4,897 results on '"ENG"'
Search Results
52. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in bacterial infections: contributions to diagnostic strategies in a tertiary care hospital in Tunisia [version 1; peer review: 2 approved]
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Jihed Anoun, Anis Mzabi, Fatma Ben Fredj, Wafa Baya, Amina Bouattay, Najah Adaily, Wiem Romdhane, Imen ben Hassine, Donia Mbarki, Yosra Dhaha, Salma Riahi, and Mariem Ajmi
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Infections ,Neutrophil-to-lymphocyte ratio (NLR) ,Platelet-to-lymphocyte ratio (PLR) ,Diagnosis. ,eng ,Medicine ,Science - Abstract
Background Bacterial infections continue to pose a global health challenge, driven by antibiotic resistance and septicemia. This study aimed to assess the diagnostic utility of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in bacterial infections versus non-infectious causes of inflammation. Methods A prospective study included 164 adult patients who were divided into two groups: a group of patients with confirmed bacterial infections and a second group of patients with other diagnoses (inflammatory pathologies, neoplasms, venous thromboembolic diseases, etc.). NLR and PLR values were compared between the bacterial infection group and the non-infectious causes group and the diagnostic performances of NLR and PLR for detecting bacterial infections were evaluated in comparison with other infection markers. Results NLR and PLR were significantly higher in bacterial infections (p < 10^-6), and NLR was correlated positively with inflammation markers. NLR and PLR demonstrated significant potential in diagnosing bacterial infections, with an AUC of 0.72 and 0.60, respectively, using the following cutoff values: 4.3 for NLR and 183 for PLR. Conclusion These findings underscore the importance of NLR and PLR as adjunctive tools for bacterial infection diagnosis.
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- 2024
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53. Examining the development and utilisation of Community-Based Health Information Systems (CBHIS) in Africa: A Scoping Review [version 1; peer review: 2 approved]
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Michael Ogutu, Jacinta Nzinga, Benjamin Tsofa, Beatrice Kuvuna, Fatuma Guleid, and Moriasi Nyanchoka
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Community-based health information systems (CBHIS) ,Community health systems (CHS) ,Health systems ,Data utilisation ,data-driven decision-making ,Community accessibility ,eng ,Medicine ,Science - Abstract
Introduction The community-based health information system (CBHIS) is a vital component of the community health system, as it assesses community-level healthcare service delivery and generates data for community health programme planning, monitoring, and evaluation. CBHIS promotes data-driven decision-making, by identifying priority interventions and programs, guiding resource allocation, and contributing to evidence-based policy development. Objective This scoping review aims to comprehensively examine the use of CBHIS in African countries, focusing on data generation, pathways, utilization of CBHIS data, community accessibility to the data and use of the data to empower communities. Methods We utilised Arksey and O'Malley's scoping review methodology. We searched eight databases: PubMed, EMBASE, HINARI, Cochrane Library, Web of Science, Scopus, Google Scholar, and grey literature databases (Open Grey and OAIster). We synthesized findings using a thematic approach. Results Our review included 55 articles from 27 African countries, primarily in Eastern and Southern Africa, followed by West Africa. Most of the studies were either quantitative (42%) or qualitative (33%). Paper-based systems are primarily used for data collection in most countries, but some have adopted electronic/mobile-based systems or both. The data flow for CBHIS varies by country and the tools used for data collection. CBHIS data informs policies, resource allocation, staffing, community health dialogues, and commodity supplies for community health programmes. Community dialogue is the most common approach for community engagement, empowerment, and sharing of CBHIS data with communities. Community empowerment tends towards health promotion activities and health provider-led approaches. Conclusion CBHIS utilizes both paper-based and electronic-based systems to collect and process data. Nevertheless, most countries rely on paper-based systems. Most of the CBHIS investments have focused on its digitization and enhancing data collection, process, and quality. However, there is a need to shift the emphasis towards enabling data utilisation at the community level and community empowerment.
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- 2024
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54. Evaluation of centralised and decentralised models of care during the 2020 Ebola Virus Disease outbreak in Equateur Province, Democratic Republic of the Congo: A brief report [version 2; peer review: 2 approved]
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Steve Ahuka-Mundeke, Rebecca M. Coulborn, Armand Sprecher, Anja De Weggheleire, Maria Mashako, Divya Nair, Justus Nsio Mbeta, and Emmanuel Lampaert
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Viral Haemorrhagic Fever ,Central Africa ,SORT IT ,Outbreak ,Epidemic response ,Decentralized care ,eng ,Medicine ,Science - Abstract
Background Traditionally in the Democratic Republic of the Congo (DRC), centralised Ebola treatment centres (ETCs) have been set exclusively for Ebola virus disease (EVD) case management during outbreaks. During the 2020 EVD outbreak in DRC’s Equateur Province, existing health centres were equipped as decentralised treatment centres (DTC) to improve access for patients with suspected EVD. Between ETCs and DTCs, we compared the time from symptom onset to admission and diagnosis among patients with suspected EVD. Methods This was a cohort study based on analysis of a line-list containing demographic and clinical information of patients with suspected EVD admitted to any EVD health facility during the outbreak. Results Of 2359 patients with suspected EVD, 363 (15%) were first admitted to a DTC. Of 1996 EVD-suspected patients initially admitted to an ETC, 72 (4%) were confirmed as EVD-positive. Of 363 EVD-suspected patients initially admitted to a DTC, 6 (2%) were confirmed and managed as EVD-positive in the DTC. Among all EVD-suspected patients, the median (interquartile range) duration between symptom onset and admission was 2 (1-4) days in a DTC compared to 4 (2-7) days in an ETC (p
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- 2024
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55. Reframing the role of communication in consensual and/or ethical (non)monogamies: A proposal for a change in academic terminology [version 1; peer review: 2 approved]
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Daniel Cardoso
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consensual non-monogamy ,ethical non-monogamy ,taxonomy ,onomastics ,hypernyms ,meta-methodology ,eng ,Science ,Social Sciences - Abstract
In this essay, I focus on the politics and impacts of naming, especially in the social and human sciences, and more specifically on studies that focus on subordinated or discriminated groups. Through this essay, I argue that naming conventions are some of the most important – and dangerous – tools and acts that researchers have at their disposal and, thus, should be employed with the utmost care. Considering the ongoing discussions – both inside and outside of academia – around the terms “consensual non-monogamies” and “ethical non-monogamies”, this essay proposes a novel solution to help create less morally-slanted, and overreaching, hypernyms, or umbrella terms. Here, I provide a rationale for using “explicitness” as a fundamental concept on which to build new classificatory hypernymic terminology. The terminology proposed is equally applicable (and applied) to both monogamies and non-monogamies, and is tripartite: Explicit, Implicit, and Covert. In addition to the terminological proposal, I include in this essay a series of intended limitations and constraints to its usage, its interoperability with other systems, objections to (and responses to) the usage of this system, and advantages of this novel classificatory system, as well as an outline of how this proposal might be improved upon.
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- 2024
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56. Strengths-based practice in adult social care: Understanding implementation [version 2; peer review: 2 approved]
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Sharanya Mahesh, Robin Miller, and Ila Bharatan
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strengths-based practice ,adult social care ,social work with adults ,implementation ,eng ,Medicine - Abstract
Background There has been increasing emphasis towards adopting strengths-based practice (SBP) within adult social care in England. Whilst there is agreement that SBP is the right approach to discharge adult social care duties, there is limited evidence regarding the implementation of SBP. This paper presents findings from the evaluation of the implementation of SBP in fourteen local authorities in one region in England. Methods We employed a mixed methods research design, drawing on data from a scoping review, 36 interviews with practice leaders and two surveys, one with wider adult social care staff and the other, with external organisations like independent care providers and community and voluntary organisations. Our data collection and analysis were guided by two well established implementation theories: the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT). Interviews were analysed deductively, and surveys were analysed descriptively. Results Local authorities are at different stages in their implementation journey. The Care Act 2014 and support for SBP demonstrated by key professional groups were seen as major drivers for implementing SBP. Whilst SBP resonated with the professional principles of social workers and occupational therapists, staff did not always have the confidence and skills to adapt to SBP. Changing paperwork and recording systems, providing training opportunities to develop staff competencies, establishing new care pathways, genuine co-production, and senior management buy-in were key enablers supporting implementation. Conclusions To successfully implement SBP, a whole system approach that meaningfully collaborates with key professionals across sectors is essential. When implemented well, SBP has the potential to empower individuals by focusing on what matters to them.
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- 2024
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57. Global distribution patterns of siphonophores across horizontal and vertical oceanic gradients [version 1; peer review: 2 approved]
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Cristina Claver, Xabier Irigoien, Naiara Rodríguez-Ezpeleta, and Oriol Canals
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Siphonophores ,DNA metabarcoding ,gelatinous plankton ,biogeography ,eng ,Science ,Social Sciences - Abstract
Background Siphonophores are diverse, globally distributed hydrozoans that play a central role in marine trophic webs worldwide. However, they still constitute an understudied fraction of the open ocean gelatinous taxa, mainly due to challenges related to siphonophore sampling and identification, which have led to a general knowledge gap about their diversity, distribution and abundance. Methods Here, we provide a global overview of the oceanic vertical distribution of siphonophores using DNA metabarcoding data from 77 bulk mesozooplankton samples collected at four different depth ranges (0-200, 200-500, 500-1000, 1000-3000 m depth) along the Atlantic, Pacific, and Indian Oceans during the MALASPINA-2010 circumnavigation expedition. Results We detected a total of 44 siphonophore species (which represents about one quarter of the described siphonophore species) from which 26 corresponded to Calycophores, 14 to Physonectae and 2 to Cystonectae. Our results suggest wider horizontal and vertical distributions of siphonophore species than previously described, including novel records of some species in certain oceanic basins. Also, we provide insights into the intraspecific variation of widely distributed species. Finally, we show a vertical structuring of siphonophores along the water column; Calycophores (siphonophores without pneumatophores) dominated the epipelagic (from the surface to 200 m depth) and upper mesopelagic layers (from 200 to 500 m depth), while the proportion Physonectids (siphonophores with pneumatophore) notably increased below 500 meters and were dominant at bathypelagic depths (>1000 m depth). Conclusions Our results support that the siphonophore community composition is vertically structured. Also, we provide insights into the potential existence of genetic variations within certain species that dominate some ocean basins or depth ranges. To our knowledge, this is the first time that DNA metabarcoding data is retrieved to study siphonophore distribution patterns, and the study provides evidence of the potential of molecular techniques to study the distribution of gelatinous organisms often destroyed in net sampling.
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- 2024
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58. Rituals as Nature-Based Governance of reciprocity between people and nature [version 2; peer review: 2 approved]
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Carsten Herrmann-Pillath
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ritual as nature-based governance ,interchange between people and nature ,possession as more-than-human ritual ,ritual governance of nature-based solutions ,eng ,Science ,Social Sciences - Abstract
The conventional approach to environmental governance, based on institutions, regulations, and interventions, has failed to stop the current ecological catastrophe. I suggest a radical alternative: Ritual as the core mode of ‘nature-based governance’ (NBG) that enacts deep and comprehensive reciprocity between people and nature. NBG grounds governance mechanisms in embodied more-than-human practices with normative force. I build on theories of embodiment to suggest a general concept of ritual that is inspired by but generalizes over Indigenous thought and is informed by East Asian ideas about ritual as the pivot of social order. Further, the embodiment framework recognises ritual as a kind of action humans and non-humans share as living beings. Therefore, rituals can be harnessed in workable governance mechanisms to create and sustain communities of multi-species cohabitation. I distinguish between two basic types of reciprocity corresponding to two types of governance: Disembodied reciprocity enacted by conventional human-only governance schemes and embodied reciprocity enacted by NBG. Embodied reciprocity creates relationality of people and nature. Equipped with these theoretical insights, I suggest practical applications in the context of NBG of Nature-based solutions, discussing three stylized models. These are the formation of urban multi-species communities in urban gardening and urban forests, the commoning of ecosystem services of animal populations in wildfire protection, and reconceptualizing eco-compensation as a reciprocal ritual of gift-giving,
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- 2024
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59. Feasibility of increasing calcium content of drinking tap water following quality regulations to improve calcium intake at population level [version 2; peer review: 2 approved]
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Verónica Sosio, Eduard Maury-Sintjago, Andrés Porta, José M Belizán, María Bernardita Puchulu, Jorge L López, Natalia Matamoros, Gabriela Cormick, and Jorge E Colman Lerner
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calcium ,calcium chloride ,drinking water ,low-and middle-income country ,water quality ,eng ,Medicine - Abstract
Background Calcium intake is below recommendations in several parts of the world. Improving calcium intake has benefits not only for bone health but also helps to prevent pregnancy hypertension disorders. Calcium concentration of tap water is usually low The aim of the present study was to determine the maximum amount of calcium that can be added to tap water while complying with drinking water Argentine regulations. Methods Tap water samples were collected from the Province of Buenos Aires (Argentina). Physicochemical properties and saturation index were measured. Different incremental concentrations of calcium chloride were added to the experimental aliquots. Results Baseline water had a mean calcium concentration of 22.00 ± 2.54 mg/L, water hardness of 89.9 ± 6.4 mg/L CaCO3, and a saturation index of -1.50 ± 0.11. After the addition of 0.4554 ± 0.0071 g of salt, water hard-ness reached 355.0 ± 7.1 mg/L CaCO3, a calcium concentration of 140.50 ± 2.12 mg/L, and a saturation index -0.53 ± 0.02. Conclusions This study shows that at laboratory level it is feasible to increase calcium concentration of drinking water by adding calcium chloride while complying with national standards. Calcium concentration of drinking tap water could be evaluated and minimum calcium concentration of tap water regulated so as to improve calcium intake in populations with low calcium intake.
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- 2024
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60. Tourette syndrome research highlights from 2023 [version 2; peer review: 2 approved]
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Virginie Czernecki, Cyril Atkinson-Clement, Per Andrén, Natalia Szejko, Nanette Mol Debes, Cécile Delorme, Kirsten Müller-Vahl, Kevin J. Black, Peristera Paschou, Apostolia Topaloudi, Andreas Hartmann, and Simon Morand-Beaulieu
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Tics ,Tourette ,annual review ,eng ,Medicine ,Science - Abstract
In this, the tenth annual update for the F1000Research Tics collection, we summarize research reports from 2023 on Gilles de la Tourette syndrome and other tic disorders. The authors welcome article suggestions and thoughtful feedback from readers.
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- 2024
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61. Later eating rhythm measured in children at 7 years of age in the ALSPAC cohort [version 3; peer review: 2 approved]
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Kate Northstone, Mengxuan Zou, Laura Johnson, Francisca Ibacache Fuentes, and Sam Leary
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ALSPAC ,children ,diet ,later eating rhythm ,eng ,Medicine ,Science - Abstract
Later eating rhythm (LER) refers to later timing, greater energy intake (EI), and higher frequency of eating occasions (meal/snack) in the evening. The significance of LER in child health is becoming increasingly recognised. However, the lack of consensus regarding definitions of LER make it challenging to fully comprehend its role. This data note describes LER variables derived in the Avon Longitudinal Study of Parents and Children (ALSPAC), an ongoing birth cohort which enrolled 14,541 pregnant women living in Avon, UK, with an expected date of delivery between April 1991 - December 1992. When children were 7 years, parents completed a structured 3-day food diary, recording all foods/drinks consumed over 3 days (preferably 1 weekend day and 2 weekdays). Data was available for 7,285 children (50.1% response rate). A subsample of 4,869 children had exact time of eating occasions added to the existing database, which only included broad indications of eating timing based on 2-7 hour long meal slots. 13 LER variables were derived for the entire week and weekdays/weekend days separately. These comprise: 1) eating around individual bedtime (number days); 2) eating around average bedtime (number days); 3) time of evening main meal (hrs:mins); 4) time of last eating occasion (hrs:mins); 5) EI in the evening (percentage of total daily energy intake, %TDEI); 6) EI within 2hrs before bedtime (%TDEI); 7) EI for evening main meal (%TDEI); 8) EI for evening snacks (%TDEI); 9) Night eating1 (NE1): eating over 30% of total daily energy intake after 18:00 (number days); 10) NE2: eating over 25% of total daily energy intake within 2hrs before bedtime (number days); 11) eating frequency after 17:00 (number of eating occasions); 12) regularity of dinner (number of days); 13) frequency of evening snacks (number days). We describe the derivation, prevalence and inter-corelations between LER variables.
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- 2024
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62. Effects of scapulothoracic exercises on chest mobility, respiratory muscle strength, and pulmonary function in male COPD patients with forward shoulder posture: A randomized controlled trial [version 2; peer review: 2 approved]
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Sarawut Lapmanee, Usa Chinwaro, and Kanogwun Thongchote
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COPD ,scapulothoracic exercise ,Respiratory muscles ,Shoulders ,Thoracic wall ,eng ,Medicine ,Science - Abstract
Background The postural abnormality, forward shoulder posture (FSP), is the most common cause of respiratory impairment in older individuals with chronic obstructive pulmonary disease (COPD). A recent study found that performing pectoral stretching and scapular strengthening exercises for eight weeks could reduce FSP in healthy participants. We aimed to determine the effects of pectoral stretching and scapular stabilizer strengthening exercises on FSP, chest wall mobility, respiratory muscle strength, and pulmonary function in male patients with COPD. Methods This study was randomized clinical trial. Forty male COPD patients with FSP aged 60–90 years were included and randomly allocated to control (n=20) and exercise (n=20) groups. Following completion of the scapulothoracic exercises (three days/week, for eight weeks), respiratory functions were assessed by measuring the magnitude of FSP, chest mobility, respiratory muscle strength, and pulmonary functions. Results FSP and thoracic kyphosis angle significantly decreased compared to controls (p
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- 2024
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63. Adaption and psychometric evaluation of the Hindi version of Neck Disability Index in the rural population of Northern India: A cross cultural study [version 2; peer review: 2 approved]
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Balamurugan Janakiraman, Aksh Chahal, Praveen Kumar Kandakurti, Mohammad Sidiq, Sai Jaya Prakash CH, Krishna Reddy Vajrala, Mohammad Miraj, Janvhi Singh, Abdul Aziz Almotairi, Faizan Zaffar Kashoo, Ramprasad Muthukrishnan, Yousef Almotairi, and Arunachalam Ramachandran
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Translation ,Psychometric testing ,Hindi ,Neck pain ,Neck disability index ,Rural India ,eng ,Medicine ,Science - Abstract
Background To ensure the validity and therapeutic utility of the Neck disability index (NDI) scale, translations, cultural adaptations and psychometric evidence is necessary. This study aimed to address the absence of a suitable and validated Hindi version of the NDI for the rural population. The specific objectives were to translate, adapt, and evaluate the psychometric properties of the newly developed Hindi version of the NDI. Methods Following guidelines provided by the American Association of Orthopedic Surgeons, the original English NDI scale was cross-culturally adapted into Hindi. The adaptation process included translations (forward and backward), expert committee review, pre-testing and cognitive debriefing with 30 individuals experiencing chronic non-specific neck pain. The outcome of this process was the creation of the Hindi version of the NDI, termed NDI-Hi. Subsequently, NDI-Hi was administered to 211 participants with neck pain from multiple centers for psychometric testing. The evaluation involved test-retest reliability over a 48-hour interval, factor analysis, assessment of internal reliability measures, and criterion-related validity by comparing it with the NPAD-Hindi version. Results The NDI-Hi version exhibited favorable psychometric properties, including good test-retest reliability with an intra-class correlation coefficient (ICC) of 0.87. Internal consistency of the scale was high, indicated by Cronbach’s alpha coefficient (α) of 0.96. The standard error of measurement (SEM) was determined to be 2.58, and the minimal detectable change (MDC) was calculated to be 7.15. Furthermore, the NDI-Hi showed significant correlation with the NPAD-Hindi version, with a correlation coefficient (rho) of 0.86, and a p-value of less than 0.001. Conclusions The NDI-Hi demonstrated validity and reliability as an outcome tool for assessing neck disability. It can be effectively utilized in clinical practice and research settings involving Hindi-speaking individuals with chronic non-specific neck pain. The adapted scale is particularly well-suited for the rural Northern Indian Hindi-speaking population.
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- 2024
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64. Indocyanine green based antimicrobial photodynamic therapy as an adjunct to non-surgical periodontal treatment in periodontal maintenance patients: a clinico-microbiological study [version 2; peer review: 2 approved, 1 not approved]
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Ramya Shenoy, Urbashi Roy Chowdhury, Pooja Rao, Deepa Kamath, and Suchitra Shenoy M
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Periodontal disease ,Chronic periodontitis ,Residual periodontal pockets ,Photodynamic therapy ,Laser Therapy ,Indocyanine Green ,eng ,Medicine ,Science - Abstract
Background: Antimicrobial Photodynamic therapy for the treatment of periodontitis is being increasingly gaining attention but at present, very limited data are available on the clinical and microbiological outcomes obtained following Indocyanine Green as the photosensitizer in Maintenance patients. The objective was to evaluate the efficiency of Indocyanine(ICG)-green based photodynamic therapy as an adjunct to scaling and root planing in patients enrolled in maintenance therapy. Methodology: Using a split mouth study design, 24 participants enrolled in the maintenance therapy, having diagnosed as Periodontitis, were randomly subjected to scaling and root planing(SRP). The test group additionally received ICG-based (Aurogreen®, Aurolabs, Madurai, India,1mg/ml) aPDT with an 810nm diode laser. Clinical assessment of Plaque index, modified Sulcus bleeding index, Probing pocket depth, Clinical loss of attachment and microbiological analysis of A. actinomycetemcomitans, P. gingivalis, T. forsythia and F.nucleatum were performed at baseline and 3 months after treatment. Results: It was observed that although there was no significant difference between the test and control group at baseline and 3 months, there was a statistically significant reduction in the mean values in both the groups at 3 months. Microbiological analysis showed substantial reduction in detection frequency of the bacteria assessed at 3 months in both the groups. Conclusion: Within the limits of the study, ICG-based aPDT did not show additional advantage over SRP alone at 3 months, though it could be a promising treatment modality in maintenance patients in terms of patient comfort and the treatment time taken. More randomised clinical trials should be employed to understand the exact mode of action of ICG based aPDT and its role in treatment of periodontal disease.
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- 2024
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65. Incentivizing green building technology: A financial perspective on sustainable development in India [version 1; peer review: 2 approved, 1 approved with reservations]
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Tilottama Singh, Richa Goel, Neeraj Priyadarshi, Bhekisipho Twala, Rajesh singh, and Rakesh Kumar
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Financial incentive ,Green Building ,Renewable energy ,Technology ,Government ,eng ,Medicine ,Science - Abstract
Future viability depends on ensuring a sustainable society because green energy methods may efficiently reduce greenhouse gas emissions. Nevertheless, stakeholders, consumers, and developers continue to be notably ignorant of the financial incentives connected to green technology. Moreover, there is still a dearth of studies on the range of financial incentives offered by different authorities in India. Monetary incentives, such as tax breaks, indirect tax exemptions, and refunds, are crucial in encouraging the use of green technology in the modern world. This study explores the importance of financial incentives for green building technologies in India, which also looks at the wide range of incentives provided by federal, state, and local governments. Furthermore, the study highlights various state government programs such as goods subsidies, exemptions from local taxes, and fee waivers. Notably, several incentives aimed at consumers, developers, and other stakeholders have been implemented by the Indian Green Building Council (IGBC). This review study emphasizes the effectiveness of financial incentives in green construction projects and draws attention to a clear knowledge gap regarding the adoption of green technology. This study also provides insights into potential future directions. Studies and research results emphasize the importance of spreading the word about financial incentives as a key factor in determining the adoption of green technologies. Many parties, including governmental organizations, municipal governments, developers, and clients engaged in green building technology projects, stand to gain increased awareness.
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- 2024
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66. Case Report: Acute large bowel obstruction with actinomycosis of the sigmoid colon mimicking neoplasm [version 2; peer review: 2 approved]
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Rached Bayar, Rami Zouari, Mohamed Hajri, Dhouha Bacha, Ines Mallek, and Sana ben slama
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Abdominal actinomycosis ,actinomyces ,acute intestinal obstruction ,antibiotic therapy ,surgery. ,eng ,Medicine ,Science - Abstract
Introduction Actinomycosis is an uncommon inflammatory bacterial disease caused by Actinomyces species, especially Actinomyces Israeli. Abdominopelvic forms are relatively rare and may involve the colon as a solid mass, mimicking a malignant tumor. Case presentation A 68-year-old Tunisian man, with a history of diabetes, hypertension, penicillin allergy, and renal failure, presented to the emergency department with abdominal pain, vomiting, and bowel obstruction. CT scan showed an acute intestinal obstruction upstream with obstructive tissular mass at the sigmoid colon. Emergency surgery revealed a sigmoid mass and a pre-perforative cecum. Total colectomy was performed, with ileostomy and distal end closure. Histological examination confirmed Actinomyces infection. The patient was then placed on long-term doxycycline and Bactrim, with no recurrence over a 9-month follow-up period. Conclusion Abdominal actinomycosis, though rare, presents diagnostic challenges. It can be mistaken for malignancy, leading to unnecessary surgery in non-complicated cases, since it is effectively treated by antibiotics. In complicated cases, a combined approach involving both surgery and antibiotic therapy is necessary until the infection is completely eradicated.
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- 2024
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67. A realist review of the causes of, and current interventions to address ‘missingness’ in health care. [version 2; peer review: 1 approved, 2 approved with reservations]
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Michelle Major, David A. Ellis, Andrea Williamson, Sharon Simpson, Claire Duddy, Geoff Wong, Calum Lindsay, Kate O'Donnell, Mhairi Mackenzie, and David Baruffati
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Missed appointments ,did not attend ,realist review ,primary care ,failed appointments ,missingness ,eng ,Medicine - Abstract
Background This protocol describes a realist review exploring the problem of “missingness” in healthcare, defined as the repeated tendency not to take up offers of care that has a negative impact on the person and their life chances. More specifically, the review looks at the phenomenon of patients missing multiple appointments in primary care in the UK – at the causal factors that influence how patients come to be “missing” in this way, and what interventions might support uptake and “presence” in healthcare. Background research informing this project suggests that a high rate of missed appointments predicted high premature death rates, and patients were more likely to have multiple long-term health conditions and experience significant socioeconomic disadvantage. Most research in this field focuses on population- or service-level characteristics of patients who miss appointments, often making no distinction between causes of single missed appointments and of multiple missed appointments. There have therefore been no interventions for ‘missingness’, accounting for the complex life circumstances or common mechanisms that cause people to repeatedly miss appointments. Methods We use a realist review approach to explore what causes missingness - and what might prevent or address it - for whom, and in what circumstances. The review uses an iterative approach of database searching, citation-tracking and sourcing grey literature, with selected articles providing insight into the causal dynamics underpinning missed appointments and the interventions designed to address them. Discussion The findings of this review will be combined with the findings of a qualitative empirical study and the contributions of a Stakeholder Advisory Group (STAG) to inform the development of a programme theory that seeks to explain how missingness occurs, whom it affects and under what circumstances. This will be used to develop a complex intervention to address multiple missed appointments in primary care. PROSPERO registration CRD42022346006
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- 2024
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68. Effectiveness of Motivational Interviewing and cross platform messaging application in improving oral health knowledge, attitude and behaviours among pregnant women- A Randomized Controlled Trial [version 1; peer review: 2 approved]
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Amitha Basheer N, Praveen Jodalli, Sultan Abdulrahman Almalki, and Inderjit Murugendrappa Gowdar
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Pregnancy ,Oral health ,Wellbeing ,Motivational Interviewing ,Health education ,Randomized controlled trial ,eng ,Medicine ,Science - Abstract
Background Body goes through significant hormonal and physiological changes during pregnancy, which could be linked to changes in oral health. Many women are unaware of the negative consequences of poor dental health during and after pregnancy, both for themselves and their children. Therefore, this study aimed to assess the effectiveness of Motivational Interviewing (MI) and cross platform messaging application (WhatsApp messenger) for oral health education on the oral health knowledge, attitude and behaviours among pregnant women attending ante natal care. Methods A randomized controlled trial was conducted among 84 pregnant women. Simple random sampling was employed to select participants after oral examination. Participants were randomly allocated to two groups (Group 1: Cross-platform messaging application [WhatsApp]; Group 2: MI) using a lottery method. Pregnant women aged 18 years and older, gestational age between 8 and 30 weeks were included. A face-to-face interview and oral examination were conducted to assess baseline knowledge and oral hygiene status. A follow-up examination was conducted after one month of intervention. Inferential statistics, including the chi-square test and independent t-test, were used to compare variables between the two groups. Results The mean knowledge score at baseline was comparable between Group 1 (WhatsApp) and Group 2 (MI). However, post-intervention, Group 2 showed a significantly higher mean knowledge score compared to Group 1. Post-intervention, Group 2 exhibited a significantly better oral hygiene status compared to Group 1. Significant improvements in oral health behaviours were observed in Group 2 compared to Group 1 (p < 0.001). Conclusions The findings suggested that while both interventions were effective, MI showed superior results in improving knowledge, oral hygiene status, and oral health behaviours. The personalized and client-centred approach of MI enables participants to explore and resolve ambivalence, promoting a deeper understanding of the importance of oral health during pregnancy. Registration: CTRI (CTRI/2021/09/036407, 10/09/2021).
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- 2024
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69. Lockbox enrichment facilitates manipulative and cognitive activities for mice [version 2; peer review: 2 approved]
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Kai Diederich, Katharina Hohlbaum, Paul Mieske, Niek Andresen, Rupert Palme, Benjamin Lang, Henning Sprekeler, Lars Mundhenk, Christa Thöne-Reineke, Olaf Hellwich, Pia Kahnau, and Lars Lewejohann
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Mice ,refinement ,animal welfare ,enrichment ,home cage ,cognition ,eng ,Science ,Social Sciences - Abstract
Background Due to the lack of complexity and variety of stimuli, conventional housing conditions of laboratory mice do not allow these animals to fully express their behavioral repertoire, including manipulative and cognitive activities. Therefore, we designed mechanical puzzles, so-called lockboxes, for mice that can be provided in their home cages. We investigated the impact of the lockbox enrichment on their phenotype and affective state when compared to conventional housing (CH) and super-environmental enrichment (SEE). Methods Young adult female C57BL/6JCrl mice were examined before and after 2-month exposure to the different types of enrichment in a phenotyping test battery, including tests for trait and state anxiety-related behavior, calorimetric measurements, body weight measurements, the analysis of stress hormone metabolite concentrations, and sequential problem-solving abilities with a novel lockbox. At the end of the study, adrenal gland weights were determined and pathohistological evaluation was performed. For all continuous variables, the relative variability was calculated. Results While the different types of enrichment affected trait anxiety-related behavior, neither state anxiety-related behavior nor physiological variables (i.e., bodyweight, resting metabolic rate, stress hormone metabolite concentrations, adrenal gland weights) were influenced. LE improved sequential problem-solving (i.e., solving novel lockboxes) when compared to SEE. Regardless of the housing condition, the relative variability increased in most variables over time, although the coefficient of variation decreased for some variables, especially in animals with access to LE. There was no evidence of toxicopathological effects associated with the material from which the lockboxes were made. Conclusions All lockboxes are available as open-source tool. LE revealed beneficial effects on the affective state of laboratory mice and their performance in solving novel lockboxes. Neither relevant phenotype of the mice nor reproducibility of the data were compromised by LE, similar to SEE. The lockboxes may also be used as novel approach for assessing cognition in mice.
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- 2024
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70. A guide to selecting high-performing antibodies for Huntingtin (UniProt ID: P42858) for use in western blot, immunoprecipitation, and immunofluorescence [version 1; peer review: 2 approved]
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Rachel J. Harding, Carl Laflamme, Sara González Bolívar, Aled M. Edwards, Kathleen Southern, Rebeka Fanti, Riham Ayoubi, Charles Alende, Maryam Fotouhi, and Renu Chandrasekaran
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UniProt ID P42858 ,HTT ,Huntingtin ,antibody characterization ,antibody validation ,western blot ,eng ,Medicine ,Science - Abstract
Huntingtin encodes a 3144 amino acid protein, with a polyglutamine repeat tract at the N-terminus. Expansion of this repeat tract above a pathogenic threshold of 36 repeats is the causative mutation of Huntington's disease, a neurodegenerative disorder characterized by loss of striatal neurons. Here we have characterized twenty Huntingtin commercial antibodies for western blot, immunoprecipitation, and immunofluorescence using a standardized experimental protocol based on comparing read-outs in knockout cell lines and isogenic parental controls. These studies are part of a larger, collaborative initiative seeking to address antibody reproducibility issues by characterizing commercially available antibodies for human proteins and publishing the results openly as a resource for the scientific community. While use of antibodies and protocols vary between laboratories, we encourage readers to use this report as a guide to select the most appropriate antibodies for their specific needs.
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- 2024
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71. Comparative Analysis of Psychological Well-Being and Emotional Education in Graduate Students [version 2; peer review: 1 approved, 2 approved with reservations]
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Graciela Josefina Castro-Castillo, Tibisay Milene Lamus de Rodríguez, Eduardo Javier Espinoza-Solís, and Jenniffer Sobeida Moreira-Choez
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Emotional intelligence ,psychological well-being ,emotional education ,educational strategies ,graduate students ,eng ,Medicine ,Science - Abstract
Background The growing importance of emotional intelligence in academic and professional contexts has generated a need to explore its linkage with psychological well-being. Furthermore, understanding how various demographic and academic factors can influence students' emotional perception and management is crucial for optimizing educational and intervention strategies. In this context, the primary purpose of this study was to analyze the existing relationship between emotional education and psychological well-being in graduate students. Methods The objective was to conduct a comparative analysis of perceived emotional intelligence (PEI) in different study programs offered at a specific university. The methodology, framed within a positivist paradigm, was based on a quantitative approach and examines the responses of 1,522 university students using the Trait Meta-Mood Scale (TMMS-24). Results This tool, which is divided into three dimensions (emotional attention, emotional clarity, and emotional repair), was analyzed using descriptive statistics, correlation analysis, and ANOVA tests to determine demographic and academic influences on the scores. The findings indicate deficiencies in the areas of Emotional Attention and Emotional Repair, contrasting with a marked prevalence in Emotional Clarity. Variables such as sex, age, and field of study demonstrated an influence on the dimensions of PEI. Notably, significant differences in emotional perception were found between sex and academic fields. Conclusions Specifically, training directed towards empathy proved to be a prominent factor in the perception of emotional competencies. This study highlights the influence of demographic and academic variables on emotional competencies, underscoring the need to adapt strategies in education and therapy.
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- 2024
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72. ENOVAT: the European Network for Optimization of Veterinary Antimicrobial Treatment [version 1; peer review: 2 approved]
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Annet Heuvelink, Marcel Erhard, Gudrun Overesch, Lisbeth Rem Jessen, Jonathan Gómez Raja, Ludovic Pelligand, Dorina Timofte, Karolina Scahill, Kees Veldman, Ana P Vale, Els M Broens, Luis Pedro Carmo, Fergus Allerton, Peter Damborg, Chantal Britt, Alain Bousquet-Mélou, Iskra Cvetkovikj, and Petra Cagnardi
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Antimicrobial ,antimicrobial resistance ,antimicrobial treatment ,treatment guideline ,ECOFF ,MALDI-TOF MS ,eng ,Science ,Social Sciences - Abstract
The global antimicrobial resistance crisis has been the driver of several international strategies on antimicrobial stewardship. For their implementation on field level, the veterinary sector encounters several specific challenges and in particular: (i) a shortage of experts in key disciplines related to antimicrobial stewardship, (ii) a lack of evidence-based antimicrobial treatment guidelines, and (iii) inferior diagnostic tests available compared to human medicine. The present white paper describes how the COST Action ENOVAT (the European Network for Optimization of Veterinary Antimicrobial Treatment, CA18217), comprising 332 persons from 51 countries, worked towards solutions to these challenges. Initially, surveys were conducted to explore the present state in Europe in terms of existing antimicrobial use guidelines and microbiology practices performed. Concurrently, various research activities were launched to optimize diagnostics, including development of epidemiological cut-offs, clinical breakpoints and matrix-assisted laser desorption ionization time of flight mass spectrometry interpretive criteria. Also, guidelines drafting groups working towards evidence-based antimicrobial treatment guidelines for six conditions in food-producing and companion animals were established. The processes and outcomes, also in terms of capacity building, are summarized in this white paper where emphasis is placed on sustainability of the activities. Although several ENOVAT initiatives and spin-off projects will continue beyond the Action, we recommend that a new European veterinary research agenda is launched focusing on research and funding leading to long-term impacts on veterinary antimicrobial use.
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- 2024
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73. An Analysis of the Health Effects of Physical Activity due to Active Travel Policies in Rennes, France [version 2; peer review: 2 approved]
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Samuel Younkin, Natalie Levine, Jonathan Patz, Anne Roué Le Gall, and Henry Fremont
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Health-Oriented Transportation ,Active Travel ,Active Transportation ,Public Health ,Physical Activity ,Sustainability ,eng ,Medicine ,Science - Abstract
Background Rennes, a midsize city in France, features many opportunities for active travel. City officials seek to increase walking and cycling by 2030 to improve public health. Physical inactivity, a leading risk factor for premature mortality around the globe, has been shown to be associated with many chronic diseases including heart disease, type 2 diabetes, and cancer. Methods Using the 2018 household travel survey of Rennes residents, we apply the Health-Oriented Transportation statistical model to assess health impacts associated with population-level rates of walking and cycling. We consider two proposed mobility and climate objectives which outline sustainable transportation goals by 2030. These include a shift in transportation mode share to increase walking and cycling trips, as well as a broad reduction in vehicle miles traveled (VMT) across the metropolitan area. Results Our regression analysis demonstrated that factors of household car access and inner-city residency were predictors of prevalence (observed one-day proportion engaging in walking or cycling), participation (weekly proportion), and intensity (mean individual physical activity achieved through walking/cycling) of active travel. Age and education were additionally associated with prevalence. The 2030 mobility objective (mode share: 9% cycle, 35% walk) was associated with a reduction of 1,051 DALYs (disability-adjusted life-years), translating to $73 million USD ($23-$177) in averted costs. The climate objective (10% reduction in VMT) was associated with a reduction of 369 DALYs when replaced entirely by walking and 714 DALYs with cycling, translating to $26 million ($8-$62) and $50 million ($15-$121) saved, respectively. Conclusions Rennes residents experience high participation in active travel, particularly those in the inner city. If residents achieve the city’s active travel goals for 2030, there is potential for a large reduction in health burden and subsequent costs. Reaching these goals may require significant investment in transportation programming and infrastructure to improve active travel opportunities.
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- 2024
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74. Experimental Human Pneumococcal Carriage using Streptococcus pneumoniae serotype 3 in Malawi: a dose ranging and reproducibility human infection study [version 1; peer review: 2 approved, 1 approved with reservations]
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Clara Ngoliwa, Kondwani Jambo, Neema Toto, Vitumbiko S. Nkhoma, Lorensio Chimgoneko, Marc Henrion, Lumbani Makhaza, John Ndaferankhande, Stephen B. Gordon, Gift Chiwala, Gareth Lipunga, Anthony Emeritus Chirwa, Bridgette Galafa, Faith Thole, Evarista Kudowa, Morrison Peace Kamanga, Godwin Tembo, Dingase Dula, Daniela M. Ferreira, Tarsizio Chikaonda, Ndaziona Peter Kwanjo Banda, and Edna Nsomba
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Pneumococcal carriage ,Streptococcus pneumoniae Serotype 3 ,Experimental Human Pneumococcal Challenge ,Human Infection Study ,Controlled Human Infection Model ,vaccine ,eng ,Medicine ,Science - Abstract
Background Streptococcus pneumoniae is a major cause of morbidity and mortality from respiratory tract infections, pneumonia, meningitis, and sepsis. Nasopharyngeal carriage of pneumococcus is a prerequisite for pneumococcal disease and transmission. Since the global introduction of pneumococcal conjugated vaccines, rates of pneumococcal disease have declined for many vaccine type serotypes but serotype 3 (SPN3) continues to cause significant disease. The Experimental Human Pneumococcal Challenge (EHPC) model is a unique method of determining pneumococcal colonisation, understanding the impact of colonisation on acquired immunity and for testing pneumococcal vaccines. This study will develop a serotype 3 EHPC model to address some pertinent questions on the burden of pneumococcal disease in Malawi. Methods Healthy adults aged 18-50 years will be recruited, with a maximum target of 83 participants to complete all study visits. The study will consist of a dose ranging and safety study, followed by a reproducibility study. Sequential cohorts of 10 healthy participants will be challenged with escalating doses of SPN3 in the dose ranging study. Samples will be collected before inoculation and on days 2, 7, 13, 16, 21 and 28 following inoculations, for determination of carriage. A total of 33 participants will be enrolled in the reproducibility part and will use a dose that established ≥60% of carriage, and with a high safety profile. Samples will be collected for determination of both local and systemic immunological responses to pneumococcal challenge. Upon completion of study visits, participants will complete a questionnaire establish acceptability. Interpretations We expect to establish an optimal SPN3 dose required to establish nasopharyngeal colonisation in healthy adults in an EHPC model. The model can then be used to evaluate pneumococcal vaccines in both healthy and at-risk populations.
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- 2024
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75. Case Report: Soft tissue infection with Burkholderia thailandensis capsular variant: case report from the Lao PDR [version 1; peer review: 2 approved, 1 approved with reservations]
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Rathanin Seng, Natnaree Saiprom, Narisara Chantratita, Sayaphet Rattanavong, Sarunporn Tandhavanant, Manophab Luangraj, Andrew Simpson, Tamalee Roberts, David Dance, and Souphaphone Vannachone
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Burkholderia thailandensis ,B. thailandensis capsular variant ,Lao PDR ,eng ,Medicine ,Science - Abstract
Background Burkholderia thailandensis is an environmental bacteria closely related to Burkholderia pseudomallei that rarely causes infection in humans. Some environmental isolates have shown to express a capsular polysaccharide known as B. thailandensis capsular variant (BTCV), but human infection has not previously been reported. Although B. thailandednisis has been identified in environmental samples in Laos before, there have not been any human cases reported. Case A 44-year-old man presented to a district hospital in Laos with a short history of fever and pain in his left foot. Physical examination identified a deep soft-tissue abscess in his left foot and an elevated white blood count. A deep pus sample was taken and melioidosis was suspected from preliminary laboratory tests. The patient was initially started on cloxacillin, ceftriaxone and metronidazole, and was then changed to ceftazidime treatment following local melioidosis treatment guidelines. Laboratory methods A deep pus sample was sent to Mahosot Hospital microbiology laboratory where a mixed infection was identified including Burkholderia sp. Conventional identification tests and API 20NE were inconclusive, and the B. pseudomallei-specific latex agglutination was positive. The isolate then underwent a Burkholderia species specific PCR which identified the isolate as B. thailandensis. The isolate was sent for sequencing on the Illumina NovaSeq 6000 system and multi-locus sequence typing analysis identified the isolate had the same sequence type (ST696) as B. thailandensis E555, a strain which expresses a B. pseudomallei-like capsular polysaccharide. Conclusion This is the first report of human infection with B. thailandensis in Laos, and the first report of any human infection with the B. thailandensis capsular variant. Due to the potential for laboratory tests to incorrectly identify this bacteria, staff in endemic areas for B. thailandensis and B. pseudomallei should be aware and ensure that appropriate confirmatory methods are used to differentiate between the species.
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- 2024
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76. Towards implementing telemedicine in Tunisia: A knowledge, attitude and practice study among medical doctors [version 2; peer review: 1 approved, 2 approved with reservations]
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Nesrine Souayeh and Mariem Nouira
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telemedicine ,knowledge ,attitude ,medical informatics ,Tunisia ,eng ,Medicine ,Science - Abstract
Background: The use of information and communication technology such as telemedicine occupies nowadays a huge place in modern medicine practice all over the world, mainly after the COVID-19 pandemic. However, its implementation in Tunisia and other developing countries has achieved little success with low utilization and can be challenging for several reasons. In this study, our aim was to assess the knowledge, attitudes and practice of Tunisian medical doctors regarding telemedicine. Methods: This was a cross-sectional web survey, administered to medical doctors in Tunisia in October 2022. Respondents’ level of knowledge of telemedicine was assessed by calculating a knowledge score (0 to 12). Attitude subsections were about perceived telemedicine attributes of relative advantage, compatibility, trial ability and complexity. Results: A total of 243 participants were included. The mean age was 45 ± 9.6 years old, and 57.2% were female, with a mean of 14.3 ± 10.3 years of professional experience. The majority (95.9%) had an average or high level of computer skills. More than half (59.3%) had a poor level of telemedicine knowledge. A good level of knowledge was significantly associated with age category over 50 years (p = 0.02) and with years of experience over 10 (p = 0.03). The majority (89.3%) had a moderate or high score about perceived advantages. The majority (88.5%) accepted use of telemedicine in their future practice. Almost half (46.9%) had practiced telemedicine activities before using a mobile phone (91%) or social media (64%). The principal limitations of applying telemedicine were challenges of organization and implementation, and incomplete patient examination. Conclusions: Although Tunisian doctors’ knowledge and practice of telemedicine were unsatisfactory, their positive attitude and willingness to try it in their future practice were encouraging. There is an urgent need for implementing telemedicine in Tunisia to improve health care coverage in some unprivileged areas.
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- 2024
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77. Articulating the ultimate objectives of research capacity strengthening programmes: Why this is important and how we might achieve it. [version 1; peer review: 2 approved]
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Nadia Tagoe, Justin Pulford, Imelda Bates, and Meshack Nzesei Mutua
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Research capacity strengthening ,evaluation ,global South ,eng ,Medicine ,Science - Abstract
‘Research capacity strengthening’ (RCS) is an umbrella term that can be used to describe a wide variety of activities conducted in support of diverse objectives premised upon distinct, potentially opposing, views. Despite this, the ultimate objective of RCS activities is rarely made explicit which can be problematic when diverse objectives are possible. By ‘ultimate’ objective we are referring to the overarching (often long-term) goal an RCS initiative is intended to contribute towards (e.g. better population health) as opposed to the more immediate ‘proximate’ (often short-term) objectives of any such activity (e.g. improved capacity to undertake infectious disease research). We argue a need for those funding, designing and implementing RCS initiatives to make clear statements as to the ultimate objective that they foresee their respective initiative contributing towards as well as the proposed pathway and associated assumptions that underlie their approach. Examples of distinct ultimate objectives for RCS initiatives are presented alongside fictitious examples of how they may be transparently reported from both a funder and implementor perspective. Such transparency should be routine within the scope of funding calls for RCS activities (even when such activities are only a minor component of the call), subsequent applications to those calls and any description of an applied RCS activity/ies and/or the associated outcomes thereof. The process of determining one’s ultimate objective will further cause funders and actors to think through their respective initiatives more thoroughly and make informed choices and better designed RCS projects. Doing so would reduce any ambiguity associated with the use of the term ‘research capacity strengthening’ and would provide a stronger foundation for robust programme evaluation.
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- 2024
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78. Key Guidelines for Responding to Reviewers [version 1; peer review: 2 approved]
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Sana Salah, Hela Kamoun, Saida Hidouri, Anis Jellad, and Helmi Ben Saad
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Academic publishing ,Manuscript evaluation ,Manuscript review process ,Peer assessment ,Peer review ,Research quality ,eng ,Medicine ,Science - Abstract
Background The process of preparing a scientific manuscript is intricate, encompassing several critical stages, including pre-writing, research development, drafting, peer review, editing, publication, dissemination, and access. Among these, the peer review process (PRP) stands out as a pivotal component requiring seamless collaboration among editors, reviewers, and authors. Reviewers play a crucial role in assessing the manuscript’s quality and providing constructive feedback, which authors must adeptly navigate to enhance their work and meet journal standards. This process can often appear daunting and time-consuming, as authors are required to address numerous comments and requested changes. Authors are encouraged to perceive reviewers as consultants rather than adversaries, viewing their critiques as opportunities for improvement rather than personal attacks. Methods Opinion article. Aim To equip authors with practical strategies for engaging effectively in the PRP and improving their publication acceptance rates. Results Key guidelines include thoroughly understanding and prioritizing feedback, maintaining professionalism, and systematically addressing each comment. In cases of significant disagreement or misunderstanding, authors have the option to refer the issue to the editor. Crafting a well-organized and scientific “response to reviews” along with the revised manuscript can substantially increase the likelihood of acceptance. Best practices for writing an effective response to reviews include expressing gratitude, addressing major revisions first, seeking opinions from co-authors and colleagues, and adhering strictly to journal guidelines. Emphasizing the importance of planning responses, highlighting changes in the revised manuscript, and conducting a final review ensures all corrections are properly documented. Conclusion By following these guidelines, authors can enhance their manuscripts’ quality, foster positive relationships with reviewers, and ultimately contribute to scholarly advancement.
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- 2024
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79. Managing hypertension in rural Gambia and Kenya: Protocol for a qualitative study exploring the experiences of patients, health care workers, and decision-makers [version 3; peer review: 2 approved]
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Anthony Etyang, Ellen Nolte, Brahima A. Diallo, Nancy Kagwanja, Syreen Hassan, Noni Mumba, Robinson Oyando, Jainaba Badjie, Andrew M. Prentice, Benjamin Tsofa, and Pablo Perel
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Hypertension ,intervention ,community-centred ,management ,control ,health care workers ,eng ,Medicine - Abstract
Background Hypertension is the single leading risk factor for premature death in Sub-Saharan Africa (SSA). Prevalence is high, but awareness, treatment, and control are low. Community-centred interventions show promise for effective hypertension management, but embedding such interventions sustainably requires a good understanding of the wider context within which they are being introduced. This study aims to conduct a systematic health system assessment exploring the micro (patients/carers), meso (health care workers and facilities), and macro (broader system) contexts in rural Gambia and Kenya. Methods This study will utilise various qualitative approaches. We will conduct (i) focus group discussions with people living with hypertensive to map a ‘typical’ patient journey through health systems, and (ii) in-depth interviews with patients and family carers, health care workers, decision-makers, and NCD partners to explore their experiences of managing hypertension and assess the capacity and readiness of the health systems to strengthen hypertension management. We will also review national guidelines and policy documents to map the organisation of services and guidance on hypertension management. We will use thematic analysis to analyse data, guided by the cumulative complexity model, and theories of organisational readiness and dissemination of innovations. Expected findings This study will describe the current context for the management of hypertension from the perspective of those involved in seeking (patients), delivering (health care workers) and overseeing (decision-makers) health services in rural Gambia and Kenya. It will juxtapose what should be happening according to health system guidance and what is happening in practice, drawing on the experiences of study participants. It will outline the various barriers to and facilitators of hypertension management, as perceived by patients, providers, and decision-makers, and the conditions that would need to be in place for effective and sustainable implementation of a community-centred intervention to improve the management of hypertension in rural settings.
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- 2024
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80. Principled pragmatism: A Latin American contribution for foreign policy analysis? [version 2; peer review: 2 approved, 1 not approved]
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Rafael Velazquez Flores and Alejandro Monjaraz-Sandoval
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Foreign Policy Analysis ,Latin America ,Principled Pragmatism ,Realism ,Institutional Liberalism ,Constructivism ,eng ,International relations ,JZ2-6530 - Abstract
The key purpose of this paper is to identify key Latin American theories proposed to study foreign policy. The essay points out that Latin America has made a significant contribution to foreign policy analysis. The most important conceptual contribution in the field is the concept of principled pragmatism. A crucial premise is that Latin American nations resort to this type of policy to come to agreement with the United States, address domestic issues, advance national interests, and cope with economic problems. The paper is divided into four sections. The first describes key analytical models and theoretical approaches created to explain foreign policy. The second identifies the Latin American thought on this subject. The third section explains the concept of principled pragmatism. This approach stems from the models and theories explained in the second section and from the Latin American thinking described in the third section. The last segment explains the case study of Cuban foreign policy in the early 1960s using the notion of principled pragmatism.
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- 2024
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81. Leveraging Quadratic Polynomials in Python for Advanced Data Analysis [version 2; peer review: 2 approved]
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Olena Voloshkina, Rostyslav Sipakov, and Anastasiia Kovalova
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python ,quadratic polynomials ,analyzing data ,polynomial model ,eng ,Medicine ,Science - Abstract
This research explores the application of quadratic polynomials in Python for advanced data analysis. The study demonstrates how quadratic models can effectively capture nonlinear relationships in complex datasets by leveraging Python libraries such as NumPy, Matplotlib, scikit-learn, and Pandas. The methodology involves fitting quadratic polynomials to the data using least-squares regression and evaluating the model fit using the coefficient of determination (R-squared). The results highlight the strong performance of the quadratic polynomial fit, as evidenced by high R-squared values, indicating the model’s ability to explain a substantial proportion of the data variability. Comparisons with linear and cubic models further underscore the quadratic model’s balance between simplicity and precision for many practical applications. The study also acknowledges the limitations of quadratic polynomials and proposes future research directions to enhance their accuracy and efficiency for diverse data analysis tasks. This research bridges the gap between theoretical concepts and practical implementation, providing an accessible Python-based tool for leveraging quadratic polynomials in data analysis.
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- 2024
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82. The genome sequence of a segmented worm, Terebella lapidaria Linnaeus, 1767 [version 1; peer review: 2 approved]
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Anna Holmes, Patrick Adkins, Teresa Darbyshire, John Bishop, and Nova Mieszkowska
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Terebella lapidaria ,a segmented worm ,genome sequence ,chromosomal ,Terebellida ,eng ,Medicine ,Science - Abstract
We present a genome assembly from an individual Terebella lapidaria (segmented worm; Annelida; Polychaeta; Terebellida; Terebellidae). The genome sequence spans 765.20 megabases. Most of the assembly is scaffolded into 16 chromosomal pseudomolecules. The mitochondrial genome has also been assembled and is 15.97 kilobases in length.
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- 2024
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83. Factors affecting community ambulation post-stroke: a mapping review protocol [version 2; peer review: 2 approved]
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Jane Morgan-Daniel, Sudeshna A. Chatterjee, Kanika Bansal, and Dorian K. Rose
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Real-world ,Participation ,Re-integration ,Outdoor ,Walking ,Scoping Review ,eng ,Medicine ,Science - Abstract
Background Most stroke survivors consider community ambulation an essential but unmet goal of their recovery. Historically, interventions to enhance community ambulation have focused on improving biomechanical impairments of gait; however, recent evidence suggests that biopsychosocial and environmental factors may impact community ambulation, even beyond more obvious physical impairments. The identification of factors that pose as significant facilitators or barriers to community ambulation may serve to guide stakeholders in designing relevant and evidence-based interventions for improving community ambulation post-stroke. Objective This review aims to map the type and extent of existing evidence on the physical, biopsychosocial, and environmental factors affecting community ambulation post-stroke. Additionally, this review will describe the various methods used to examine the extent to which stroke survivors are restricted to community ambulation. Methods Nine databases will be searched including CINAHL, PubMed, and Web of Science. We will include studies published in English during or after 2001. Studies that examine physical, biopsychosocial, and/or environmental factors affecting community ambulation in ambulatory adults at least six months post-stroke will be considered for inclusion. Studies that assess general physical activity or community mobility through transportation modes other than walking will be excluded. All identified records will be collated in citation management software, followed by steps of deduplication, title/abstract screening, and full-text reviews by at least two independent reviewers. The bibliographies of the extracted studies will also be reviewed for relevant articles. The extracted studies will be analyzed, critically appraised, and presented in tabular, narrative, and evidence map formats. Discussion The evidence gained will be used to build a framework for community ambulation, informing stakeholders to develop meaningful interventions to improve community ambulation. The mapped evidence will motivate future studies to develop holistic approaches that specifically focus on the most vital factors that influence post-stroke community ambulation.
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- 2024
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84. Zoom fatigue related to online learning among medical students in Thailand: Prevalence, predictors, and association with depression [version 2; peer review: 2 approved]
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Thammanard Charernboon, Korravit Hanvivattanakul, Rinradee Lenavat, Veevarin Charoenporn, Sirashat Hanvivattanakul, and Kanathip Jongmekwamsuk
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depression ,medical students ,online learning ,videoconferencing fatigue ,Zoom fatigue ,eng ,Medicine ,Science - Abstract
Background Amidst the COVID-19 pandemic, the learning pattern of medical students shifted from onsite to online. This transition may contribute to what has been called “Zoom fatigue.” This study aimed to evaluate the prevalence of Zoom fatigue related to online learning, identify associated factors of Zoom fatigue, and explore its correlation with depression among medical students during the COVID-19 pandemic. Methods This cross-sectional study was conducted among 1st to 6th-year Thai medical students. The online survey was administered using a demographic and health behavior questionnaire, the Patient Health Questionnaire-9 (PHQ-9), and the Thai version of the Zoom Exhaustion & Fatigue Scale (ZEF-T). Results Among the 386 participating students, 221 (57%) were female, with a mean age of 20.6 years. The prevalence of high Zoom fatigue was 9.6%. In the multivariable regression analysis, a lower academic year and a higher number of online learning sessions were significant predictors of Zoom fatigue (p < 0.001), while regular exercise emerged as a protective factor (p = 0.009). The prevalence of depressive disorder was 61.9%, and a significant correlation was found between having a depressive disorder and experiencing Zoom fatigue (p = 0.004). Conclusion Zoom fatigue among medical students was correlated with depression. Consequently, medical students experiencing Zoom fatigue should undergo further assessment for depression. It is crucial to closely monitor medical students in lower academic years with a high number of online sessions for signs of Zoom fatigue. Additionally, implementing strategies, such as reducing the frequency of online sessions and promoting regular exercise, may help alleviate the symptoms.
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- 2024
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85. Views and practices on medical cannabis of unlicensed providers in Thailand: a qualitative study [version 4; peer review: 2 approved]
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Darika Saingam, Muhammadfahmee Talek, Kanittha Thaikla, and Sawitri Assanangkornchai
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Medical cannabis ,illegal providers ,prescription practice ,in-depth interview ,legalization ,decriminalization ,eng ,Medicine ,Science - Abstract
Background Despite the legalization of cannabis use for medical purposes in Thailand in February 2019, illicit providers are still widespread and accessible. This study aimed to understand why people still chose to receive medical cannabis treatment or products from unlicensed or illegal providers. The practices of unlicensed or illegal providers in provision of medical cannabis products or treatment services were also examined. Methods Qualitative in-depth interviews were conducted among medical cannabis providers and users, including 36 unlicensed and 7 licensed providers and 25 users in 2019-2021. Snowball sampling was used to recruit participants until saturation of data was achieved. Interviews included open-ended questions about the providers’ practices and attitudes towards medical cannabis. Interviews were recorded and transcribed, and thematic analysis was performed. Results Overall, six reasons were identified to answer why unlicensed/illicit providers were still popular, including: 1) easy accessibility; 2) familiarity with the unlicensed providers before the legal scheme became available; 3) favorable characters (kind, supportive, non-judgmental) of unlicensed providers; 4) affordable treatment fees; 5) trust in the quality of the medicines; and 6) lack of knowledge and negative attitudes towards cannabis from healthcare professionals. Most providers started their career as medical cannabis providers by using it themselves or with their relatives and being satisfied with the results. They used cannabis products to treat all diseases, including skin, eyes, HIV/AIDS, non-communicable diseases and all kinds of cancers. Additionally, they believed that it was effective, with no or minimal adverse effects. Conclusions This study suggests that some patients will continue receiving medical cannabis treatment and products from unlicensed or illegal providers. More attention should be paid on increasing the capacity of medical cannabis service systems within public health hospitals, and the certification of unlicensed providers, so as to integrate them into a regulated system.
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- 2024
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86. Long-Term Impact of a Medical School Course on the Intersection of Art and Medical History [version 2; peer review: 1 approved, 2 approved with reservations]
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Gabriel Slamovits, Bobbi G. Coller, and Barry S. Coller
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art history ,medical history ,wellness ,humanities ,medical education ,eng ,Special aspects of education ,LC8-6691 ,Medicine - Abstract
Background One recent trend in medical education is the integration of humanities into the curriculum, including viewing works of art in museums, with analysis of short-term, but not long-term, impact. We developed a course for medical students, trainees, and faculty at the Icahn School of Medicine at Mount Sinai co-taught by an art historian and a physician/medical historian that features images of great works of art to make connections between art and medical history with the following goals: 1. To encourage the students to make careful and systematic observations, describe what they see to others in the group, and exchange their views respectfully, 2. To sensitize students to the patient’s experience of illness by discussing artists’ depictions of patients and the impact of their illness on family and friends, and 3. To highlight milestones in medical history by focusing on artworks that epitomize the state of medical care and science at a defined point in time. We have taught the course for more than a decade and so wanted to assess whether participating in the course had a long-term impact. Methods We created and deployed a five-question survey to 167 students and received responses from 35 of those students. Results 97% of respondents answered that they still think about the course, and large majorities of the respondents indicated that the course, had an impact on how they viewed works of art (91%), their appreciation of the history of medicine (89%), and their observational skills (80%). More than half the students responded that the course sensitized them to the patient’s perspective of illness (63%) and had an impact on how they viewed their role as a physician (51%). Conclusions Our course has had a long-term impact on the respondents across a wide range of professional and personal characteristics.
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- 2024
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87. Estimating dengue disease and economic burden to inform municipal-level policymakers: Method for a pragmatic city-level observational cohort study [version 3; peer review: 2 approved, 1 approved with reservations, 1 not approved]
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Sri Andriani, Nandyan N. Wilastonegoro, Priya Agarwal-Harding, Perigrinus H. Sebong, and Donald S. Shepard
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cost ,dengue ,economic burden ,Indonesia ,pragmatic ,presenteeism ,eng ,Medicine - Abstract
Background Recent trials have confirmed the effectiveness of promising dengue control technologies – two vaccines and Wolbachia. These would generally be applied at the municipal level. To help local officials decide which, if any, control strategy to implement, they need affordable, timely, and accurate data on dengue burden. Building on our previous work in Mexico, Indonesia, and Thailand, we developed a streamlined prospective method to estimate dengue burden at the municipal level quickly, accurately, and efficiently. Methods The method entails enrolling and repeatedly interviewing 100 patients with laboratory-confirmed dengue. They will be selected after screening and testing about 1,000 patients with clinical dengue. The method will capture both acute and chronic effects relating to disease, economic burden, and psychological impacts (presenteeism). The total time requirements are 1.5 years, comprised of 0.25 years for planning and approvals, 1 year for data collection (a full dengue cycle), and 0 .25 years for data cleaning and analysis. A collaboration with municipal and academic colleagues in the city of Semarang, Central Java, Indonesia shows how the method could be readily applied in Indonesia’s eighth largest city (population 1.8 million). Conclusions Many surveillance studies gather only information on numbers of cases. This proposed method will provide a comprehensive picture of the dengue burden to the health system, payers, and households at the local level.
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- 2024
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88. Machine learning based stellar classification with highly sparse photometry data [version 2; peer review: 2 approved, 1 approved with reservations]
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Sebastian Scher, Seán Enis Cody, Albert Zijlstra, Iain McDonald, Nick Cox, and Emma Alexander
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stellar classification ,photometry ,astrophysics ,machine learning ,sparsity ,XGBoost ,eng ,Science ,Social Sciences - Abstract
Background Identifying stars belonging to different classes is vital in order to build up statistical samples of different phases and pathways of stellar evolution. In the era of surveys covering billions of stars, an automated method of identifying these classes becomes necessary. Methods Many classes of stars are identified based on their emitted spectra. In this paper, we use a combination of the multi-class multi-label Machine Learning (ML) method XGBoost and the PySSED spectral-energy-distribution fitting algorithm to classify stars into nine different classes, based on their photometric data. The classifier is trained on subsets of the SIMBAD database. Particular challenges are the very high sparsity (large fraction of missing values) of the underlying data as well as the high class imbalance. We discuss the different variables available, such as photometric measurements on the one hand, and indirect predictors such as Galactic position on the other hand. Results We show the difference in performance when excluding certain variables, and discuss in which contexts which of the variables should be used. Finally, we show that increasing the number of samples of a particular type of star significantly increases the performance of the model for that particular type, while having little to no impact on other types. The accuracy of the main classifier is ∼0.7 with a macro F1 score of 0.61. Conclusions While the current accuracy of the classifier is not high enough to be reliably used in stellar classification, this work is an initial proof of feasibility for using ML to classify stars based on photometry.
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- 2024
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89. Poweromin X Ten, a polyherbal formulation improves male sexual function: In vivo and network pharmacology study [version 2; peer review: 2 approved]
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Bharath Harohalli Byregowda, Esekia Raja Selvan, Sai Teja Meka, C. Mallikarjuna Rao, Gangadhar Hari, Bhim Bahadur Chaudhari, Kiran Kumar Kolathur, Sree Lalitha Bojja, Anoop Austin, Nitesh Kumar, and Sudheer Moorkoth
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LC-MS/MS ,Network pharmacology ,Polypharmacology ,Reproductive toxicity ,Sexual activity ,Dopamine ,eng ,Medicine ,Science - Abstract
Introduction Poweromin X Ten (PXT) is a polyherbal formulation, traditionally used to enhance male sexual function. However, the safety and benefits of PXT have not been scientifically evaluated. Therefore, the present study investigated the toxicity and aphrodisiac potential of PXT in male rats and explored its principal mechanisms of action. Methods Male Wistar rats were orally administered PXT (50 or 100 mg/kg) for 28 days, and sexual activity parameters, including latency and frequency of mounting and intromissions, were studied. The reproductive toxicity and spermatogenic potential were also examined. Furthermore, dopamine and serotonin levels in brain regions associated with sexual activity were assessed. Network analysis was used to identify the key bioactive compounds and their core targets involved in their beneficial actions. Results Treatment with PXT improved sexual activity in male rats, as evidenced by reduced mounting and intromission latency and a significant increase in mount frequency. Moreover, PXT exhibited spermatogenic potential and did not induce reproductive toxicity. Notably, treatment with 50 mg/kg PXT elevated dopamine levels in median preoptic area and hypothalamus. Pathway analysis indicated that PXT primarily modulated the PI3K-Akt, calcium, and MAPK signalling pathways to enhance male sexual function. Network analysis identified macelignan, β-estradiol, testosterone, and paniculatine as key bioactive components of PXT, which likely act through core targets, such as androgen receptor (AR), Mitogen-activated protein kinase 3 (MAPK3), epidermal growth factor receptor (EGFR), estrogen receptor 1 (ESR1), and vascular endothelial growth factor (VEGF) to facilitate the improvement of male sexual function. Conclusion Study results suggest that PXT is a safer alternative with aphrodisiac and spermatogenic potential. These effects are partly attributed to the enhanced dopamine levels in the brain. Furthermore, this study provides insights into the specific signalling pathways and bioactive compounds that underlie the improvements in male sexual function associated with PXT.
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- 2024
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90. Use of pumice stone and silica fume as precursor material for the design of a geopolymer [version 2; peer review: 2 approved]
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Alexis Iván Andrade Valle, Jefferson Javier Castillo Cevallos, Mayte Lisbeth Mieles Mariño, Marcelo David Guerra Valladares, Andrea Natalí Zárate Villacrés, María Gabriela Zúñiga Rodríguez, Cristian Andrés Marcillo Zapata, and Tito Oswaldo Castillo Campoverde
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Alkali activation ,molar concentration ,geopolymer ,silica fume ,pumice powder ,eng ,Medicine ,Science - Abstract
Background Geopolymers are alternative materials to cement because they require less energy in their production process; hence, they contribute to the reduction in CO2 emissions. This study aims to evaluate the possibility of using industrial residues such as silica fume (SF) to improve the physical and mechanical properties of a pumice stone (PS)-based geopolymer. Methods Through an experimental methodology, the process starts with the extraction, grinding, and sieving of the raw material to carry out the physical and chemical characterization of the resulting material, followed by the dosage of the geopolymer mixture considering the factors that influence the resistance mechanical strength. Finally, the physical and mechanical properties of the geopolymer were characterized. This research was carried out in four stages: characterization of the pumice stone, design of the geopolymer through laboratory tests, application according to the dosage of the concrete, and analysis of the data through a multi-criteria analysis. Results It was determined that the optimal percentage of SF replacement is 10%, which to improves the properties of the geopolymer allowing to reach a maximum resistance to compression and flexion of 14.10 MPa and 4.78 MPa respectively, showing that there is a direct relationship between the percentage of SF and the resistance. Conclusions Geopolymer preparation involves the use of PS powder with a composition rich in silicon and aluminum. The factors influencing strength include the ratio of sodium silicate to sodium hydroxide, water content, temperature, curing time, molarity of sodium hydroxide, and binder ratio. The results showed an increase in the compression and flexural strength with 10% SF replacement. The geopolymer’s maximum compressive strength indicates its non-structural use, but it can be improved by reducing the PS powder size.
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- 2024
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91. SEVUparin as a potential Adjunctive Treatment in children with severe malaria: A phase I trial safety and dose finding trial (SEVUSMAART) [version 2; peer review: 2 approved, 1 approved with reservations]
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Mainga Hamaluba, Thomas N. Williams, Christabel Mogoka, Luc Kambale Kamavu, Mike Chaponda, Sam Miti, Nick White, Nick Day, Nchafatso Obonyo, Diana M. Gibb, Elizabeth C. George, Arjen Dondorp, Kathryn Maitland, Roisin Connon, A. Sarah Walker, Jonathan Jonathan Gwasupika, and Emmanuel Oguda
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severe malaria ,adjunctive therapy ,children ,Africa ,clinical trial ,heparin-like molecule ,eng ,Medicine ,Science - Abstract
Background Even on the best antimalarial treatments (injectable artesunate) African children with severe malaria have poor outcomes with most deaths occurring early in the course of hospital admission ( 2mmol/l). Three intravenous doses will be given at admission (0 hours), 8 and 16 hours. APPT will be measured 1 hour after each dose (to assess maximum toxicity). Studying 20 children will allow sufficient data on safety to be generated across a range of doses to identify the maximum tolerated dose (MTD) using the Continual Reassessment Method, which adapts or informs subsequent doses for each child based on the data from previously enrolled children. The MTD will be identified based on the dose-toxicity model updated by each previous patient’s APTT results using standard methods. Conclusions The results of the Phase I trial will identify the final dose to be tested in a Phase II trial in terms of both efficacy and safety outcomes. Registration PACTR number: 202007890194806 (date 20/07/2020) ISRCTN32271864 (date 28/07/2021)
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- 2024
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92. ‘Almost nothing is firmly established’: A History of Heredity and Genetics in Mental Health Science [version 2; peer review: 1 approved, 2 approved with reservations]
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Rebecca Wynter, Sarah Marks, and Sarah Chaney
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genetics ,mental health ,psychiatry ,history ,eugenics ,schizophrenia ,eng ,Medicine ,Science - Abstract
Background For more than a century, scientists have tried to find the key to causation of mental ill health in heredity and genetics. The difficulty of finding clear and actionable answers in our genes has not stopped them looking. This history offers important context to understanding mental health science today. Methods This article explores the main themes in research on genetics and inheritance in psychiatry from the second half of the nineteenth century to the present day, to address the question: what is the history of genetics as a causative explanation in mental health science? We take a critical historical approach to the literature, interrogating primary and secondary material for the light it brings to the research question, while considering the social and historical context. Results We begin with the statistics gathered in asylums and used to ‘prove’ the importance of heredity in mental ill health. We then move through early twentieth century Mendelian models of mental inheritance, the eugenics movement, the influence of social psychiatry, new classifications and techniques of the postwar era, the Human Genome Project and Genome Wide Association Studies (GWAS) and epigenetics. Setting these themes in historical context shows that this research was often popular because of wider social, political and cultural issues, which impacted the views of scientists just as they did those of policymakers, journalists and the general public. Conclusions We argue that attempting to unpick this complex history is essential to the modern ethics of mental health and genetics, as well as helping to focus our efforts to better understand causation in mental ill-health. For a succinct timeline of the history of psychiatric genetics, alongside the history of other proposed causes for mental ill-health, visit: https://historyofcauses.co.uk/
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- 2024
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93. Co-designing ab initio electronic structure methods on a RISC-V vector architecture [version 1; peer review: 3 approved]
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Rogeli Grima Torres, Pablo Vizcaíno, José Julio Gutiérrez Moreno, and Filippo Mantovani
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High-performance computing ,co-design ,ab initio ,RISC-V ,materials science ,eigensolver library ,eng ,Science ,Social Sciences - Abstract
Ab initio electronic structure applications are among the most widely used in High-Performance Computing (HPC), and the eigenvalue problem is often their main computational bottleneck. This article presents our initial efforts in porting these codes to a RISC-V prototype platform leveraging a wide Vector Processing Unit (VPU). Our software tester is based on a mini-app extracted from the ELPA eigensolver library. The user-space Vehave and a RISC-V vector architecture implemented on an FPGA were tested. Metrics from both systems and different vectorisation strategies were extracted, ranging from the most simple and portable one (using autovectorisation and assisting this by fusing loops in the code) to the more complex one (using intrinsics). We observed a progressive reduction in the number of vectorial instructions, executed instructions and computing cycles with the different methodologies, which will lead to a substantial speed-up in the calculations. The obtained outcomes are crucial in advancing the porting of computational materials and molecular science codes to (post)-exascale architectures using RISC-V-based technologies fully developed within the EU. Our evaluation also provides valuable feedback for hardware designers, engineers and compiler developers, making this use case pivotal for co-design efforts.
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- 2024
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94. Factors associated with inadequate urinary iodine concentration among pregnant women in Mbeya region Tanzania. [version 5; peer review: 2 approved]
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Tedson Lukindo, Adam Hancy, Sauli E. John, Fatma M. Abdallah, Ray Masumo, Heavenlight A. Paulo, Ramadhan Noor, Fatoumata Lankoande, Gemma Bridge, Raman Bedi, Elifatio Towo, Germana H. Leyna, and Abraham Sanga
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Iodine deficiency ,medium urine iodine concentration ,pregnant women ,socio-demographic and dietary risk factors ,eng ,Medicine ,Science - Abstract
Background Insufficient and above WHO-recommended levels of iodine intake during pregnancy can lead to serious health outcomes. This study aimed to assess median urine iodine concentration and its associated risk factors among pregnant women in the Mbeya region, Tanzania. Method A cross sectional survey involving 420 pregnant women (n=420) aged 15-49, registered in Reproductive and Child Health Clinics was conducted. Socio-demographic and dietary factors were assessed by structured questionnaire and the urine samples were analyzed using the ammonium persulfate digestion method. Results Median urinary iodine concentration (mUIC) was 279.4μg/L and it ranged from 26.1 to 1915μg/L. Insufficient mUIC (below 150μg/L) was observed in 17.14% of participants, sufficient mUIC was 24.29% and 58.57% had mUIC above the recommended level (>250μg/L). Sample women who reported consuming fish in the last 24 hours had an increased risk of insufficient mUIC [Adjusted OR= 2.60 (95%CI 1.31-5.15)] while the risk was lower for those who attended at least primary education [AOR= 0.29 (CI 0.08-0.99)]. Further, sample women resident in Mbarali district, in the oldest age group (35-49) and having a higher socio-economic status were associated with an increased risk of having MUIC above recommended level [AOR=4.09 (CI 1.85-9.010], [AOR=2.51 (CI 0.99-6.330] and, [AOR=2.08 (CI 0.91-4.71) respectively. Conclusion This study demonstrated a significant association between geographical, age and socio-economic factors and median urine iodine concentration above the WHO-recommended level. Further, this study found association between inadequate iodine in diet and insufficient median urine iodine concentration. Therefore, educational programs on iodine intake should be strengthened.
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- 2024
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95. Case Report: Tropical sprue, diagnostic challenges of an old but unrecognized disease [version 3; peer review: 2 approved]
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Marwa Mabrouk, Hatem Ghadhoune, Olfa Hammami, Ilhem Mchirgui, Yosra Yahia, Hend Allouche, Insaf Trabelsi, Jihene Guissouma, and Hana Ben Ali
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Chronic diarrhea ,small bowel disease ,malabsorption ,tropical sprue ,villous atrophy. ,eng ,Medicine ,Science - Abstract
Tropical sprue (TS) is a post-infective disease of the small bowel characterized by a malabsorption syndrome affecting tropics inhabitants and visitors. Diagnosis of TS remains challenging since it can be confused with common diarrheal diseases, especially in non-endemic areas. We report a Tunisian case of latent TS. A 58-year-old male with a history of chronic watery diarrhea, was admitted to the intensive care unit for confusion which was related to a severe metabolic acidosis. Despite the neurological improvement after hydro-electrolytic resuscitation and acid-base disorders correction, the patient continued to have three to five loose stools daily. A nutritional assessment showed a malabsorption syndrome: iron, Vitamin B12and folate deficiencies; normochromic normocytic anemia and hypoalbuminemia. Gastrointestinal endoscopy showed duodenal villous atrophy and biopsy confirmed subtotal villous atrophy with increased intraepithelial lymphocytosis and a thickened hyalonalized sub-epithelial basal lamina. Celiac disease was evoked, however the patient did not improve on a gluten-free diet and the celiac serology was negative. On re-interviewing, we discovered that the patient had spent two months in India three years prior. Given the travel history, clinico-biological and histological data TS was highly considered and a good response to a five-month antibiotic course combined to nutritional supplementation supported this diagnosis. Clinico-biological, endoscopic and histological findings were overlapping between TS and other malabsorption diseases, explaining diagnosis difficulties. TS should be systematically discussed in tropics visitors presenting with chronic diarrhea. Improvement after micronutrient and vitamin deficiencies replacement combined to a prolonged antibiotic course supports the diagnosis of TS.
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- 2024
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96. The genome sequence of the blonde ray, Raja brachyura Lafont, 1871 [version 1; peer review: 2 approved]
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Patrick Adkins, Rachel Brittain, and Kesella Scott-Somme
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Raja brachyura ,blonde ray ,genome sequence ,chromosomal ,Rajiformes ,eng ,Medicine ,Science - Abstract
We present a genome assembly from an individual female Raja brachyura (Blonde Ray; Chordata; Chondrichthyes; Rajiformes; Rajidae). The genome sequence spans 2,700.50 megabases. Most of the assembly is scaffolded into 49 chromosomal pseudomolecules, including the X sex chromosome. The mitochondrial genome has also been assembled and is 17.12 kilobases in length. Gene annotation of this assembly on Ensembl identified 24,252 protein-coding genes.
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- 2024
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97. Paying reviewers and regulating the number of papers may help fix the peer-review process [version 3; peer review: 2 approved, 1 approved with reservations]
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Mohamed L. Seghier
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peer review ,research disseminations ,referees ,publishers ,scholarly communication ,awards and incentives ,eng ,Medicine ,Science - Abstract
The exponential increase in the number of submissions, further accelerated by generative AI, and the decline in the availability of experts are burdening the peer review process. This has led to high unethical desk rejection rates, a growing appeal for the publication of unreviewed preprints, and a worrying proliferation of predatory journals. The idea of monetarily compensating peer reviewers has been around for many years; maybe, it is time to take it seriously as one way to save the peer review process. Here, I argue that paying reviewers, when done in a fair and transparent way, is a viable solution. Like the case of professional language editors, part-time or full-time professional reviewers, managed by universities or for-profit companies, can be an integral part of modern peer review. Being a professional reviewer could be financially attractive to retired senior researchers and to researchers who enjoy evaluating papers but are not motivated to do so for free. Moreover, not all produced research needs to go through peer review, and thus persuading researchers to limit submissions to their most novel and useful research could also help bring submission volumes to manageable levels. Overall, this paper reckons that the problem is not the peer review process per se but rather its function within an academic ecosystem dominated by an unhealthy culture of ‘publish or perish’. Instead of reforming the peer review process, academia has to look for better science dissemination schemes that promote collaboration over competition, engagement over judgement, and research quality and sustainability over quantity.
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- 2024
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98. Incorporating basic periodontal screening into antenatal care services provided in Rwanda: A policy brief [version 2; peer review: 2 approved]
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Kehinde Kazeem Kanmodi and Peace Uwambaye
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Antenatal care ,periodontitis ,preterm birth ,preterm deliveries ,policy brief ,Rwanda ,eng ,Medicine ,Science - Abstract
Background Preterm birth, which is child delivery before 37 weeks of pregnancy, is the primary cause of perinatal mortality worldwide. Preterm birth remains a major public health challenge in Rwanda, affecting approximately 13.8% of birth. The World Health Organization estimates that 15 million babies are born prematurely each year. While the association between periodontitis and preterm deliveries is increasingly recognized, little is known about this link in Rwanda. This policy brief aims to bridge this knowledge gap by presenting the findings of a recent study investigating the prevalence of periodontitis among pregnant women in Rwanda and its association with preterm deliveries. This policy brief also aims to inform and guide decision making towards incorporating periodontal screening into the antenatal care package in Rwanda. This has the potential to improve pregnancy outcomes and contribute to improved oral health in the future. Policy outcome and Implications Contemporary evidence has shown a six-fold increased risk of preterm delivery for women with periodontitis in Rwanda, with a concerningly high prevalence (60%) among pregnant women. Additionally, nurses working in antenatal clinics displayed insufficient knowledge about gum disease. Actionable recommendations The adoption of basic periodontal screening within existing antenatal care packages is recommended. This, coupled with nurse training and public awareness campaigns, can empower women and healthcare professionals to prioritize oral health for better pregnancy outcomes. Conclusions Integrating periodontal screening into antenatal care has the potential to significantly reduce preterm deliveries and contribute to a healthier future generation in Rwanda.
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- 2024
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99. The genomes of the aquarium sponges Tethya wilhelma and Tethya minuta (Porifera: Demospongiae) [version 2; peer review: 2 approved]
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Sergio Vargas, Dirk Erpenbeck, Stefan Krebs, Fabian Deister, Warren R. Francis, and Gert Wörheide
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Tethya wilhelma ,Tethya minuta ,Porifera ,Demospongiae ,genome ,model organism ,eng ,Medicine ,Science - Abstract
Sponges (Phylum Porifera) are aquatic sessile metazoans found worldwide in marine and freshwater environments. They are significant in the animal tree of life as one of the earliest-branching metazoan lineages and as filter feeders play crucial ecological roles, particularly in coral reefs, but are susceptible to the effects of climate change. In the face of the current biodiversity crisis, genomic data is crucial for species conservation efforts and predicting their evolutionary potential in response to environmental changes. However, there is a limited availability of culturable sponge species with annotated high-quality genomes to further comprehensive insights into animal evolution, function, and their response to the ongoing global change. Despite the publication of a few high-quality annotated sponge genomes, there remains a gap in resources for culturable sponge species. To address this gap, we provide high quality draft genomes of the two congeneric aquarium species Tethya wilhelma and Tethya minuta, small ball-shaped demosponges that are easily maintained long-term in ex situ culture. As such, they offer promising opportunities as laboratory models to contribute to advancing our understanding of sponge biology and provide valuable resources for studying animal evolution, function, and responses to environmental challenges.
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- 2024
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100. Talent management of library and information science professionals: A review of research and future directions [version 2; peer review: 2 approved]
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Chandrakant Swain, Dillip K Swain, and Bijayalaxmi Rautaray
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Talent management ,career growth ,organizational resilience ,retention policy ,employment strategy ,talent pool ,eng ,Medicine ,Science - Abstract
Background This study aims to review the extant literature on talent management with the objective of influencing library and information management by addressing the key facets of talent management, such as talent management strategies, importance of career development, evaluation of talented employees, and organizational resilience. Methodology Literature on the development of talent and career management was retrieved from various scholarly papers indexed in Scopus and Web of Science to have a meticulous literature review serving as the platform of the present study. In light of the authors’ observations, two models were developed. The literature provides precise information that talent management plays a decisive role in promoting organizational excellence invariably in all kinds of organizations in general and libraries in particular. Results This study provides constructive recommendations for the implementation of effective talent management and retention policies for library and information professionals. Moreover, this study adds immense value to the corpus of existing literature to set a platform for the augmentation of library management in futuristic vision. Conclusion This study provides constructive recommendations to policy makers and library administrators to foster talented employees for excelling library and information services for the next several decades.
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- 2024
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