additionally, this technique cannot restore the meniscus extrusion. Furthermore, directly repair of the meniscus to bone may lead to a biologically weak structure at the footprint of the meniscus root. Nonanatomical repair itself shows less tibiofemoral contact area and increased mean contact pressure compared to anatomic repair.

Several additional procedures have been proposed to maximize the result of meniscus root repair, including peripheral meniscocapsular release, centralization suture, and root reconstruction to minimize meniscus extrusion. In case of a significant tear gap found, root reconstruction is recommended to address the gap.
Retear after Rotator Cuff Repair
Authors: Marsetio Aldo Fransiskus
Published: October 2024

Fixation failure is still being a main concern after a repair of rotator cuff tear. Risk factors for retear after rotator cuff repair may rise from the patient side and surgeon side. Non-modifiable risk factors from the patient side include: age, fatty infiltration, muscle atrophy, chronicity and time to surgery, tear size and retraction, critical shoulder angle and acromiohumeral interval. Meanwhile, some factors on the patients are modifiable, include: diabetes mellitus, hyperlipidemia, high body mass index, bone mineral density, smoking habit, exercise and work level. On the other hand, surgery also play important role in determining the prognosis of the repair, namely arthroscopic VS open, suture technique, biological augmentation, and corticosteroid injection. Additionally, immobilization period, ROM exercise and strengthening exercise may also affect the risk of retear. By understanding the contributing risk factors, it is expected that surgeon can prevent or overcome the retear.
Strategies for Cartilage Repair and Regeneration
Authors: Adachi Nobuo
Published: October 2024

Articular cartilage is a hyaline cartilage consisting of a small number of chondrocytes and the surrounding extracellular matrix. Since articular cartilage lacks blood vessels and nerve fibers, it is quite difficult to work normal wound healing process once it is damaged. For localized cartilage defects, drilling or microfracture techniques that introduce cells from bone marrow, osteochondral autograft harvested from non-weight bearing area of the joint, and autologous cultured chondrocyte implantation have been performed. However, there is no gold standard procedure. The meniscus plays important roles in the knee joints, such as shock absorption, load distribution, and lubrication. For the meniscal tears in the vascularized area, suture is aggressively performed to preserve the function of the meniscus. However, there are still many cases with non-vascularized filed tears and degenerative tears that require extensive partial meniscectomy.

Regenerative medicine is expected to be applied to cases of articular cartilage or meniscus injuries that are difficult to treat with conventional therapies, and some clinical applications have been started in Japan. In regenerative medicine, the important factors are the cells to be transplanted, the scaffold for cell proliferation, and the growth factors to promote cell proliferation and cell function. In the regeneration of articular cartilage and meniscus, cells are usually isolated and cultured from biopsied tissues and transplanted alone or with a scaffold, but the high quality control required for cell culture and the two-step process of tissue collection and transplantation in surgery are major barriers to clinical application. We have been attempting to regenerate articular cartilage and meniscus by transplanting small pieces of cartilage or meniscus without culture process. To date, we have confirmed the efficacy of minced tissue as a cell source in vitro and have reported good tissue regeneration of articular cartilage and meniscus in vivo using rabbits and pigs.
Reviewing Revision Anterior Cruciate Ligament Reconstruction: Why and How?
Authors: Syaukat Ahmad , Shiddieqy Pohan Muhammad Alvin
Published: October 2024

Introduction & Objectives:

Revision ACL reconstruction occurred in 3.9- 9.2% cases of ACL repairs cases. Multiple revisions also increased comorbidities and lowers return-to-sport opportunity. We aimed to answer risk factors affecting requirements of revision ACL reconstruction and comparison of different techniques utilized for ACL reconstructions.

Materials & Methods:

PubMed and Europe PMC database were searched using following MeSH terms: “(“revision” AND ("acl" OR "anterior cruciate ligament") AND "reconstruction" AND "outcomes")”. This systematic review was conducted using PRISMA algorithm, searches yielded 1,649 abstracts for screening After employing screening criteria, final number of 32 relevant peer-reviewed open access studies from years 2018-2023. All authors read and voted for inclusion to paper. All papers were compiled, relevant information extracted, and narrated.

Results:

Gender was found to play some role in subsequent ACL reconstruction after primary ACL reconstruction failure. Another risk factors for revision ACL reconstruction included younger age (less than 30 years old) and use allograft for reconstruction. Revision ACL reconstruction conducted less than one year after symptoms were first experienced resulted in better outcome. The revision group more frequently experienced failure of the previous meniscal repair. Higher sport activity, or on the opposite, involvement in sport was an outcome of better revision ACL reconstruction. Surgical ACL reconstruction with internal bracing significantly decreased risk of ACL revision. Choices of graft, including greater utilization of autograft, and usage of BTB graft may improve patient outcomes.

Conclusions:

Younger age, allograft use, higher physical activity, and failure to repair meniscal damage risked revision ACL repair. Newer techniques may prevent ACL re-rupture and improve primary ACL repair outcomes. Choosing autograft and newer techniques results in better outcomes.
Complete Medial Meniscus Posterior Root Tear Without an Extrusion Due to Meniscocapsular Thickening in Sportswoman: A Case Report
Authors: Ivander Gian , Parsaoran Butarbutar John Christian , Riantho Albert , Fidiasrianto Kevin
Published: October 2024

Introduction:

Medial Meniscus Posterior Root Tear (MMPRT) is the most common type of meniscus root tear attributed to its lesser mobility and higher load. Complete MMPRT is usually accompanied by significant meniscus extrusion (ME) which can be defined as displacement ≥3mm of meniscus from central margin of tibial. Meniscocapsular ligament (ML) is located posteromedially, along with meniscotibial ligament help stabilizing the meniscus. Here, we present an interesting case of sportswoman with complete MMPRT without an extrusion.

Case Presentation:

a 47-year-old sportswoman initially presented to outpatient clinic complaining right knee pain over 2 months especially when squatting. Her BMI is 20.6 and Physical examination revealed a joint effusion and tenderness at deep flexion. Palpation on medial joint line was unremarkable. Further investigation using MRI showed complete horizontal tear on right medial meniscus posterior. The patient underwent an arthroscopic transtibial pullout repair (ATPR) which intraoperatively we found a complete radial MMPRT without ME and thickening of ML. After surgery, the patient was instructed to wear a knee immobilizer for 2 weeks.

Results:

The patient had a substantial improvement in pain and functional score after an ATPR procedure.

Discussion:

Prevalent risk factors of MMPRT include age ≥50, female sex, BMI ≥25, and lower sports activity level (<2/weeks). In this case, the patient’s gender was the only risk factor. Patient was a former running athlete, which led an active lifestyle (sports ≥4/weeks). Recently, she started doing heavy squats and noticed click sound before her complaint. During ATPR, we found no ME despite complete MMPRT. Study by Muzaffar et al. showed that out of total 202 cases of meniscus tears were followed by ME in which 64,26% cases were MMPRT. There were still no studies that linked ML thickening to activity levels. However, study by Grzelak et al. concluded that cruciate ligament might become hypertrophied related to age of training onset and training duration. Therefore, we postulated the thickening of ML, which possibly related to the patient background as a sportswoman, plays role in holding the meniscus.

Conclusion:

We reported in this case, interestingly ME does not occur possibly due to thickening of ML.
Haglund's Deformity as a Cause of Achilles Tendon Sleeve Avulsion: A Case Report
Authors: Kartika Pramudita Angga , Basunanda Tresna Angga
Published: October 2024

Background:

The incidence of complete achilles tendon rupture is 18 per 100.000 patient-years and is usually presents to GP. Haglund’s deformity is believed to be a factor in achilles tendon rupture.

Case Report:

A 47-year-old soccer athlete came to the police clinic with complaints of pain in his left ankle after playing soccer 2 days ago. Pain was felt after the patient's left leg holds the body when going to shoot by a popping sound on the patient's left leg. The patient came after consulting with the paramedics and suspected of sprain. The results of vital sign was normal, VAS 4, BMI 24,9 kg/m2, ROM ankle joint was limited, thompson test (+) matle test (+), there was a bump on the right and left above the heel for more than 5 years show in figure 1 and 2. The patient was referred for an X-ray. From the results of the X-rays it was concluded that there was an Achilles tendon sleeve avulsion.

Discussion:

We report that there was an achilles tendon rupture in a soccer athlete with ideal BMI and no history of severe trauma. A ruptured Achilles tendon at the calcaneus attachment, which does not include a bone that can be fixed, is called “sleeve avulsion”, like in our case. Acute Achilles tendon rupture usually occurs at the watershed region. In the current case, the achilles tendon rupture occurred directly at the level of its distal insertion. These findings suggest that the recurrent stress load of the Achilles tendon, in particularly athletes, could be a trigger factor for Haglund’s deformity. A chronic inflammatory process reduces achilles tendon strength and can lead to tendon rupture, even in the presence of minor trauma. The first additional test that can be performed to detect a achilles tendon rupture is the thompson test. Thompson test is reported to have a sensitivity of 96% and a specificity of 93%. The next physical examination that can be used is the Matles test. The sensitivity and specificity of this test were reported to be 88% and 85% respectively.

Conclusion:

Underestimating Haglund's deformity can harm the patient, one of which is the occurrence of achilles tendon rupture. Anamnesa and physical examination for suspected achilles tendon rupture are very necessary, considering that most patients with achilles tendon rupture come to general practitioners. Increasing general practitioner knowledge about trauma cases in athletes will have a positive effect in the management of sports injury cases.
Sexual Harassment and Hierarchical Workplace Relationships after #MeToo: Consequences for Women Subordinates
Authors: Hart Chloe Grace , McLaughlin Heather
Published: October 2024

The #MeToo movement illustrated how higher-ups may abuse their power by engaging in sexual harassment and generated heightened concern about hierarchical workplace romantic relationships. In a survey experiment, the authors test whether sexual attention from a superordinate outside one’s reporting chain (desired or not) leads to stereotyping and resultant career penalties. A woman employee who reported sexual harassment was seen as less warm and more attention seeking and cutthroat but also more assertive and willing to speak truth to power, although some perceptions varied by the harassment type. A woman who declared a romantic relationship with a superordinate was viewed as less committed to the organization. This stereotyping did not translate to workplace penalties apart from a marginally significant raise penalty against the woman who reported unwanted sexual advances. However, the authors find that experiencing sexual attention from a superordinate, whether desired or not, is damaging to working women’s reputations.
Coronary Endarteritis Secondary to Stent Infection, a Rare but Catastrophic Complication of Percutaneous Coronary Intervention: A Case Series and Review of Literature
Authors: Sudhakar B.G.K. , Azmeera Mahesh , Kumar Rajendra , Padmanabhan T.N.C. , Reddy N. Sreedhar
Published: October 2024

Coronary stent infection (CSI) is a rare but fatal complication of percutaneous coronary intervention (PCI) occurring in less than 0.1% cases. CSI usually manifests as fever and acute coronary syndrome but in some cases presentation may be confusing. Without prompt diagnosis and appropriate treatment, the outcome is poor with mortality reaching 30%. Here, we present 5 cases of CSI resulting in coronary artery aneurysms. Interestingly, CSI occurred during the first stent implantation, mostly in post-acute myocardial infarction patients. Blood culture, pericardial fluid analysis, and coronary angiogram were used as diagnostic tools in our cases. Three of our patients had infective endocarditis involving native mitral and aortic valves and one patient had pericardial effusion and cardiac tamponade. Stent thrombosis and aneurysm formation were observed in all cases. All patients received appropriate and adequate antibiotic therapy before undergoing coronary angiogram and surgery. Cardiac catheterization laboratory hardware reuse, repeated procedures, complex procedures requiring instrumentation, and prolonged indwelling catheters may increase the risk of bacteremia and stent infection. Currently, there are no established criteria or protocols for diagnosis and management of CSI.
Efficacy and tolerability of subcutaneous repository corticotropin injection in refractory ocular inflammatory diseases
Authors: Yavari Negin , Ghoraba Hashem , Or Christopher , Thng Zheng Xian , Mohammadi S. Saeed , Karaca Irmak , Mobasserian Azadeh , Akhavanrezayat Amir , Le Anthony , Lyu Xun , Khatri Anadi , Yoo Woong Sun , Feky Dalia El , Than Ngoc Trong Tuong , Elaraby Osama , Saengsirinavin Aim-On , Zhang Xiaoyan , Anover Frances Andrea , Gupta Ankur Sudhir , Halim Muhammad Sohail , Jison Louis A. , Nguyen Quan Dong
Published: October 2024

Background

Repository corticotropin injection (RCI) has been suggested to exert immunomodulatory and anti-inflammatory effects in ocular inflammation. The index retrospective study aimed to evaluate the efficacy and tolerability of subcutaneous RCI in patients with active scleritis or uveitis.

Main body

Medical records of patients who were diagnosed with different types of active scleritis or uveitis and received RCI for more than six months at a tertiary eye center were reviewed. Patient characteristics including age, sex, comorbidities, clinical findings, treatment details, and adverse events were recorded. A total of 17 eyes of 17 patients were included. Median age was 43 years old and 53% of patients were male. Mean treatment duration was 25.4 ± 15.5 months. Indications for RCI therapy were scleritis (7 anterior and 1 posterior) (47.8%), panuveitis (17.4%), retinal vasculitis (17.4%), chronic/recurrent anterior uveitis (13%), and posterior uveitis (4.35%). RCI was initiated at a dose of 40 to 80 units 3 times weekly. Given the adequate control of inflammation, RCI was successfully discontinued in four patients (23.5%). Prior to RCI therapy, 14 (82.3%) patients were on oral prednisone at an average of 10 mg daily (range 2.5–40 mg), and two (11.7%) patients discontinued prednisone immediately before initiating RCI due to side effects. After six months of therapy, the prednisone dose was reduced in four (23.5%) patients to an average of 3 mg daily (range 1–5 mg) and was stopped in eight (53%) patients. Concomitant immunomodulatory therapies (IMTs) included mycophenolate mofetil (23.5%) and methotrexate (23.5%), and adalimumab (23.5%). Ten patients were on IMTs prior to using RCI, and during the course of treatment, IMT was stopped in two patients and reduced in one. Side effects included insomnia (23%), hypertension (11.7%), lower extremity edema (11.7%), hyperglycemia (11.7%), weight gain (11.7%), and infection (5.8%).

Conclusion

RCI may be considered as a potential therapy with acceptable tolerability for patients with non-infectious scleritis or uveitis.
The use and usefulness of the Peninsula Health Falls Risk Assessment Tool (PHFRAT) process in residential aged care: a mixed methods study across 25 aged care facilities
Authors: Mercado Crisostomo Ibarra , Meulenbroeks Isabelle , Huang Guogui , Wabe Nasir , Seaman Karla , Clive Joanna , Westbrook Johanna
Published: October 2024

Background

Falls remain a persistent problem in residential aged care (RAC) facilities. Fall screening and assessment tools such as the Peninsula Health Falls Risk Assessment Tool (PHFRAT) are widely used to inform falls risk and guide fall prevention interventions. However, it is unclear how it is used in practice and whether clinicians believe it supports resident care. This study aimed to measure the extent of use of PHFRAT to understand clinicians’ perceptions of its value and usefulness.

Methods

This mixed method study involved an analysis of PHFRAT assessment from 25 RAC facilities in New South Wales, Australia, and interviews with seven RAC staff about how PHFRAT information is used in practice. In the quantitative component, descriptive statistics were applied to PHFRAT data to summarise how RAC staff use the PHFRAT including the completeness and content of the three parts. In the qualitative component, thematic analysis techniques were applied to interview data.

Results

The sample included 215 RAC residents with 703 PHFRATs, of which 617 documented fall prevention interventions. Among these 617 PHFRATs, 593 (96.1%) included strategies related to staff assistance and 283 (45.9%) recorded strategies related to device provision. While nearly all residents (96.74%) received at least one PHFRAT assessment over the study period, many PHFRAT assessments were incomplete (part 1: 11.5% of information missing; part 2: 10.8%; part 3: 17.1%). There were few variations in fall interventions prescribed to individual residents by their fall risk level. Interviews with RAC staff indicated that PHFRAT assessments are the responsibility of registered nurses with limited input from other staff or residents. While the structured process was viewed positively in guiding risk assessment and intervention assessment, a lack of input from others prevented strategies from being tailored to residents’ specific needs and preferences. A shortage of resources, lack of communication, and limited staff education were identified as the main barriers to PHFRAT guideline implementation.

Conclusion

The PHFRAT provides a useful structure for clinicians to assess falls risk factors and plan falls prevention strategies. In the future, increased multidisciplinary input into fall prevention strategy development may improve the comprehensiveness of fall prevention plans.
USP9X-mediated deubiquitination of Raptor contributes to autophagy impairment and memory deficits in P301S mice
Authors: Zheng Siyi , Zhu Jiahui , Wang Cailin , Wu Yanqing , Sun Shangqi , Guo Hongxiu , Chang Yanmin , Ma Rong , Li Gang
Published: October 2024

Background

Tauopathies, including Alzheimer’s disease, are characterized by the pathological aggregation of tau protein, which is strongly linked to dysregulation of the autophagy-lysosomal degradation pathway. However, therapeutic strategies targeting this pathway remain limited.

Methods

We used both in vitro and in vivo models to investigate the role of Raptor in tau pathology. Knockdown of Raptor was performed to assess its impact on mTORC1 activation, autophagy, and tau accumulation. The relationship between USP9X and Raptor was also examined. Pharmacological inhibition of USP9X with WP1130 was employed to further confirm the involvement of the USP9X-Raptor-mTORC1 axis in tau degradation.

Results

Elevated Raptor levels in the hippocampus of P301S mice led to hyperactivation of mTORC1, impairing autophagy flux. Knockdown of Raptor effectively suppressed mTORC1 activation, promoted autophagy, and mitigated the accumulation of tau and its phosphorylated isoforms. This reduction in tau pathology was accompanied by decreased neuronal loss in the hippocampus, amelioration of synaptic damage, and improvement in cognitive function. The increased Raptor protein observed in the hippocampus of P301S mice was likely attributable to elevated USP9X content, which enhanced Raptor deubiquitination and protected it from proteasomal degradation. Pharmacological inhibition of USP9X with WP1130 in vitro effectively suppressed Raptor, promoted autophagy, and accelerated the degradation of tau and phosphorylated tau.

Conclusions

Our findings highlight Raptor and USP9X as promising molecular targets for therapeutic intervention in tauopathies. Targeting the USP9X-Raptor-mTORC1 axis may provide a novel strategy for promoting autophagy and mitigating tau pathology in Alzheimer’s disease and other tauopathies.

Graphical Abstract
Immunomodulatory effects of trastuzumab deruxtecan through the cGAS-STING pathway in gastric cancer cells
Authors: Oh Kyoung-Seok , Nam Ah-Rong , Bang Ju-Hee , Jeong Yoojin , Choo Sea Young , Kim Hyo Jung , Lee Su In , Kim Jae-Min , Yoon Jeesun , Kim Tae-Yong , Oh Do-Youn
Published: October 2024

Although the efficacy of trastuzumab deruxtecan (T-DXd) against HER2-positive gastric cancers (GCs) has driven its clinical application, the precise mechanisms governing its immunomodulatory role remain unclear. In this study, we examined the immune-related mechanisms of action of T-DXd in GC cells. T-DXd exhibited potent antitumor effects in GC cells across diverse HER2 expression levels by inducing DNA damage and apoptosis. Activation of the DNA damage response by T-DXd led to increased PD-L1 expression. RNA-Seq analysis revealed that T-DXd modulated immune-related pathways, resulting in the upregulation of genes associated with inflammation and IFN signaling. Importantly, T-DXd activated the cGAS-STING pathway, inducing an IFN-I response in HER2-positive GC cells. Furthermore, T-DXd activated dendritic cells via the cancer cell-intrinsic cGAS-STING-IFN axis and enhanced PBMC-mediated tumor cell killing by activating CD8+ T cells. These findings provide valuable insights into the role of the cytosolic DNA sensing pathway in the action of T-DXd and offer a compelling rationale for combining T-DXd with immune checkpoint blockade therapies in GC treatment.
Design, synthesis, and biological investigations of new pyrazole derivatives as VEGFR2/CDK-2 inhibitors targeting liver cancer
Authors: Salem Manar G. , Nafie Mohamed S. , Elzamek Aya A. , Elshihawy Hosam A. , Sofan Mamdouh A. , Negm Elham
Published: October 2024

New Series of N-Manniche bases 3,4 (a-c) and 5,6 (a-b) were synthesized through the reaction of benzaldehyde and amine with 3-methyl-4-(aryldiazenyl)-1H-pyrazol-5-ol derivatives 2(a-c), they were fully characterized by FT-IR, (1H, 13C) NMR data in addition to their mass spectra. The Structural Activity Relationship of the target compounds were examined for their cytotoxicity. Some newly synthesized compounds showed promising antiproliferation properties when tested against HepG2 cancer cells. Compounds 4a, 5a, and 6b showed potent cytotoxicity against HepG2 with IC50 values of 4.4, 3.46 and 2.52 µM compared to Sorafenib (IC50 = 2.051 µM) and Roscovitine (IC50 = 4.18 µM). Furthermore, they were safe against the THLE2 cells with higher IC50 values. Compound 6b exhibited promising dual VEGFR2/CDK-2 inhibition activities; it had an IC50 value of 0.2 μM with VEGFR2 inhibition of 93.2%, and it had an IC50 value of 0.458 μM with CDK-2 inhibition of 88.7%. In comparison to the untreated control group (0.95%), compounds 5a (38.32%) and 6b (42.9%) considerably increased the cell population in total apoptosis. In addition, compounds 5a and 6b arrested the cell population at G0-G1 and S phases, respectively. Molecular docking experiments confirmed the virtual binding mechanism of the most active drugs, which were found to have good binding affinities with both receptor active sites.
Age, sex, and cell type-resolved hypothalamic gene expression across the pubertal transition in mice
Authors: Sokolowski Dustin J. , Hou Huayun , Yuki Kyoko E. , Roy Anna , Chan Cadia , Choi Wendy , Faykoo-Martinez Mariela , Hudson Matt , Corre Christina , Uusküla-Reimand Liis , Goldenberg Anna , Palmert Mark R. , Wilson Michael D.
Published: October 2024

Background

The hypothalamus plays a central role in regulating puberty. However, our knowledge of the postnatal gene regulatory networks that control the pubertal transition in males and females is incomplete. Here, we investigate the age-, sex- and cell-type-specific gene regulation in the hypothalamus across the pubertal transition.

Methods

We used RNA-seq to profile hypothalamic gene expression in male and female mice at five time points spanning the onset of puberty (postnatal days (PD) 12, 22, 27, 32, and 37). By combining this data with hypothalamic single nuclei RNA-seq data from pre- and postpubertal mice, we assigned gene expression changes to their most likely cell types of origin. In our colony, pubertal onset occurs earlier in male mice, allowing us to focus on genes whose expression is dynamic across ages and offset between sexes, and to explore the bases of sex effects.

Results

Our age-by-sex pattern of expression enriched for biological pathways involved hormone production, neuronal activation, and glial maturation. Additionally, we inferred a robust expansion of oligodendrocytes precursor cells into mature oligodendrocytes spanning the prepubertal (PD12) to peri-pubertal (PD27) timepoints. Using spatial transcriptomic data from postpubertal mice, we observed the lateral hypothalamic area and zona incerta were the most oligodendrocyte-rich regions and that these cells expressed genes known to be involved in pubertal regulation.

Conclusion

Together, by incorporating multiple biological timepoints and using sex as a variable, we identified gene and cell-type changes that may participate in orchestrating the pubertal transition and provided a resource for future studies of postnatal hypothalamic gene regulation.
Clusters of African countries based on the social contacts and associated socioeconomic indicators relevant to the spread of the epidemic
Authors: Korir Evans Kiptoo , Vizi Zsolt
Published: October 2024

Introduction

It is well known that social contact patterns differ from country to country. This variation coincides with significant socioeconomic heterogeneity that complicates the design of effective nonpharmaceutical interventions. This study examined how socioeconomic heterogeneity in selected African countries might be factored in to explain better patterns of social contact mix between countries.

Methods

We used a standardized contact matrix for 32 African countries, estimated in (Prem et al. in PLoS Comput Biol 17(7):e1009098, 2021). We scaled the matrices using an epidemic model from (Röst et al. in Viruses 12(7):708, 2020). We also analyzed aggregated data from the World Bank country website. The data includes 28 variables; social, economic, environmental, institutional, governance, health and well-being, education, gender inequality, and other development-related indicators that describe countries. Principal component analysis was used to visualize socioeconomic similarities between countries and identify the indicators for maximum variation. The $(2D)^{2} PCA$

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approach was used to reduce the dimension of synthetic contact matrices for each country to avoid the dimensionality curse. Then, hierarchical aggregate clustering was used to identify groups of countries with similar social patterns, taking into account the country’s socioeconomic performance.

Results

Our model yielded four meaningful clusters, each with a few distinguishing features. Social contacts varied between groups, but were generally similar within each set. The socioeconomic performance of the country influenced the clusters.

Conclusions

Our results suggest that integrating socioeconomic factors into social contacts can better explain infectious disease transmission dynamics and that similar interventions can be implemented in countries within the cluster
Global burden of soil-transmitted helminth infections, 1990–2021
Authors: Chen Jin , Gong Yanfeng , Chen Qin , Li Shizhu , Zhou Yibiao
Published: October 2024

Background

Soil-transmitted helminth (STH) infections can cause a significant disease burden. It is estimated that 1.5 billion people worldwide are infected with STHs, primarily in tropical and subtropical regions. This study aimed to assess the distribution of the global burden and trend of STH infections from 1990 to 2021.

Methods

We retrieved data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 on the age-standardized rates (ASRs) of prevalence and disability-adjusted life-years (DALYs) of STH infections for all age groups in 204 countries and territories from 1990 to 2021. The ASRs of prevalence and DALYs by age, gender, and socio-demographic index (SDI) were calculated to quantify the spatial distribution and temporal trend. Spearman correlation analysis was used to examine the relationship between ASR and SDI.

Results

In 2021, there were an estimated 642.72 million cases and 1.38 million DALYs caused by STH infections worldwide. The age-standardized prevalence rate (ASPR) of STH infections was 8429.89 [95% uncertainty interval (UI): 7697.23, 9362.18 ] per 100,000 population globally. The ASPR of STH infections varied across 21 geographic regions in 2021, being mainly prevalent in most African and Latin American locations. The prevalence was higher in the groups of 5–19 years, especially the group of 5–9 years with the ASPR of 16,263 (95% UI: 14,877.06, 18,003.49) and ASR of DALYs of 40.69 (95% UI: 25.98, 60.91) per 100,000. The ASPR of STH infections showed an obvious decreasing trend worldwide (estimated annual percent change = − 4.03, 95% confidence interval: − 4.13, − 3.93) with variations in different species infections during the study years. At the regional level, the ASR of STH infections prevalence (r = − 0.8807, P < 0.0001) and DALYs (r = − 0.9069, P < 0.0001) were negatively correlated with SDI .

Conclusions

STH infections remain a public health problem in 2021, particularly in regions such as the middle parts of Africa and Americas, and in the 5–19 age populations. The reduction in the rate of prevalence and the loss of DALYs are negatively correlated with the increase in SDI. Enhancing political commitment, providing accurate preventive chemotherapy, and advancing techniques for surveillance and mapping systems are essential to achieve the target of ending STH infections as a public health problem by 2030.

Graphical Abstract
“Idol talks!” AI-driven image to text to speech: illustrated by an application to images of deities
Authors: Sherly P. Steffy , Velvizhy P.
Published: October 2024

This work aims to provide an innovative solution to enhance the accessibility of images by an innovative image to text to speech system. It is applied to Hindu and Christian divine images. The method is applicable, among others, to enhance cultural understanding of these images by the visually impaired. The proposed system utilizes advanced object detection techniques like YOLO V5 and caption generation techniques like ensemble models. The system accurately identifies significant objects in images of Deities. These objects are then translated into descriptive and culturally relevant text through a Google text-to-speech synthesis module. The incorporation of text generation techniques from images introduces a new perspective to the proposed work. The aim is to provide a more comprehensive understanding of the visual content and allow visually impaired individuals to connect with the spiritual elements of deities through the immersive experience of auditory perception through a multimodal approach to make them feel inclusive in the community. This work is also applicable to preserve Cultural Heritage, Tourism and integrating with Virtual Reality (VR) and Augmented Reality (AR). Images of the artistic cultural legacy are hardly available in annotated databases, particularly those featuring idols. So we gathered, transcribed, and created a new database of Religious Idols in order to satisfy this requirement. In this paper, we experimented how to handle an issue of religious idol recognition using deep neural networks. In order to achieve this outcome, the network is first pre-trained on various deep learning models, and the best one which outperforms others is chosen. The proposed model achieves an accuracy of 96.75% for idol detection, and an approximate 97.06% accuracy for text generation according to the BLEU score.
Hyperdimensional computing: a framework for stochastic computation and symbolic AI
Authors: Heddes Mike , Nunes Igor , Givargis Tony , Nicolau Alexandru , Veidenbaum Alex
Published: October 2024

Hyperdimensional Computing (HDC), also known as Vector Symbolic Architectures (VSA), is a neuro-inspired computing framework that exploits high-dimensional random vector spaces. HDC uses extremely parallelizable arithmetic to provide computational solutions that balance accuracy, efficiency and robustness. The majority of current HDC research focuses on the learning capabilities of these high-dimensional spaces. However, a tangential research direction investigates the properties of these high-dimensional spaces more generally as a probabilistic model for computation. In this manuscript, we provide an approachable, yet thorough, survey of the components of HDC. To highlight the dual use of HDC, we provide an in-depth analysis of two vastly different applications. The first uses HDC in a learning setting to classify graphs. Graphs are among the most important forms of information representation, and graph learning in IoT and sensor networks introduces challenges because of the limited compute capabilities. Compared to the state-of-the-art Graph Neural Networks, our proposed method achieves comparable accuracy, while training and inference times are on average 14.6× and 2.0× faster, respectively. Secondly, we analyse a dynamic hash table that uses a novel hypervector type called circular-hypervectors to map requests to a dynamic set of resources. The proposed hyperdimensional hashing method has the efficiency to be deployed in large systems. Moreover, our approach remains unaffected by a realistic level of memory errors which causes significant mismatches for existing methods.