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Posttraumatic stress disorder and associated factors in the aftermath of the 2015 earthquake in Nepal: A systematic review and meta-analysis
We aimed to estimate the pooled incidence of posttraumatic stress disorder among survivors after the 2015 earthquake in Nepal based on available literature and highlight the psychological effects of natural disasters that can hamper the recovery process in the aftermath of disaster. The study protocol was registered on PROSPERO with reference number CRD42024576444. Electronic databases such as PubMed and Google Scholar were searched for observational studies in English that assessed posttraumatic stress disorder at least 1 month after the earthquake via a validated tool from April 2015 to August 2024. In addition, references to the included studies were thoroughly searched. High-quality articles were included after the risk of bias assessment. The random-effects model was used to calculate the pooled incidence with a 95% confidence interval along with subgroup analysis. An analysis of 25 studies revealed a pooled incidence of 22.6%, ranging from 17.6 to 27.5%. A high degree of heterogeneity (I2 = 97.56%, p<0.001) was observed in the results, with the incidence ranging from 3% to 51%. The subgroup analyses revealed that the incidence of posttraumatic stress disorder after an earthquake varied significantly across studies in terms of the time of assessment, sex, age, marital status, ethnicity, educational level, disease history, bereavement, injury to the body, witnessing death, social support, loss of property and damage to one’s house. However, stratified analyses could not fully explain the heterogeneity in the results. Our analysis revealed a high incidence of posttraumatic stress disorder among survivors of the 2015 earthquake in Nepal. Addressing the psychological well-being of these survivors is essential. Psychosocial counseling becomes pivotal in assisting them in coping with the trauma they have experienced since the earthquake.
A systematic review of military-to-civilian transition, The role of gender
Background The military-to-civilian transition can be a challenging period for many service members; however, recent research suggests that female ex-service personnel (veterans) confront additional complexities during reintegration into civilian life. This systematic review aimed to identify and synthesise findings across qualitative studies exploring the impact of gender on this transition process. Methods Peer-reviewed literature was drawn from a multi-database search, limited to qualitative studies. The studies included either female veterans or both male and female veterans aged 18 years or older who had previously served in the Armed Forces within the Five Eyes (FVEY) countries (Australia, Canada, New Zealand, the United Kingdom, and the United States). We used a Framework Analysis approach to guide the synthesis of the qualitative data. An assessment of study quality was conducted using the Joanna Briggs Institute (JBI) Qualitative Critical Appraisal Checklist for Qualitative Studies. The study protocol is registered with the Open Science Framework (registration: osf.io/5stuj). Results In total, 10,113 articles were screened after the removal of duplicates, 161 underwent full-text review, with 19 meeting the eligibility criteria. The review identified eleven themes split across individual’s experience whilst serving and after transitioning out of the military service. Both male and female veterans discussed a period of acculturation when they joined service and adapted to military norms, culture and identity. Female veterans faced additional challenges at this stage centred on the conflict between feminine norms and the military masculine ideal. Upon leaving service both male and female veterans experienced a loss of military identity and purpose, and dissonance with civilian norms illustrating a military-civilian divide. For female veterans, adjustments and adaptations learned in the military clashed with civilian feminine norms and stereotypically male veteran culture. Female veterans also struggled with the legacies of gender inequality, discrimination, and sexual assault which affected their development of a female veteran identity and affected the provision of services designed to meet their needs as a female. Despite these challenges, female veterans’ expressed pride in their service and accomplishments. Conclusions Any effort to improve the military-to-civilian transition should take account of the legacy of gender discrimination, especially within the military service, and the potential mismatch between historical civilian female norms and the more traditionally masculine norms of military life. Disclosures This project was supported by a grant from the Forces in Mind Trust (FiMT) 2202.
Surfaces environmental monitoring of SARS-CoV-2: Loop mediated isothermal amplification (LAMP) and droplet digital PCR (ddPCR) in comparison with standard Reverse-Transcription quantitative polymerase chain reaction (RT-qPCR) techniques
The persistence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) on substrates, and the impact of fomites on Coronavirus Disease 19 (COVID-19) transmission, is until now, widely discussed. Consequently, further investigations are required for a correct risk assessment in high-risk facilities such as hospitals, healthcare facilities (HCFs), and long-term care facilities (LTCFs). Therefore, appropriate surveillance and disinfection programs represent the best approach to guarantee the safety of these communities. This study proposes an environmental SARS-CoV-2 surfaces routine monitoring approach in HCF and communities’ settings, to provide rapid and effective evaluation of surface hygienic conditions and the effectiveness of applied sanitization measures. Surfaces samples (n = 118) were collected using the SRK® kit (Copan Italia) from 2020 to 2023. Three molecular techniques were compared: Reverse Transcription Loop mediated isothermal AMPlification (RT-LAMP, Enbiotech), Reverse-Transcription quantitative polymerase chain reaction (RT-qPCR) (RT-qPCR, Seegene) and droplet digital PCR (ddPCR, Bio-Rad). For ddPCR, two RNA extraction methods were compared: TRIzol LS (Invitrogen) versus QIAmp Viral Mini kit (QIAGEN), showing how the latter is more suitable for surfaces. Regarding the quantitative ddPCR results, the ROC analysis allowed to reduce the manufacturer cut-off for droplets number (from 3 to 1) for the positive samples. Moreover, a new cut-off for the viral RNA copies’ number/μL for each target (N1 and N2) on environmental monitoring was fixed at 2,82. The results obtained using the QIAmp kit, suggested that the N2 target is more stable in the environment and could be most suitable for the virus environmental detection. The percentage of positive samples was similar among the techniques (26% for RT-LAMP, 36% for ddPCR and 23% for RT-qPCR). Using RT-qPCR as reference method, a sensitivity (SE) of 30% for RT-LAMP and 41% for ddPCR was observed. By contrast, specificity (SP) was higher for RT-LAMP (75%) respect to ddPCR (66%). Comparing the faster RT-LAMP with the sensitive ddPCR the 26% and 74% of SE and SP for RT-LAMP, were reported. The low sensitivity for RT-LAMP and ddPCR could be explained with the use of clinical rather than environmental kits, other than the changing in the virus prevalence during the sampling campaign. Although the RT-LAMP requires improvements in term of SE and SP, this research presents an innovative environmental monitoring and prevention method for SARS-CoV-2, that could be extended to other pathogens that are under environmental surveillance.
Analysis of financial convergence between the BRICS and OECD countries
Financial convergence is a process for establishing a relationship among the financial markets of different countries; as a result of such process the rates of similar financial assets in different markets and countries become very close to each other. Some factors might create financial convergence. of which the trade and international capital flows among countries, the presence of banks and other financial institutions in the international arena, the availability of clear and accurate information of markets and financial organizations, and the existence of similar infrastructure and their characteristics from economic, legal and cultural perspectives can be mentioned. The issue of financial convergence with the aim of achieving global financial markets and taking advantage of its capabilities and characteristics would be very important for all countries, especially the emerging countries. This study examines financial convergence in the money and capital markets of the Organization for Economic Co-operation and Development (OECD) and BRICS countries in the period of 2007–2020. The study utilizes the Panel Convergence Methodology and Cluster Analysis (Philips and Sul methodology) along with a clustering algorithm. The findings indicate a lack of overall convergence between OECD and BRICS countries in both financial markets (money and capital) this is due to the lack of similar economic infrastructure, differences in the size of the economy, and variations in trade, financial and monetary freedom indicators, trade relations, and capital transfers. The cluster test in the money market confirms the existence of 3 convergence clubs among the studied countries. The convergence of emerging BRICS countries in the money market, with a large number of OECD developed countries, is a confirmation of the development of their banking sector in the recent years. On the other hand, the capital market survey also shows the presence of 5 convergence clubs between OECD and BRICS countries. Besides, it’s been shown that South Africa, along with Lithuania, Turkey, Slovakia and Latvia, has established a divergent group.
Prevalence and factors associated with alcohol use disorders among people living with HIV attending care and treatment centers at Kilimanjaro, Tanzania: A cross-sectional study
Background Alcohol use disorders (AUD) are prevalent among people living with HIV (PLHIV), with 2–6 times higher than in the general population. These conditions are linked to increased morbidity and mortality among PLHIV and amplify sexual risk behaviors, thus exacerbating the transmission of HIV. Despite these negative consequences, a paucity of studies have explored this issue in Tanzania. This study aimed to determine AUD’s prevalence and associated factors among PLHIV attending Care and Treatment Centers (CTCs). Methods A multifacility-based cross-sectional study was carried out among 532 PLHIV attending four CTC centers in Moshi Municipal, Kilimanjaro. A multistage cluster systematic sampling method was utilized to choose CTCs and participants. Data were collected using standardized tools through interviewer administration. Statistical analyses were performed using STATA (version 16). Binary logistic regression model was used to examine the associations between AUD and the independent variables, with odds ratios and their 95% confidence intervals calculated to quantify the strength of these associations. Results The mean age of participants was 46.6 years (SD±13.3). The weighted prevalence of alcohol use disorders (AUDIT ≥ 8) within the past 12 months was 28.2%. Factors significantly associated with AUD in the final model included male sex (AOR = 4.18, P <0.001), healthcare level (reference: tertiary health facility; secondary health facility AOR = 1.80, P<0.001, primary health facility AOR = 9.65, P<0.001), being divorced or widowed (AOR = 2.82, P<0.001), secondary education (AOR = 1.35, P = 0.005), and probable depression (AOR = 2.48, P <0.001). Conclusion The findings revealed a high prevalence of AUD among PLHIV, highlighting the need for policy refinement aimed at enhancing the integration of psychosocial services at CTCs.
The impacts of antipsychotic medications on eating-related outcomes: A mixed methods systematic review
Background Almost all antipsychotics are associated with weight gain. Given the gravity of this side-effect and its consequences, it is imperative to understand the mechanisms involved. One mechanism that could contribute to this side effect is the impact of antipsychotics on eating-related outcomes. Objective We aimed to synthesise the available quantitative research on the effects of first- and second-generation antipsychotics on eating-related outcomes, and qualitative research exploring people’s experiences with these medications in relation to appetite and eating behaviours (PROSPERO protocol CRD42022340211). Methods We searched Medline, PsycInfo, and Web of Science from inception to 9 May 2024. Quantitative data were synthesised without meta-analysis using vote counting based on direction of effect. Qualitative data were synthesised using thematic synthesis. Results Searches identified 8,746 citations yielding 61 separate studies; 55 quantitative and 6 qualitative, published 1982–2024. Using GRADE, our assessment of the quantitative review findings ranged from low to very low-level certainty. Given the lack of direct evidence from high-quality placebo-controlled trials, it is pertinent to interpret the quantitative findings with caution. Using GRADE-CERQual, our assessment of the qualitative review findings ranged from low to very low-level certainty; these findings suggest that the relationship between antipsychotics and food intake is influenced by an interplay of individual, interpersonal and external factors, the most significant of which is food environment. Limitations The internal validity of this review was affected by the serious limitations of the included quantitative studies and the paucity of qualitative evidence. Strengths We used GRADE and GRADE-CERQual frameworks to enhance the transparency of our judgement of the certainty of the evidence. Lived experience perspectives were incorporated in different stages of the review to enhance its relevance and practical implications. Conclusions There is insufficient evidence from well-conducted studies to determine the effect of antipsychotics on eating-related outcomes.
Women’s enrollment in community-based health insurance and its determinants in Sidama national regional state, Ethiopia, 2024: A multilevel analysis
Introduction Accessing affordable and high-quality healthcare remains a persistent challenge in low- and middle-income countries like Ethiopia. Community-based health insurance (CBHI) programs offer a promising solution to expand healthcare coverage and provide financial protection, particularly for vulnerable populations such as women. This study aimed to investigate the factors that influence CBHI enrollment among women in Sidama National Regional State, Ethiopia, using a multilevel analysis. Methods A community-based cross-sectional study was conducted using a multistage sampling technique from December 15th to January 12th, 2024, in the central Sidama zone, Sidama National Regional State. The study included 835 women aged 18 years and older, residing both in rural and urban areas. Face-to-face interviews were conducted using a pre-tested questionnaire to collect comprehensive data on socio-demographic, economic, and scheme-related factors. Data collection utilized the Open Data Kit mobile application, and data analysis was performed using Stata version 16, employing multilevel modified Poisson modeling to identify determinants of CBHI enrollment. Results Among 845 samples, 835 women were interviewed, resulting in a response rate of 98.8%. Individual-level factors such as older age (APR = 1.02, 95%CI: 1.01–1.03, p<0.001), larger family size (APR = 1.09, 95%CI: 1.03–1.16, p = 0.001), and moderate wealth index (APR = 2.72, 95%CI: 1.28–5.79, p = 0.009) showed positive associations with CBHI enrollment, depicted a higher likelihood of individuals joining the insurance scheme. In addition, at the community level, higher rates of women’s literacy (APR = 1.73, 1.18–2.55, p = 0.005), and women’s autonomy (APR = 2.64, 95%CI: 1.50–4.65, p = 0.001) were positively correlated with CBHI enrollment. Conclusions The study revealed that the enrollment rate among women in the CBHI scheme was 35%, indicating a need for improved outreach efforts. Significant factors that affected enrollment included older age, larger family size, and moderate wealth. Additionally, positive community-level influences such as higher literacy rates and increased autonomy for women contributed to higher enrollment. To improve CBHI enrollment, the target should focus on younger women and those from smaller families. Financial support, such as subsidies for low-income women, can also encourage participation. Investing in women’s literacy and empowerment programs will enable them to make informed health choices, thereby increasing enrollment. Finally, ongoing research is necessary to track enrollment trends and identify barriers. Utilizing qualitative methods will yield insights into women’s perceptions of CBHI, facilitating more effective strategies. Implementing these recommendations can enhance women’s access to healthcare through CBHI.
Higher risk of carotid plaque among lean individuals with non-alcoholic fatty liver disease: A retrospective study
Background Lean individual with non-alcoholic fatty liver disease (L-NAFLD) is a prominent area of research, yet its pathogenesis and association with other diseases such as atherosclerotic cardiovascular disease remain uncertain. Object A retrospective study, investigate the association between non-alcoholic fatty liver disease (NAFLD) and carotid plaque (CP) in lean [body mass index (BMI) <24Kg/m2] and non-lean (BMI≥24Kg/m2) populations, as well as identify the related influence factors. Method 3,587 participants were eligible and categorized into 4 groups based on the presence with CP and BMI, binary logistic regression analysis was utilized alongside other statistical methods. Results L-NAFLD participants had a 1.395-fold higher risk of CP compared to lean individuals without NAFLD. Age, gender, systolic blood pressure, low-density lipoprotein cholesterol, fasting blood glucose, and Fibrosis-4 index (FIB-4) were identified as independent risk factors with cutoff values lower than the normal upper limits. However, this association was not observed among non-lean participants, regardless of confounding factors adjustment. Moreover, the impact of FIB-4 on the association of NAFLD and CP was more significant in lean CP participants (OR = 1.360 for 1.30 ~ 2.67, and OR = 2.002 for >2.67~<3.48) than in non-lean CP ones. Conclusion The L-NAFLD population had a higher risk of CP, while lean CP individuals experienced more severe liver fibrosis. Implementing stricter management of risk factors may improve the health status of high-risk populations.
Single-cell transcriptomics analysis reveals dynamic changes and prognostic signature in tumor microenvironment of PDAC
Improving photovoltaic water pumping system performance with ANN-based direct torque control using real-time simulation
Abstract Photovoltaic Water Pumping Systems (PVWPS) have become increasingly important as a renewable energy solution in rural areas, providing energy independence, cost savings, and environmental friendliness. This system has two main controllers. The first controller is employed to maximize power extraction from the PV array by controlling the duty ratio of the DC-DC boost converter. The second controller is responsible for regulating the operation of the induction motor through the switching pulses of the Voltage Source Inverter (VSI). These two controllers play an essential role in the system, which increases efficiency and performance. Therefore, the innovative aspect of this work consists of introducing Artificial Neural Networks (ANNs) based on each PVWPS controller. On the one hand, ANN-based MPPT is implemented to ensure optimal performance of the PV array under varying irradiation levels. On the other hand, to overcome the defects and problems caused by Direct Torque Control (DTC), such as flux and torque ripples, high switching frequency, and challenges at low speeds, an ANN-based DTC is proposed in which each of the hysteresis comparators, switching table, and speed controller in the DTC are replaced by ANN controllers. The PVWPS based on the proposed controls is thoroughly modeled and simulated using MATLAB/Simulink software and validated using dSPACE DS1104 Board. The results demonstrate significant improvements, including a 75.51% reduction in flux ripples, a 77.5% reduction in torque ripples, a 44.79% improvement in response time, and an increase in the water quantity. Furthermore, the Real-Time simulation and visualization obtained are consistent with the simulation outcomes.