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Modelling the seasonal dynamics of Aedes albopictus populations using a spatio-temporal stacked machine learning model
Developing and validating a HEalthCare NAvigation Competency (HECNAC) Scale for refugees in the United States
The complex healthcare system in the United States (US) poses significant challenges for people, particularly minorities such as refugees. Refugees often encounter additional layers of challenges to healthcare navigation due to unfamiliarity with the system, limited health literacy, and language barriers. Despite their challenges, it is difficult to identify the gaps as few tools exist to measure navigation competency among this population and many conventional tools assume English proficiency, making them inadequate for refugees and other immigrants. To address this gap, this study developed and validated a HEalthCare NAvigation Competency (HECNAC) Scale tailored to refugees’ needs. The scale development process followed three phases: domain identification through a literature review and stakeholder interviews (n = 15), content validation through the Delphi method (2 rounds, n = 12), and face validity assessment via cognitive interviews (2 rounds, n = 4). Based on a literature review and stakeholder interviews, the initial version of the scale was developed, including ten domains and 47 items. An introductory email concerning the scale and the Delphi process was subsequently sent to 21 eligible experts, including staff from refugee resettlement agencies, health care providers serving refugee communities, and refugees. Twelve experts completed the two rounds of the Delphi, resulting in a consensus on 39 items. After conducting cognitive interviews with 4 Afghan refugees, the scale was finalized with ten domains and 35 items. The finalized scale captures multifaceted aspects of healthcare navigation crucial for refugees, organized into domains such as health system knowledge, insurance, making an appointment, transportation, preparing for a visit, in the clinic, interpretation, medicine, medical bills, and preventive care. Overall, the HECNAC Scale represents a significant step towards understanding and assessing refugees’ competencies in navigating the US healthcare system. It has the potential to guide tailored interventions and standardized training curricula and ultimately mitigate persistent barriers faced by refugees in accessing healthcare services.
Author Correction: Binding affinity screening of polyphenolic compounds in Stachys affinis extract (SAE) for their potential antioxidant and anti-inflammatory effects
The assessment of routine health information system performance towards improvement of quality of reproductive, maternal, newborn, child and adolescent health services in Ondo and Ekiti States, Nigeria
Background Nigeria’s reproductive, maternal, newborn, child, and adolescent health indicators have remained unsatisfactory in the face of poor-quality healthcare services. Nigeria initiated the reproductive, maternal, newborn, child, and adolescent, elderly + nutrition (RMNCAEH+N) quality of care (QoC) agenda to address the challenge. The health management information system (HMIS) is integral to the agenda but there is sparse evidence on its performance so far. This study assessed the performance of routine HMIS for RMNCAEH+N QoC in Ondo and Ekiti States. Methods This paper described the review of health facility records and health facility survey components of a multi-component study which employed a mixed-method research design. Using the routine health information system performance diagnostic tool, service data captured for over one year were critically reviewed in randomly selected sample of 169 public health facilities (Ondo:117; Ekiti:52) and information was obtained from facility heads or designates. Performance of routine HMIS for RMNCAEH+N QoC in terms of data collection, data quality, and data use were analysed using univariate and bivariate statistics. Results Results show that 67.3% of health facilities in Ekiti and 88.9% of facilities in Ondo had all required HMIS tools for selected RMNCAEH+N services (p<0.001). Data accuracy was 70.1% for Ondo and 40.4% for Ekiti (p <0.001); 82.9% of facilities in Ondo and 44.2% in Ekiti had complete data (p <0.001); almost all facilities (Ondo: 99.1%; Ekiti: 96.2%, p = 0.224) demonstrated data consistency; and, 82.9% of facilities in Ondo and 94.2% of facilities in Ekiti demonstrated timeliness in data submission (p = 0.048). Also, 70.1% (Ondo) and 78% (Ekiti) of facilities had quality improvement (QI) teams (p = 0.338); 53.5% (Ondo) and 77.1% (Ekiti) of QI teams regularly extracted data, calculated, and visualised prioritized indicators (p = 0.007); while 72.1% (Ondo) and 79.2% (Ekiti) regularly reviewed data and used it to make QI decisions (p = 0.367). Conclusion Routine RMNCAEH+N QoC data management system in Ondo and Ekiti States vary in terms of the status of reporting forms, data quality, and data use for decision-making, and there were specific performance gaps. The routine RMNCAEH+N QoC data management system in Ondo and Ekiti States needs improvement and findings from this study can serve as the basis for evidence-based advocacy for the required efforts and investment toward improved performance.
Adaptive hybrid virtual inertia controller for PMSG-based wind turbine based on fuzzy logic control
Abstract The integration of renewable energy sources into microgrids presents some challenges due to the decreased system overall inertia associated with the presence of converter -based sources. To overcome this issue and to enhance the system inertia, various concepts for virtual inertial control have been proposed in the literature. However, the concept of improving the system frequency through wind turbines has gained widespread acceptance. Several frequency support techniques have been proposed recently. However, conventional virtual inertia controllers may not satisfy the performance requirements in terms of frequency nadir and rate of change of frequency (ROCOF) over a wide range of microgrid operating conditions. This paper proposes a hybrid adaptive virtual inertia control strategy based on Fuzzy logic. The hybrid strategy integrates kinetic energy based virtual inertia control and virtual capacitance control schemes. The gains of both KE based virtual inertia control loop and virtual capacitance control loop are adapted simultaneously to enhance frequency support of low inertia microgrid under wide range of renewable energy sources (RES) disturbances and load changes. Different case studies are simulated on MATLAB/ Simulink to evaluate the dynamic performance of the proposed adaptive hybrid virtual inertia strategy under different conditions.
A cross-sectional study on the assessment of adherence to cardiovascular medications in Sudan heart center
Background Non-adherence to cardiovascular medications is a global problem with clinical, economic, and humanistic consequences. Investigation of this problem may open the road for proper management of cardiovascular diseases. Objective Our objectives were to assess the level of adherence to, and to examine factors influencing adherence to, cardiovascular medications in subjects visiting a heart center in Sudan. Methods We have conducted a cross-sectional study that assessed adherence to cardiovascular medications among subjects visiting outpatient cardiac clinics in a heart center-Khartoum State, Sudan. The validated Adherence to Refills and Medication Scale (ARMS) tool was used to assess the level of medication adherence. A score of >16 was used as a cut-off point to categorize surveyed patients into non-adherent (e.g., 17–48) and adherent (e.g., 12–16) in ARMS. Descriptive statistics (frequencies and percentages) and inferential tests such as One-Way ANOVA and Binary regression were used for data analysis. Results A total of 255 subjects were enrolled in this study. Slightly more than half the respondents were males (54.5%) and their ages ranged between (51–60 years), and have no insurance coverage (58%). Most of the subjects were married (60.4%), were from Khartoum-State (67.8%), and were unemployed (77.6%). About 39.6% had primary education while 34.5% had secondary (34.5%) education. Diabetes (56.1%) and hypertension (45.5%) were common among the study population. The results showed a high non-adherence prevalence rate (97.6%). The cited reasons for non-adherence include forgetfulness and the costs of refilling medications. Education and age were associated with the level of adherence. Those with high non-adherence behaviors were the more educated, younger and old patients, those not employed, and those having comorbid diseases. Conclusion The results generally showed a high level of non-adherence to cardiovascular medications, necessitating interventions to support patients’ adherence.
Publisher Correction: Molecular mechanisms impact on fluoroquinolone resistance among E.coli from enteric carriage monitoring before prostate biopsy and earliest description of qnrB81
Effects of intraoperative hypothermia on patients undergoing laparoscopic surgery: A retrospective cohort study
Objective This study aims to explore the association between intraoperative hypothermia and outcomes in adult patients undergoing laparoscopic surgery. Methods A retrospective analysis of 2048 adult laparoscopic surgery patients treated between 2020 and 2021 was conducted at Songklanagarind Hospital, Thailand. Intraoperative hypothermia, defined as a core temperature below 36°C, was recorded as either one or more than one episode. Patient demographics, clinical information and postoperative outcomes were extracted from the hospital information system. The outcomes were intraoperative and postoperative cardiac arrhythmias, postoperative oxygen requirement, length of post-anesthetic care unit (PACU) stay, and length of hospital stay. Univariate and multivariate logistic/linear regression models were fit to assess the association between hypothermia and outcomes, presented as odds ratio (OR) or beta-coefficient (β) with 95% confidence interval (CI). Results The incidence of intraoperative hypothermia was 34.9%, with 688 experiencing one episode and 27 experiencing multiple episodes. On multivariate analysis, patients with one and more than one episode of hypothermia had an increased risk of intraoperative cardiac arrhythmia compared to normothermic patients (OR [95%CI]: 1.67[1.24,2.25] and 3.65[1.53,8.74], respectively, P<0.001). Normothermic patients and hypothermic patients with more than one-episode had a higher odds of postoperative oxygen requirement compared to hypothermic patients with only one episode (OR [95%CI]:1.32[1.02,1.7] and 2.64[1.1,6.32], respectively, P = 0.019). Hypothermic patients with one and more than one-episode also had longer PACU stays compared to normothermic patients (β[95%CI]:3.82[1.34,6.29] and 12.43[2.29,22.57] minutes, respectively, P = 0.001). No significant differences were observed in the other outcomes. Conclusions Intraoperative hypothermia in laparoscopic surgery is associated with a higher likelihood of intraoperative cardiac arrhythmias, prolonged PACU stay and higher postoperative oxygen requirement. Further research and prospective studies are warranted to validate these results and develop strategies to manage intraoperative hypothermia effectively.
Author Correction: Effect of ozonation on the phytochemicals of black seed oil and its anti-microbial, anti-oxidant, anti-inflammatory, and anti-neoplastic activities in vitro
Congenital pulmonic and aortic stenosis in Newfoundland dogs: Results of a 14-year French cardiovascular screening program (921 dogs)
Introduction Aortic stenosis (AS) and pulmonic stenosis (PS) are two of the most common canine congenital heart diseases (CHD), with a high relative risk for Newfoundland dogs to develop inherited subvalvular AS. For this reason, a cardiovascular screening program has been set up by the French Newfoundland kennel club in order to manage mattings and reduce AS prevalence. Materials and methods The records of untreated and non-anesthetized adult Newfoundland dogs screened between 2010 and 2023 were retrospectively reviewed. All dogs underwent physical examination and standard transthoracic echocardiography with concomitant ECG tracing. All examinations were reviewed by one single board-certified specialist in cardiology. Results A total of 921 dogs were screened during the study period (female:male sex ratio = 1.94, median age [IQR] = 1.9 years [1.6–2.7], body weight = 55.0 kg [50–60]). For most dogs (90.6% for AS and 91% PS), a single examination was required to obtain a definitive cardiac status, although most operators (122/133 = 91.7%) were non-specialist general practitioners. Out of the 921 screened dogs, 913/921 (99.1%) and 919/921 (99.8%) were respectively free of AS and PS, with no AS and PS detection during the last 3 years of the program. The inbreeding coefficient, which was assessed from the pedigree analysis of all screened dogs except one, was not significantly different between dogs with either AS (0.59%; P = 0.86) or PS (0.39%; P = 0.72) and those without any arterial stenosis (0.39%). Conclusion This 14-year cardiovascular screening program has experienced a strong involvement of veterinarians, breeders, and owners throughout France. Unlike reports from other European and North American countries, this program suggests the low and decreasing prevalence of both AS and PS in the Newfoundland breed in France.
Integrating multiomics analysis and machine learning to refine the molecular subtyping and prognostic analysis of stomach adenocarcinoma
Identification of cuproptosis and ferroptosis-related subtypes and development of a prognostic signature in colon cancer
Colon cancer, as a highly prevalent malignant tumor globally, poses a significant threat to human health. In recent years, ferroptosis and cuproptosis, as two novel forms of cell death, have attracted widespread attention for their potential roles in the development and treatment of colon cancer. However, the investigation into the subtypes and their impact on the survival of colon cancer patients remains understudied. In this study, utilizing data from TCGA and GEO databases, we examined the expression differences of ferroptosis and cuproptosis-related genes in colon cancer and identified two subtypes. Through functional analysis and bioinformatics methods, we elucidated pathway differences and biological characteristics between these two subtypes. By leveraging differential genes between the two subtypes, we constructed a prognostic model using univariate Cox regression and multivariate Cox regression analysis as well as LASSO regression analysis. Further survival analysis and receiver operating characteristic curve analysis demonstrated the model’s high accuracy. To enhance its clinical utility, we evaluated the clinical significance of the model and constructed a nomogram, significantly improving the predictive ability of the model and providing a new tool for prognostic assessment of colon cancer patients. Subsequently, through immune-related analysis, we revealed differences in immune cell infiltration and immune function between high- and low-risk groups. Further analysis of the relationship between the model and immune cells and functions revealed potential therapeutic targets. Drug sensitivity analysis revealed associations between the expression of model-related genes and drug sensitivity, suggesting their involvement in tumor resistance through certain mechanisms. AZD8055_1059, Bortezomib_1191, Dihydrorotenone_1827, and MG-132_1862 were more sensitive in the high-risk group. Finally, we analyzed differential expression of model-related genes between tumor tissues and normal tissues, validated through real-time quantitative PCR and immunohistochemistry. In summary, our study provides a relatively accurate prognostic tool for colon cancer patients, offering guidance for treatment selection and indicating the potential of immunotherapy in colon cancer.
Blockchain enabled traceability in the jewel supply chain
Coevolutionary dynamics in the grass-livestock social-ecological system of China’s alpine pastoral areas: A case study of the Qilian Mountains region in China
Evaluating the dynamic co-evolution and feedback mechanisms within socio-ecological systems is crucial for determining the resilience and sustainability of environmental governance strategies. The grass-livestock system, as a complex entity encompassing livestock nutrition, foraging behavior, vegetation ecology, pastoralists’ economic income, and policy interventions, indicates that any change in a single element may trigger a chain reaction within the system. This paper uses a system dynamics approach to construct a simulation model of the grass-livestock system in alpine pastoral areas, simulating the long-term dynamic co-evolution of the socio-ecological system in the Qilian Mountains region of China. Four optimization schemes were proposed, and the synergistic development of the grass-livestock system in alpine pastoral areas under each scheme was simulated. The results show that, under the premise of sustainable use of grazing-based artificial grassland, the combination of reasonable use of fenced grasslands and cooperative management by pastoralists can effectively control livestock numbers, ensure pastoralists’ income, and maintain grassland quality within the next 20 years, thereby achieving coordinated socio-economic and ecological development. Additionally, optimizing feed supply can significantly improve grass production, livestock weight, and income. Therefore, it is recommended that alpine pastoral areas prioritize both grassland ecological management and development, adopt grassland restoration technologies, strengthen the management of artificial grasslands, set reasonable grazing bans, develop pastoralist cooperative organizations and design internal operational mechanisms.
A two-stage model of the fuzzy analytic hierarchy process and the fuzzy synthetic evaluation technique to prioritize sustainable sanitation services under uncertainty
Women were at the centre of social networks in Iron Age Britain
Abnormalities in male gametophytes development responsible for low seed set of Peudosasa subsolida
Pseudosasa subsolida belongs to the Pseudosasa genus within the Poaceae family. Due to its unique flowering cycle and the physiological traits associated with asexual reproduction, acquiring floral material from P. subsolida is particularly challenging. To investigate the causes of the low seed set rate in P. subsolida, floral organs and the development of male and female gametes were examined using conventional paraffin sectioning. The results revealed that the spikelet of P. subsolida exhibited the characteristics of a pseudospikelet with a latent bud, while the inflorescence displayed traits of an infinite inflorescence. Each spikelet contained approximately 10–16 florets and was accompanied by two bracts at its base. The fundamental structure of the florets comprised one lemma, one palea, three lodicules, three stamens, and one pistil. At the later stages of anther development, some abnormalities were observed, including the failure of pollen grains to form, deformation and shrinkage of the cells in the anther sac and tapetum, loss of the cells in the middle layer, cavitation of the microspores, and no identifiable contents The study concluded that the primary factor contributing to the low seed setting rate of P. subsolida was the aberrant development of male gametophytes. The significance of this study lay in its pioneering exploration of the reproductive structure of P. subsolida, and provide a theoretical reference for the fundamental examination of flower structure.
Impact of gas composition, pressure, and temperature on interfacial Tension dynamics in CO₂-Enhanced oil recovery
Construction on training course and training quality evaluation index system of chronic disease medication therapy management service (MTMs) in China: A Delphi study
Objective This study aims to construct a training course and quality evaluation index system for chronic disease Medication Therapy Management service (MTMs) that is suitable for China’s national conditions. It seeks to provide tools and a scientific foundation for assessing the quality of MTMs training. Methods Drawing from domestic and international literature and combining with the practice of chronic disease medication management by Chinese pharmacists, a preliminary framework for the evaluation index system was established. The Delphi method was used to solicit expert opinions, evaluate and improve the evaluation index system. Indicator weights were determined by using the Analytic Hierarchy Process (AHP). Results Both rounds of expert inquiry achieved a positive degree of 100% (18/18 experts). The authority coefficients (Cr) were 0.90 and 0.91 respectively. The Kendall coordination coefficients (Kendall’s W) of the second and third-level indicators for the first round of inquiry were 0.230 and 0.189, while those for the second round were 0.326 and 0.213. Finally, an MTMs training course and training quality evaluation index system was structured, comprising 3 first-level indicators, 11 second-level indicators, and 39 third-level indicators. Conclusion The evaluation index system constructed in this study is scientifically robust and rational, offering a foundation to standardize MTMs training practices effectively.