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The Turkish validity and reliability of the Reward-Based Eating Drive (RED-13) Scale
This paper established the Turkish validity and reliability of the Reward-based Eating Drive Scale (RED-13). This methodological study was conducted between January and June 2022. The study population consisted of all patients admitted to the dietary polyclinic of a hospital. The sample consisted of 500 participants. Data were collected using a personal information form and the Reward-Based Eating Drive Scale (RED-13). The data were analyzed using numbers, percentages, arithmetic means, standard deviations, correlation tests, t-tests, exploratory and confirmatory factor analyses, and Cronbach’s α reliability coefficients. The scale consists of 13 items and three subscales, explaining 66.1% of the total variance. The confirmatory factor analysis shows that x²/sd= 2.47, indicating an acceptable model. The goodness of fit indices are also acceptable (GFI = 0.99, AGFI = 0.99, CFI= 1.00, RMSEA = 0.08, and SRMR = 0.05). The total scale has a Cronbach’s α of 0.91. The first and second halves have Cronbach’s α values of 0.86 and 0.83, respectively. The scale has a Spearman-Brown coefficient of 0.85 and a Guttman Split-Half coefficient of 0.83. The scale has good internal consistency (reliability). The results indicate that the Reward-Based Eating Drive Scale (RED-13) is valid and reliable for the Turkish population. Trial registration The study was registered on ClinicalTrials.gov (number: NCT05017506).
Modeling the number of new cases of childhood type 1 diabetes using Poisson regression and machine learning methods; a case study in Saudi Arabia
Diabetes mellitus stands out as one of the most prevalent chronic conditions affecting pediatric populations. The escalating incidence of childhood type 1 diabetes (T1D) globally is a matter of increasing concern. Developing an effective model that leverages Key Performance Indicators (KPIs) to understand the incidence of T1D in children would significantly assist medical practitioners in devising targeted monitoring strategies. This study models the number of monthly new cases of T1D and its associated KPIs among children aged 0 to 14 in Saudi Arabia. The study involved collecting de-identified data (n=377) from diagnoses made between 2010 and 2020, sourced from pediatric diabetes centers in three cities across Saudi Arabia. Poisson regression (PR), and various machine learning (ML) techniques, including random forest (RF), support vector machine (SVM), and K-nearest neighbor (KNN), were employed to model the monthly number of new T1D cases using the local data. The performance of these models was assessed using both numbers of KPIs and metrics such as the coefficient of determination (R2), root mean squared error (RMSE), and mean absolute error (MAE). Among various Poisson and ML models, both model considering birth weight over 3.5 kg, maternal age over 25 years at the child’s birth, family history of T1D, and nutrition history, specifically early introduction to cow milk and model taking into account birth weight over 3.5 kg, maternal age over 25 years at the child’s birth, and nutrition history (early introduction to cow milk) emerged as the best-reduced models. They achieved R2 of (0.89,0.88), RMSE (0.82, 0.95) and MAE(0.62,0.67). Additionally, models with fewer KPIs, like model that considers maternal age over 25 years and early introduction to cow milk, achieved consistently high R2 values ranging from 0.80 to 0.83 across all models. Notably, this model demonstrated smaller values of RMSE (0.92) and MAE (0.67) in the KNN model. Simplified models facilitate the efficient creation and monitoring of KPIs profiles. The findings can assist healthcare providers in collecting and monitoring influential KPIs, enabling the development of targeted strategies to potentially reduce, or reverse, the increasing incidence rate of childhood T1D in Saudi Arabia.
Towards sustainable architecture: Enhancing green building energy consumption prediction with integrated variational autoencoders and self-attentive gated recurrent units from multifaceted datasets
Global awareness of sustainable development has heightened interest in green buildings as a key strategy for reducing energy consumption and carbon emissions. Accurate prediction of energy consumption plays a vital role in developing effective energy management and conservation strategies. This study addresses these challenges by proposing an advanced deep learning framework that integrates Time-Dependent Variational Autoencoder (TD-VAE) with Adaptive Gated Self-Attention GRU (AGSA-GRU). The framework incorporates self-attention mechanisms and Multi-Task Learning (MTL) strategies to capture long-term dependencies and complex patterns in energy consumption time series data, while simultaneously optimizing prediction accuracy and anomaly detection. Experiments on two public green building energy consumption datasets validate the effectiveness of our proposed approach. Our method achieves a prediction accuracy of 93.2%, significantly outperforming traditional deep learning methods and existing techniques. ROC curve analysis demonstrates our model’s robustness, achieving an Area Under the Curve (AUC) of 0.91 while maintaining a low false positive rate (FPR) and high true positive rate (TPR). This study presents an efficient solution for green building energy consumption prediction, contributing significantly to energy conservation, emission reduction, and sustainable development in the construction industry.
Beyond antibodies: Beta-2 glycoprotein I as the unsung guardian of pregnancy
The physiological function of beta 2 glycoprotein I (β2GPI) itself is not well understood, other than that it is a primary antigen to anti-phospholipid antibodies in the autoimmune disease antiphospholipid syndrome. β2GPI is a soluble blood protein that is predominantly synthesized in hepatocytes. Why is the expression of β2GPI observed in the placenta despite its abundance in the circulating blood of healthy individuals? Does the placenta produce a specific-acting β2GPI?. β2GPI was recently shown to adopt two interconvertible biochemical confirmations based on the integrity of disulfide bonds: oxidized and reduced. The present study investigates the physiological function of β2GPI in trophoblast cells, with a focus on the reduced and oxidized forms of β2GPI under the hypothesis that placental β2GPI has a different activity from circulating β2GPI. Endogenous β2GPI secretion in trophoblast cells were predominantly in the reduced form, while those in HepG2 liver cells were mainly in the oxidized form. Progesterone increased reduced-β2GPI in both the trophoblast and liver cells. Oxidized-β2GPI significantly inhibited trophoblast cell migration and increased placental soluble fms-like tyrosine kinase-1 (sFlt-1). Furthermore, excess sFlt-1 significantly increased oxidized-β2GPI secretion in HepG2 cells. Circulating oxidized-β2GPI levels were significantly higher in women with pre-eclampsia than in those without pre-eclampsia. Therefore, oxidized-β2GPI may contribute to the pathogenesis of pre-eclampsia. Under oxidative stress, the excessive oxidation of β2GPI and/or excessive placental sFlt-1 may trigger a negative spiral between trophoblast and liver cells.
“People in my life just play different roles”: A retrospective qualitative study of friendships among young adults who self-harmed during adolescence
Self-harm is a global public health concern presenting increasing rates in recent years, especially among young people. This population seldom access formal help, and typically rely on informal sources of support, mainly friends. The role, importance and meaning of friendships in the context of self-harm remains poorly understood, highlighting the need to explore young people’s lived experiences. In the present study we conducted semi-structured retrospective qualitative interviews, prompted by the Card-sort Task for Self-Harm About Friends (CaTS-AF), to explore the experiences of 11 young adults (M=19.09; SD=0.70; M=2, F=9) who self-harmed during adolescence. Data were analysed using Reflexive Thematic Analysis (RTA). Three themes were developed which consider 1) the role of friendships in self-harm progression; 2) the role of self-harm in friendship evolution; and 3) the meaning of friendships in the context of adolescents’ self-harm. The first two themes highlight the interdependent nature of friendships and self-harm, where these two experiences influence one another. Furthermore, not only are friendships shaped by self-harm, but they acquire specific meanings, dynamics and expectations within the context of the behaviour. Overall, friends are a key part of adolescents’ self-harm, as sources of both risk and protection. It is essential to further integrate friendships, a developmentally significant aspect of adolescents’ social experiences, into self-harm research and clinical practice.
Rapidly obtaining genome sequence of Severe Fever with Thrombocytopenia Syndrome virus directly from clinical serum specimen using long amplicon based nanopore sequencing workflow
Severe Fever with Thrombocytopenia Syndrome (SFTS) is an emerging viral infectious disease discovered in 2009 with a high fatality rate and continuing to pose a public threat for many countries. Surveillance of genome sequence of its causative pathogen, Severe Fever with Thrombocytopenia Syndrome virus (SFTSV), could provide evidence for SFTS control, diagnosis method update, viral evolution dynamic and pathogenic mechanism research, etc. Here, we developed a workflow for rapidly obtaining the genome sequence of SFTSV directly from clinical samples to facilitate the viral genome sequence surveillance. Three pairs of primers targeting the terminal conserved regions of three segments were newly designed to more efficiently enrich nearly whole viral genome. Datasets comprised reads generated in different timeframes for four simulated samples with high to low serially diluted viral loads were subjected to analysis. For a simulated sample with a Ct value of 35 and sequenced for 10 minutes, the average coverage depth could reach over 700x, and the genome coverage could reach 98.69% after subtraction of the primer sequence, and the sequence identity with Sanger sequencing could reach over 99.91%. Two clinical serum specimens were used to validate the workflow and sequences were successfully obtained. A long amplicon based nanopore sequencing workflow was established, which could finish in 10 hours from serum specimen to genome sequence. This workflow has potential to provide essential information for SFTS control and support further pathogenesis research.
Predictors of high tobacco use prevalence among adults in Autonomous Province of Vojvodina, Serbia
Introduction Introducing a sub-national surveillance system could significantly improve the monitoring of factors related to current tobacco use prevalence and the impacts of tobacco control measures. This study utilizes initial data from the newly established “Surveillance of Behavioural Risk Factors of Non-Communicable Diseases in Vojvodina” (SBRF-NCD-V) system in the Autonomous Province of Vojvodina (APV), Serbia. Materials and methods This cross-sectional study involved 3910 healthcare users aged 18 years and older, interviewed between May 20 and August 30, 2023, across all 44 Primary Healthcare Centers in the 7 districts of APV, with sampling proportional to Census data and stratified by gender, age and type of settlement. The questionnaire used was adapted from the BRFSS instrument developed by the CDC. Two multivariate binary logistic regression models analysed associations between current (daily or occasional) tobacco smoking and 6 sociodemographic factors, as well as 7 health-related or modifiable lifestyle risk factors, stratified by gender to calculate odds ratios. Results and discussion The prevalence of daily (28.8%) or occasional (7.2%) tobacco smoking in APV (36.0%; 95% CI 34.5–37.5) surpasses national levels in Serbia and ranks among the highest in Europe. Dual use of combustible tobacco and e-cigarettes accounted for 21.7% of cases. Higher likelihoods of smoking were observed among age groups 18–34 compared to 35–49 years, rural residents (OR = 1.2; 95% CI = 41.4–46.7; p = 0.009), those with lower education levels (for primary school OR = 2.0; 95% CI = 11.7–15.4; p < 0.001), the employed (OR = 1.5; 95% CI = 64.5–69.5; p = 0.015), and individuals self-assessing their socioeconomic status as ‘poor or very poor’ (OR = 1.8; 95% CI = 11.0–14.6; p < 0.001). Significant predictors of smoking included poorer health self-assessment, higher self-assessed Body Mass Index, e-cigarette use, at least 1-hour daily tobacco exposure, alcohol consumption at least 3 times weekly and/or binge drinking, and lower physical activity levels. Conclusion Factors contributing to the high prevalence of tobacco smoking in APV, Serbia, include younger age, rural residence, lower education, employment status, lower socioeconomic status, poorer health self-assessment, higher BMI (excluding women), e-cigarette use, tobacco exposure, alcohol consumption, and lower physical activity (excluding men). These findings underscore the need for targeted interventions, such as the efficacy of local inspection services and monitoring plans, to support policy measures aimed at addressing tobacco use in the region.
Evaluating language policy implementation in South African higher education - three decades of progress and challenges: A scoping review protocol
Background South Africa’s higher education institutions (HEIs) continue to face challenges in implementing inclusive language policies that integrate indigenous African languages into academic settings, even three decades after apartheid. Higher Education Institutions (HEIs) face significant challenges in integrating indigenous African languages into academic settings. Despite progressive reforms, higher education institutions face significant challenges in integrating indigenous African languages into academic settings. Objectives This scoping review aims to evaluate the current state of language policy implementation in South African public HEis. Specifically, it seeks to: (1) map the integration of multilingual policies into teaching, research, and administrative practices; (2) identify persistent barriers to effective policy implementation; (3) explore successful strategies for promoting multilingualism (4) assess the extent of African language usage in academic contexts; and (5) identify research gaps to guide future investigations. Methods The review will adhere to the PRISMA-ScR guidelines and follow the framework outlined by Arksey and O’Malley, ensuring a systematic and transparent approach. A comprehensive search will be conducted in databases including Google Scholar, Scopus, Web of Science, ERIC, and African Journals Online (AJOL), covering studies published from 1994 to the present. This will be supplemented by grey literature from government and institutional sources. Three independent reviewers will screen studies using predefined eligibility criteria, managing and screening articles through Rayyan. Data will be extracted using a standardized form, and thematic analysis will synthesize the findings, with stakeholder consultation to validate results. Expected outcomes This review will provide a comprehensive assessment of language policy implementation, highlighting successful strategies and persistent challenges across institutions. The findings will inform policy refinement, identify effective practices, and guide future research directions for achieving linguistically inclusive higher education in South Africa, while contributing to a broader understanding of implementing multilingual policies in post-colonial educational contexts. This protocol is preregistered on OSF, available at https://doi.org/10.17605/OSF.IO/AU2SD
The impact of digital trade development on China’s export of technology-intensive products: Evidence from importing countries
Developing exports of technology-intensive products is a key focus for China’s high-quality foreign trade development. The rapid growth of global digital trade brings new opportunities and challenges for China’s exports of technology-intensive products. This paper utilizes panel data from 2005 to 2022. And we construct an extended gravity model to thoroughly investigate the impact of digital trade development in importing countries on China’s exports of technology-intensive products. The research findings indicate: (1) The development of digital trade in importing countries significantly promotes China’s exports of technology-intensive products. This effect is more pronounced beyond a certain threshold. (2) The reduction of trade costs and increased foreign direct investment play intermediary roles in facilitating the impact of digital trade in importing countries on China’s exports of technology-intensive products. However, institutional distance exerts a negative inhibitory effect on this process. (3) The impact of digital trade development in importing countries on China’s exports of technology products varies due to differences in product types, national income levels, regional characteristics, economic cooperation, and market potential. The conclusions of this paper provide theoretical and empirical evidence for the Chinese government to enhance the efficiency of exporting technology-intensive products.
Roasting temperature and fat type influence cholesterol oxidation products, fatty acid composition, physicochemical properties and sensory attributes of beef sausages
The impact of fat type (FT) and roasting temperature (RT) on oxysterols, physicochemical properties and sensory attributes of beef sausages were investigated. Beef sausages were formulated with either 20% Beef tallow (BT), Palm olein (PO) or Soybean oil (SO), and oven-cooked at either 180oC for 30 min or 240oC for 15 min. The BT, PO, and SO sausages had the highest (P<0.05) levels of saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), and polyunsaturated fatty acids (PUFA), respectively. Roasting at 240°C increased PUFA, MUFA, and total cholesterol levels, and reduced SFA moisture, and fat levels (P<0.05). The FT × RT interaction was significant for oxysterols, instrumental color and cook loss. The SO-180 sausages had higher levels of 7-ketocholesterol, 5,6β-epoxy cholesterol, cholesta-3,5-dien-7-one, and total oxysterols, but these levels decreased significantly at 240°C. The BT sausages exhibited lower overall cholesterol oxidation, though 22R-hydroxycholesterol was elevated at 180°C, while the PO sausages showed intermediate oxysterol oxidation, with 7α-hydroxycholesterol increasing at 240°C (P<0.05). The SO sausages had higher TBARS compared to other sausages (P<0.05). The BT sausages had greater lightness and lower cook loss at 240°C, while redness increased in both BT and SO sausages at 240oC (P<0.05). The BT sausages had higher hardness and chewiness. The PO sausages had better taste scores than the BT sausages, with similar results to SO sausages, and both PO and SO sausages had higher appearance and overall acceptance scores than the BT sausages. Fat type and roasting temperature synergistically affect oxysterol levels and quality attributes of beef sausages, highlighting the importance of selecting suitable fats and roasting conditions to ensure safety, nutritional value, and sensory quality.
Effects of two different peptides on pentylenetetrazole-induced seizures in larval zebrafish
Epilepsy is a common and severe neurological disease characterized by spontaneous and recurrent seizures. Although anti-seizure treatments are effective for most patients, approximately 30% remain pharmacoresistant. Moreover, uncontrolled seizures are associated with increased health risks and shortened life expectancy in individuals with refractory epilepsy. Preclinical studies play a crucial role in drug discovery, and the zebrafish (Danio rerio) have been successfully employed for this purpose. In this study, we utilized the zebrafish PTZ-induced seizure model to evaluate the effects of two peptides on seizure responses: Tripeptide (p-BTX-I) and the CX2 (a Cx43derivated peptide). Zebrafish larvae at 6 days post-fertilization were pre-treated with these peptides at various concentrations, depending on their experimental groups, 24h prior to seizure induction. We assessed seizure frequency, quantified swimming activity, measured transcript levels of genes related to inflammation and apoptosis (il1b, tnfa, cox1, cox2a, il6, casp3a, casp9, baxa, bcl2a, and c-fos), and analyzed the biodistribution of both peptides. Our results indicate that the Tripeptide exhibited anti-inflammatory and anti-apoptotic effects, particularly through reducing the expression of il1b and casp9. CX2 pre-treatment significantly downregulated inflammatory markers (il1b, il6, tnfa, and cox1). Biodistribution analysis confirmed that the CX2 peptide reached the zebrafish brain, suggesting a direct role in modulating seizure-related pathways. Our findings demonstrate that Tripeptide and CX2 peptides can modulate gene expression and mitigate molecular response associated with epileptic seizures in the zebrafish brain. These peptides thus represent promising candidates for future research aimed at developing novel anti-epileptic therapies. However, additional studies are required to evaluate their long-term efficacy, elucidate underlying mechanisms of action, and explore potential translational applications.
A scoping review of the incentives for promoting the adoption of agroecological practices and outcomes among rice farmers in Vietnam
Recent research and development efforts to achieve sustainable rice production in Vietnam have incorporated agroecological principles and practices. These efforts have come as a result of increasing pressure on food systems to achieve global food security. Growing food demand, rising population, climate change, and natural resources degradation, make it necessary to transform the current production systems towards more sustainable models. Agroecology is being promoted as one of the pathways to transition toward sustainable food production, with broad adoption requiring incentives for farmers. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, we conducted a scoping review of 120 articles to understand the incentives applied for promoting agroecological practices, whether and how the incentives promote the adoption of agroecological practices, and their relationship with economic, environmental, and social outcomes among rice farmers in Vietnam. Such in-depth reviews of the role of incentives in the agroecological transition are scarce. Results show that in about 60% of the articles, incentives led to adoption, outcomes (e.g., yield and income gains), or both, suggesting the importance and common use of incentives among rice farmers in Vietnam. Four types of incentives used were market, non-market, regulatory, and cross-compliance. These incentives directly or indirectly influenced outcomes through the adoption of agroecological practices. Market incentives (33%) were relatively more important for directly influencing outcomes, while non-market incentives (50%) were more important for indirectly influencing outcomes. Market, non-market, and regulatory incentives were more associated with the adoption of new agronomic practices, such as farm diversification, improved varieties, and organic agriculture than with other practices, while cross-compliance incentives were more highly associated with adoption of agroforestry. Generally, the incentives used were more associated with economic outcomes (56%), than with environmental (31%), and social (13%) outcomes. Overall, the results show that incentives influence outcomes differently, and a combination of different incentives is required to achieve holistic outcomes.
Optimizing electromagnetic wave propagation in cylindrical structures with beam-plasma interactions: A mode-matching approach
This study introduces a method for analyzing the propagation of electromagnetic waves in cylindrical structures with central chambers facilitating beam-plasma interactions, particularly relevant for slow-wave structures in backward wave oscillators. The boundary value problem, governed by the Helmholtz equation, is resolved using the mode-matching technique, yielding an exact solution. The analysis elucidates key phenomena, including reflection, transmission, orthogonality relations, and power flux variations with frequency and material properties. By examining the effects of plasma frequency and beam radius on phase velocity, group velocity, and interaction efficiency, the study provides insights into optimizing wave propagation and energy transfer. The results demonstrate that higher plasma frequencies and reduced beam radii enhance scattering characteristics, offering practical guidance for designing efficient electromagnetic devices.
Comparison of case-based learning and traditional lecture in teaching residents on research misconduct: a controlled before-and-after study
As scientific outputs continue to surge, research misconduct has garnered global attention. Case-based learning (CBL), an active student-centered learning strategy, possesses many advantages but has not been widely used in China due to resource constraints. This study aimed to address the research gap regarding the impact of CBL and traditional lecture on residents’ knowledge and attitudes towards research misconduct. This controlled before-and-after study was conducted at two tertiary hospitals in southwest China from November 2022 through March 2023. All medical residents at the two hospitals were defined as participants. Residents participating in CBL course at one hospital comprised the experimental group, whereas those engaging in traditional lecture at another hospital constituted the control group. The CBL and control group included 202 and 205 individuals, respectively. A total of 298 subjects were successfully matched after propensity score matching, with 149 individuals in each group. After the courses, the participants’ knowledge on research misconduct, perceived consequences for research misconduct, and their agreement rate regarding research misconduct improved in the CBL and control group (P < 0.05), but certain aspects of their perceived consequences and agreement rate did not show significant improvement in the control group. The results revealed that there is a marked enhancement in residents’ knowledge about research misconduct, their perception of its consequences, and their overall disapproval of such behavior in the CBL group. This underscores the effectiveness of CBL in fostering a deeper understanding and stronger aversion towards research misconduct among residents.
Prognostic significance of KRAS, NRAS, BRAF, and PIK3CA mutations in stage II/III colorectal cancer: A retrospective study and meta-analysis
The prognostic significance of KRAS and BRAF mutations is well-established in metastatic colorectal cancer (CRC) but remains uncertain in early-stage tumors. This study retrospectively analyzed 47 stage II/III CRC patients undergoing curative surgery to assess the association of mutations in KRAS, NRAS, BRAF, and PIK3CA with overall survival (OS) and disease-free survival (DFS). Additionally, a meta-analysis was conducted to validate the prognostic relevance of these gene mutations. We included post hoc analyses of phase III randomized controlled trials (RCTs) in stage II/III patients receiving adjuvant therapy after curative resection in the meta-analysis. Pooled hazard ratio (HR) and 95% confidence interval (CI) was calculated using a random-effect model in the overall population, stratified subgroups adjusted for microsatellite instability (MSI) status, and within MSI-high (MSI-H) and microsatellite-stable (MSS) populations. In the retrospective cohort, mutations in KRAS, NRAS, BRAF, and PIK3CA were identified in 29.8%, 4.3%, 8.5%, and 14.9% of patients, respectively. No significant association between individual genes and survival was observed. However, in MSS patients, concurrent mutations were significantly associated with shorter OS and DFS (log-rank test, P < 0.05). The meta-analysis incorporated 13 eligible studies, including 15,034 patients. Pooled analyses revealed that KRAS and BRAF mutations were significantly linked to poor OS (KRAS: HR = 1.25, 95%CI: 1.06-1.47, P = 0.008; BRAF: HR = 1.43, 95%CI: 1.26-1.63, P < 0.001) and DFS (KRAS: HR = 1.36, 95%CI: 1.21-1.53, P < 0.001; BRAF: HR = 1.21, 95%CI: 1.02-1.44, P = 0.032). The prognostic impact of BRAF mutation increased with MSI adjustment compared those without MSI adjustment. In MSS tumors, KRAS-mutant patients demonstrated significantly shorter DFS (HR = 1.63, 95%CI: 1.25-2.13, P < 0.001), while BRAF-mutant patients exhibited reduced OS (HR = 1.53, 95%CI: 1.24-1.89, P < 0.001) and DFS (HR = 1.72, 95%CI: 1.20-2.46, P = 0.003) compared to wildtype patients. Conversely, no significant survival differences were found between mutant and wildtype patients in the MSI-H population. Although PIK3CA mutation was nominally associated with OS (HR = 0.86, 95%CI: 0.75-1.00, P = 0.046), the pooled result lacked robustness. In conclusion, KRAS and BRAF mutations had a negative prognostic impact on MSS stage II/III CRC patients receiving adjuvant therapy following curative resection. These patients may benefit from more effective adjuvant treatment strategies.
Exploration of the pattern, clinical presentation and outcome of children with renal diseases: A 14-year retrospective study at a teaching hospital in Ghana
Introduction Paediatric nephropathy, a condition associated with significant morbidity and mortality, is increasing in developing countries. Data on children with renal diseases are insufficient in Ghana despite the risk it poses. This study assessed the pattern, spectrum, outcome, and predictors of dialysis and death among children with renal disease at Korle Bu Teaching Hospital (KBTH), Ghana. Materials and methods A cross-sectional retrospective review was conducted among children aged 0–17 years. Demographic characteristics, clinical and laboratory data, information on dialysis and treatment outcomes were obtained from their medical records and analyzed accordingly using STATA software version 15.1. Results A total of 332 children with renal diseases were seen (median age of 6 years), with 200(60.98%) being males. The most common renal diseases were nephrotic syndrome 141(42.47%) and acute kidney injury (AKI) 87(26.20%). Idiopathic (unknown) causes (82.98%) and intravascular hemolysis secondary to malaria (41.38%) were the major causes of nephrotic syndrome and acute kidney injury respectively. A death rate of 15.06% resulting mostly from AKI (6.33%) was observed whilst 7.83% underwent dialysis. Predictors of dialysis among those who had dialysis included being a female and having acute on chronic kidney disease whilst having high white blood cell count and acute on chronic kidney disease were significant predictors of death among children with renal diseases. Conclusion Paediatric renal diseases at KBTH were dominated by nephrotic syndrome and AKI. Timely treatment and prevention of common infectious agents and conditions causing intravascular hemolysis, which can contribute to paediatric renal diseases in Ghana, is needed to help reduce their progression to various forms of kidney disease.
Impacts of pharmacist-led medication reconciliation on discrepancies and 30-days post-discharge health services utilization in elderly Jordanians
Objectives To assess the impacts of pharmacist-led medication reconciliation (MedRec) on medication discrepancies and post-discharge health services utilization in elderly patients in Jordan. And to identify predictors of post discharge outcomes. Method Newly admitted patients, aged above 65 years were randomly allocated into either a group receiving pharmacist led MedRec or standard care. Within 24 hours of admission, a clinical pharmacist compiled a list of the Best Possible Medication History (BPMH) using at least two sources of information. The pharmacist compared the BPMHs to the admission charts to identify discrepancies and resolved them accordingly. One month post-discharge, patients were assessed for health services use, namely hospital readmissions, emergency department (ED) visits, and adverse drug events (ADEs). Logistic regressions used to investigate predictors of post discharge outcomes. Results A total of 128 patients with 151 medication discrepancies were included: 82 (54.3%) discrepancies in the intervention group, and 69 (45.7%) in the control group. A total of 52 Pharmacist-led interventions were recommended to physicians, of which 49 (94.2%) were accepted/implemented. At discharge, the majority of unintentional discrepancies were successfully resolved (p < 0.001). At 30 days post-discharge, patients who were readmitted to the hospital and visited the ED were significantly from the control group. There was no significant difference with respect to experiencing ADEs among the study groups. Patients who received pharmacist-led MedRec had almost 70% lower likelihood of hospital readmission and ED visits. Discrepancies at discharge was associated with higher odds of hospital readmissions. Conclusion Pharmacist-led MedRec services improved continuity of care for elderly patients. Implementing a structured reconciliation process successfully resolved discrepancies and reduced hospital readmissions as well as ED visits at 30-days post-discharge. This outlines potentials for healthcare cost savings. Future studies are recommended to explore long-term benefits, cost-effectiveness, and integrating pharmacist-led MedRec into standard discharge planning.
Bacterial expression, purification and folding of exceptionally hydrophobic and essential protein: Surfactant Protein-B (SP-B)
Lung Surfactant Protein B (SP-B) is essential for life. It is thus striking that, to this point, no method for making the full-length protein has been published and consequently we lack detailed understanding of SP-B’s basic structure-function relationships, as well as an inability to make it for clinical use. The major challenge in producing SP-B lies with its exceptionally hydrophobic nature. In this work, we present a method to produce recombinant SP-B in bacteria that can be used to make the full-length protein as well as the product focused on here, which is a construct lacking the N-terminal 7 residues, rSP-B (Δ7NTC48S-SP-B-6His). The construct is produced as a fusion to Staphylococcus nuclease A (SN) in Escherichia coli C43 cells, a strain known to promote production of toxic and membrane recombinant proteins. After cleavage from SN, rSP-B is folded on column and then exchanged into the lipid or detergent system of choice. rSP-B prepared in this way exhibits the correct secondary structure and demonstrates surface activity. The yield obtained is 0.3 mg of purified rSP-B (Δ7NTC48S-SP-B-6His) per liter of initial bacterial culture. We expect this method for producing SP-B will be valuable in enabling basic research into SP-B’s mechanisms, as well as possibly facilitating the inclusion of SP-B in lung surfactant formulations to treat common and frequently fatal lung conditions and in lung surfactant-based drug delivery.
Some novel concepts of interval-valued q-rung orthopair fuzzy graphs and computational framework of fuzzy air conditioning system
The interval-valued q-rung orthopair fuzzy sets being an extension of interval-valued intuitionistic and interval-valued Pythagorean fuzzy sets is more flexible model to address vague information that has only two attributes yes or no. The combination of the concept of graph structures with interval-valued q-rung orthopair fuzzy sets termed interval-valued q-rung orthopair fuzzy graphs has been introduced in the literature. Due to its nature, interval-valued q-rung orthopair fuzzy graph provides a vast space for membership and non-membership values. In this study, we initiate the notions of covering and matching in the paradigm of interval-valued q-rung orthopair fuzzy graphs (IVq-ROFGs) and provide the analysis of fuzzy air conditioning system (FACS) based on these concepts. Some results and theorems related to these concepts, previously established for different fuzzy graphs, are also extended. In the beginning, we introduce the idea of covering in IVq-ROFGs and investigate several characteristics of some special types of IVq-ROFGs like cyclic IVq-ROFGs, complete IVq-ROFGs and complete bipartite IVq-ROFGs. Afterwards, we introduce the concept of matching in IVq-ROFGs and discuss various types of matchings within this frame. To demonstrate the effectiveness of our study, we apply the concepts of SAs and SIS in IVq-ROFGs supported by algorithm and pseudocode, to establish an appropriate framework for the FACS. This framework assesses the relationship between room temperature and target temperature. Finally, comparative study is conducted to verify that the presented model is the extension of the existing models in the literature.
The reliability and validity of a non-wearable indoor positioning system to assess mobility in older adults: A cross-sectional study
Background Detecting early changes in walking speed can allow older adults to seek preventative rehabilitation. Currently, there is a lack of consensus on which assessments to use to assess walking speed and how to continuously monitor walking speed outside of the clinic. Chirp is a privacy-preserving radar sensor developed to continuously monitor older adults’ safety and mobility without the need for cameras or wearable devices. Our study purpose was to evaluate the inter-sensor reliability, intrasession test-retest reliability, and concurrent validity of Chirp in a clinical setting. Methods We recruited 35 community-dwelling older adults (mean age 75.5 (standard deviation: 6.6) years, 86% female). All participants lived alone in an urban city in southwestern Ontario and had access to a smart device with wireless internet. Data were collected with a 4-meter ProtoKinetics Zeno TM Walkway (pressure sensors) with the Chirp sensor (radar positioning) at the end of the walkway. We assessed participants walking speed during normal and adaptive locomotion experimental conditions (walking-while-talking, obstacle, narrow walking, fast walking). We selected walking speed as a measure as it is a good predictor of functional mobility but also is associated with physical and cognitive functioning in older adults. Each of the experimental conditions was conducted twice in a randomized order, with fast walking trials performed last. For intra-session reliability testing, we conducted two blocks of walks within a participant session separated by approximately 30 minutes. Intraclass Correlation Coefficient (A,1) (ICC (A,1) ) was used to assess the reliability and validity. Linear regression, adjusted for gender, was used to investigate the association between Chirp and cognition and health-related quality of life scores. Results Chirp walking speed inter-sensor reliability ICC (A,1) = 0.999[95% Confidence Interval [CI]: 0.997 to 0.999] and intrasession test-retest reliability [ICC (A,1) = 0.921, 95% CI: 0.725 to 0.969] were excellent across all experimental conditions. Chirp walking speed concurrent validity compared to the ProtoKinetics Zeno TM Walkway was excellent across experimental conditions [ICC (A,1) = 0.993, 95% CI: 0.985 to 0.997]. We found a weak association between walking speed and cognition scores using the Montreal Cognitive Assessment across experimental conditions (estimated β-value = 7.79, 95% CI: 2.79 to 12.80) and no association between walking speed and health-related quality of life using the 12-item Short Form Survey across experimental conditions (estimated β-value = 6.12, 95% CI: -7.12 to 19.36). Conclusion Our results demonstrate that Chirp is a reliable and valid measure to assess walking speed parameters in clinics among older adults.