Browse Articles
Discover research articles across all indexed journals
Automated mold defects classification in paintings: A comparison of machine learning and rule-based techniques
Mold defects pose a significant risk to the preservation of valuable fine art paintings, typically arising from fungal growth in humid environments. This paper presents a novel approach for detecting and categorizing mold defects in fine art paintings. The technique leverages a feature extraction method called Derivative Level Thresholding to pinpoint suspicious regions within an image. Subsequently, these regions are classified as mold defects using either morphological filtering or machine learning models such as Classification and Regression Trees (CART) and Linear Discriminant Analysis (LDA). The efficacy of these methods was evaluated using the Mold Features Dataset (MFD) and a separate set of test images. Results indicate that both methods improve the accuracy and precision of mold defect detection compared to no classifier. However, the CART algorithm exhibits superior performance, increasing precision by 32% to 53% while maintaining high accuracy (96%) even with an imbalanced dataset. This innovative method has the potential to transform the approach to managing mold defects in fine art paintings by offering a more precise and efficient means of identification. By enabling early detection of mold defects, this method can play a crucial role in safeguarding these invaluable artworks for future generations.
An infodemiologic review of internet resources on dental hypersensitivity: A quality and readability assessment
Background This study aimed to investigate the quality and readability of online English health information about dental sensitivity and how patients evaluate and utilize these web-based information. Methods The credibility and readability of health information was obtained from three search engines. We conducted searches in "incognito" mode to reduce the possibility of biases. Quality assessment utilized JAMA benchmarks, the DISCERN tool, and HONcode. Readability was analyzed using the SMOG, FRE, and FKGL indices. Results Out of 600 websites, 90 were included, with 62.2% affiliated with dental or medical centers, among these websites, 80% exclusively related to dental implant treatments. Regarding JAMA benchmarks, currency was the most commonly achieved and 87.8% of websites fell into the "moderate quality" category. Word and sentence counts ranged widely with a mean of 815.7 (±435.4) and 60.2 (±33.3), respectively. FKGL averaging 8.6 (±1.6), SMOG scores averaging 7.6 (±1.1), and FRE scale showed a mean of 58.28 (±9.1), with "fair difficult" being the most common category. Conclusion The overall evaluation using DISCERN indicated a moderate quality level, with a notable absence of referencing. JAMA benchmarks revealed a general non-adherence among websites, as none of the websites met all of the four criteria. Only one website was HON code certified, suggesting a lack of reliable sources for web-based health information accuracy. Readability assessments showed varying results, with the majority being "fair difficult". Although readability did not significantly differ across affiliations, a wide range of the number of words and sentences count was observed between them.
Genetic diversity and population structure analyses of tropical maize inbred lines using Single Nucleotide Polymorphism markers
Analyses of the genetic distance and composition of inbred lines are a prerequisite for parental selection and to exploit heterosis in plant breeding programs. The study aimed to assess genetic diversity and population structure of a maize germplasm panel comprising 182 founder lines and 866 derived inbred lines using Single Nucleotide Polymorphism (SNP) markers to identify genetically unique lines for hybrid breeding. The founder lines were genotyped with 1201 SNPs, and the derived lines with 1484 SNPs. Moderate genetic variation, with genetic diversity ranging from 0.004 to 0.44 with a mean of 0.25, was recorded for the founder lines, while corresponding values of 0.004 to 0.34 with a mean of 0.13 were recorded for the derived lines. Heterozygosity values ranging from 0.00 to 0.24 and a mean of 0.08 were recorded for both lines. Of the SNP markers used, 82% of the 1201 markers and 84% of the 1484 markers exhibited polymorphism information content ranging from 0.25 to 0.50. Analysis of molecular variance revealed significant genetic differences (P ≤ 0.001) among and within populations in the founder and derived lines. Most detected variations, i.e., 97% and 88.38%, were attributed to within populations in the founder and derived lines, respectively. Population structure analysis identified three distinct subpopulations among founder lines and two among derived lines. Cluster analysis supported the population structure The following genetically distant founder and derived inbred lines were selected: G15NL337 and G15NL312 (Cluster 1), 15ARG152 and RGS-PL44 (Cluster 2), RGS-PL44 and 15ARG149 (Cluster 2), and RGS-PL33 and RGS-PL44 (Cluster 2), respectively. The selected lines are genetically distinct and recommended for marker-assisted hybrid maize breeding to exploit the frequency of beneficial alleles. This study provides valuable insights for maize breeding programs, enabling the exploitation of beneficial alleles and contributing to improved crop yields and food security through hybrid breeding.
Evolutionary analysis of landscape ecological risk in Baili Rhododendron National Forest Park
It is significant to research the ecological risk of land use landscape to promote ecological conservation and restoration. The characteristics of land use dynamic change in Baili Rhododendron National Forest Park were analyzed based on GlobeLand30 data for three periods in 2000, 2010 and 2020. With the support of the landscape ecological risk evaluation model and spatial analysis methods, the features of spatial and temporal differentiation of ecological risk and its spatial correlation in the study area were evaluated. The results show that (1) the landscape pattern changed visibly from 2000 to 2020, the comprehensive land-use dynamics increased from 8.53% to 9.66%, and the land use dynamics are greatest and change most dramatically on construction sites; (2) the landscape ecological risk level of the study area as a whole showed a declining trend, and 96.82% of the ecological risk plot index decreased, and the risk distribution was dominated by lower risk, medium risk and higher risk areas; (3) landscape ecological risk was spatially positively correlated across all time periods, and the spatial aggregation was gradually weakened, with the distribution of LH and HL areas dispersed and the distribution of HH and LL areas concentrated. The overall landscape ecological risk index has witnessed a decline, indicating a positive trajectory in the development of the ecological environment.
BMI-mediated association between glyphosate exposure and increased risk of atherosclerotic heart disease: A large-scale cross-sectional study
Background Glyphosate, as the main component of glyphosate pesticides, has been shown to have toxic effects on multiple human systems. However, the association between glyphosate and atherosclerotic cardiovascular disease (ASCVD) remains unclear. This study aims to explore the effect of glyphosate exposure on ASCVD. Methods This study involved 1,602 participants and employed various statistical techniques, such as multivariable logistic regression, linear fitting, mediation analysis, subgroup analysis, and sensitivity analysis, to elucidate the association between glyphosate exposure and cardiovascular diseases. Results Compared with the low level of glyphosate exposure, the risk of ASCVD increased significantly with high level of glyphosate exposure (OR = 2.05, 95%CI = 1.17–3.58, p<0.05, p for trend<0.05), which showed a linear upward trend. Further analysis found that exposure to high levels of glyphosate and angina pectoris (OR = 2.84, 95%CI = 1.00–8.04, p<0.05, p for trend<0.05), coronary heart disease (OR = 3.76, 95%CI = 1.80–7.83, p<0.01, p for trend<0.05), heart attack (OR = 2.65, 95%CI = 1.35–5.23, p<0.01, p for trend = 0.09) were associated. Mediating analysis found that BMI mediated the association between glyphosate exposure and ASCVD, with an indirect effect of 0.002405(95%CI: 0.000182–0.01, p = 0.02) and a direct effect of 0.039336(95%CI: 0.000391–0.09), total effect of 0.041741(95%CI: 0.002112–0.10). Conclusion Increased exposure to glyphosate is associated with an increased risk of ASCVD, and BMI plays a mediating role in this association. In addition, glyphosate exposure is associated with a higher risk of angina, coronary heart disease, and heart attack.
Computational design of multi-epitope vaccine against Hepatitis C Virus infection using immunoinformatics techniques
Hepatitis C Virus (HCV) is a blood borne pathogen that affects around 200 million individuals worldwide. Immunizations against the Hepatitis C Virus are intended to enhance T-cell responses and have been identified as a crucial component of successful antiviral therapy. Nevertheless, attempts to mediate clinically relevant anti-HCV activity in people have mainly failed, despite the vaccines present satisfactory progress. In this study, we used an array of immunoinformatics approaches to design a multiepitope peptide-based vaccine against HCV by emphasizing 6 conserved epitopes from viral protein NS5B. The potential epitopes were examined for their possible antigenic combination with each other along with GPGPG linkers using structural modeling and epitope-epitope interaction analysis. An adjuvant (β-defensin) was introduced to the N-terminus to increase the immunogenicity of the vaccine construct. Molecular dynamics simulation discloses the most stable structure of the proposed vaccine. The designed vaccine is potentially antigenic in nature and can form stable and significant interaction with both receptors TLR2 and TLR3. The vaccine construct was also subjected to In-Silico cloning which confirmed its expression efficiency in a vector. The findings indicate that the designed multi-epitope vaccine have a great potential for preclinical and clinical research, which is an important step in addressing the problems related to HCV infection.
Female genital mutilation among children in Ethiopia: A time-to-event analysis of age at circumcision
Female Genital Mutilation (FGM) has become a global health concern. It is a deeply entrenched harmful practice involving partial or total removal of the external female genitalia for non-medical reasons. To inform effective policymaking and raise awareness about FGM’s health risks, understanding socioeconomic and demographic factors influencing the timing of girls’ circumcision is crucial. This study employed semi-parametric survival models to examine the association between residential status and time-to-circumcision of girls in Ethiopia. The data used in this study was the 2016 Ethiopian Demographic and Health Survey (EDHS) report, which was conducted by the Central Statistical Agency (CSA). The analysis revealed that residential status (rural vs urban, HR = 1.73: 1.35–2.70), religion (Muslim vs Christian, HR = 1.51: 1.38–2.70), mother’s educational level (none vs higher, HR = 5.25: 2.23–12.36 or primary vs higher HR = 4.12: 1.25–9.68), father’s educational level (none vs higher, HR = 1.65: 1.12–2.43), and mother’s age (15–24 years vs 35 +, HR = 1.89: 1.21–2.95 or 24–34 years vs 35 +, HR = 1.55: 1.18–2.02) are significant risk factors for age at circumcision. Mother’s age and family wealth index were time dependent risk factors. Effective interventions to reduce FGM prevalence would need to address multiple aspects simultaneously, including improving access to education (especially for girls and women), targeting both urban and rural areas with awareness campaigns, and considering culturally sensitive approaches that take into account religious and traditional beliefs while promoting the health and rights of girls and women.
Impacts of continuing education on Primary Health Care professionals—A scoping review protocol
Introduction Continuing Health Education is a strategy that integrates learning into the work process to transform health practices. Primary health care has proved to be a powerful space for consolidating continuing education, as it promotes reflection and learning based on the local singularities of the territory. Continuing health education is an important strategy for transforming the reality of Primary health care, reinventing work, and consequently changing practices. Objective This study aimed to identify and analyze the evidence regarding the impact of continuing education for health professionals in Primary Health Care in Brazil. Method This scoping review protocol that will be developed based on the Joanna Briggs Institute manual and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The databases included in the study will be MEDLINE/Pubmed, Scielo, Lilacs, EMBASE, and Web of Science. Google Scholar will be used as gray literature. Studies published between 2007 and 2024 will be included, and no language restrictions will be applied. The Rayyan management software will be used as a tool to support the selection of studies. Two independent researchers will carry out a paired review to ensure the relevance of the studies. The studies will be analyzed descriptively, which will be guided by the categorization of results into three large groups: a) thematic areas covered; b) methodologies used; c) work process indicators and/or health results. Discussion Relevant aspects will be pointed out and interrelated in narrative form with the existing literature on the subject. Through the preparation of this protocol, it is aimed to identify to identify studies with evidence on the impact of continuing education in Primary Health Care in Brazil. This review could support the formulation of new professional training policies for PHC, contributing to the improvement of professional practices and the organization of work based on the needs of each territory.
Demographics and regional trends of ischemic heart disease-related mortality in older adults in the United States, 1999–2020
Background Ischemic heart disease (IHD) has a significant impact on public health and healthcare expenditures in the United States (US). Methods We used data from the CDC WONDER database from 1999–2020 to identify trends in the IHD-related mortality of patients ≥ 75 years in the US. AAMRs per 100,000 population and APC were calculated and categorized by year, sex, race, and geographic divisions. Results Between 1999 and 2020, a total of 8,124,568 IHD-related deaths were recorded. Notable declines in AAMR were observed from 1999 to 2014 (APC: -3.86) and from 2014 to 2018 (APC: -2.55), with an overall increase from 2018 to 2020 (APC: 3.76). Older men consistently demonstrated higher AAMRs than older females, with AAMRs for both sexes decreasing steadily from 1999 to 2018 and increasing in 2020. When stratified by race/ethnicity, Whites (1931.7) had the highest AAMR, followed by Blacks (1836.5), American Indians (1510.5), Hispanics (1464.4), and Asians (1093.6). Furthermore, nonmetropolitan areas (2015.2) showed greater AAMRs than metropolitan areas (1841.8). The ≥ 85-year group consistently exhibited higher IHD-related mortality rates compared to the 75–84 years group. In comparison, the older group [≥75 years] (1873.0) consistently exhibited higher IHD-related AAMRs than the younger group [<75 years] (64.0) throughout the study, showing a significant disparity. Chronic IHD (1552.0) consistently showed the highest AAMRs throughout the study, surpassing myocardial infarction (515.6), other ischemic heart diseases (24.0), and angina pectoris (5.6). Conclusion Targeted interventions and resource allocation are crucial for areas with high IHD-related mortality. Public health policies should address demographic and geographical disparities, with further research for effective strategies.
Randomized clinical trial of ICECaP (Individualized Coordination and Empowerment for Care Partners of Persons with Dementia): Primary mental health and burden outcomes
We examine the efficacy of the Individualized Coordination and Empowerment for Care Partners of Persons with Dementia (ICECaP), an intervention that involves one-on-one individualized support from a dementia care coordinator for a dementia care partner, compared to an active control group. At least once monthly contact is made from a dementia care coordinator to the dementia care partner by telephone, video conferencing, email, or in-person support at clinical visits for the person with dementia. In this pilot randomized unblinded control trial of ICECaP, n = 61 (n = 90 randomized) care partners completed 12-months of the ICECaP intervention and n = 69 (n = 92 randomized) care partners received routine clinical support (controls) in an outpatient memory care clinic at an academic medical center, from which the participants were recruited. Early termination endpoints (death and higher level of care) and trial drop out were comparable across groups. Primary efficacy outcomes were evaluated by comparing changes in care partner mental health, burden, and quality of life from baseline to 12-months between ICECaP and controls. Linear mixed-effects model with covariate adjustment revealed no significant group differences in longitudinal changes on measures of caregiving burden, care partner depression, anxiety, quality of life, or reactions to the behavioral symptoms of the person with dementia. Hypothesized reasons for lack of initial efficacy on primary 12-month outcomes are discussed.
The effects of preoperative glenohumeral osteoarthritis on rotator cuff repair: A systematic review and meta-analysis
Purpose This meta-analysis was carried out to evaluate the clinical effectiveness of rotator cuff repair surgery in treating rotator cuff tears in individuals with mild glenohumeral osteoarthritis (GHOA). Methods A computer-based search was conducted across multiple databases including PubMed, Embase, Web of Science, and Cochrane Library using the keywords "Shoulder Joints", "Osteoarthrosis", and "rotator cuff". Only studies focusing on patients with GHOA who underwent rotator cuff repair were considered for inclusion. The pertinent data was extracted and assessed for heterogeneity. Results A total of 5 studies involving 924 patients were included in the meta-analysis. The treatment outcomes of patients with rotator cuff tears accompanied by mild GHOA and those with simple rotator cuff tears after rotator cuff repair were comparable in terms of retear(OR: 1.24; 95% CI 0.82–1.89; P = 0.31). The postoperative functional scores: the VAS score (MD: 0.14; 95% CI -0.19–0.47; P = 0.41)、ASES score (MD: -0.33; 95% CI -1.64–0.99)were similar between the two groups. Subgroup analysis of rotator cuff tears(small to moderate, MD: 0.85; 95%CI -0.65–2.39; p = 0.28; large to massive, MD: -1.94; 95% CI -8.45–4.58; P = 0.56), showed no difference in postoperative ASES scores between the two groups. Constant score (MD:-3.20; 95% CI -6.33–0.08; P = 0.04), external rotation (ER) in Range of motion (ROM) (MD: -4.42; 95% CI -6.72–2.13; P = 0.0002) and forward flexion (FF) in ROM(MD: -4.22; 95% CI -8.28–0.15; P = 0.04) were superior in patients with simple rotator cuff tears compared to those with rotator cuff tears accompanied by GHOA. Conclusion Patients with rotator cuff tears and mild GHOA can achieve shoulder joint restoration after shoulder cuff repair surgery, and there is only a certain difference in postoperative Constant Score and ROM between these two groups. Trial registration PROSPERO registration CRD42024565212.
The corneal biomechanical changes of phacoemulsification in cataract patients: A systematic review and meta-analysis
Purpose To evaluate the corneal biomechanical properties of phacoemulsification in the treatment of cataract patients. Methods Pertinent studies were searched in PubMed, EMBASE, Web of Science and clinicaltrials.gov., as of November 05, 2024. The reference lists of related published reviews were included as well. This meta-analysis was performed with Stata Software and Review Manager, we used mean difference (MD) to evaluate the statistical consequence, using I2 statistic to assess the heterogeneity. Subgroup analysis were performed under the occurrences of high heterogeneity. We used eleven items to describe the characteristics of included studies, publication bias was performed with Egger’s test. The quality assessment were evaluated with 3 items by Newcastle-Ottawa Scale (NOS) items. Results Thirteen eligible studies were identified for data synthesis and assessment. According to the result of meta-analysis, the central corneal thickness(CCT) (MD = 10.50, 95% CI: [5.01, 15.98]; P<0.05) and intraocular pressure(IOPg)(MD = -0.73, 95% CI: [-1.26, -0.19]; P<0.05) of cataract patients after phacoemulsification was significantly higher than the control groups. The values of corneal hysteresis(CH) (MD = -0.43, 95% CI: [-0.62, -0.23]; P<0.05) and corneal resistance factor(CRF) (MD = -0.49, 95% CI: [-0.64, -0.33]; P<0.05) after phacoemulsification surgery were statistically lower than the control groups. While the values of IOPcc did not show statistically different (MD = -0.13, 95% CI: [-0.67, 0.41]; P = 0.64). Conclusion Included data analysis indicated that the values of CCT, CH, CRF and IOPg showed statistical change in cataract patients after phacoemulsification surgeries compared with control groups. There is a correlation between corneal biomechanics and phacoemulsification surgeries.
Combating trade in illegal wood and forest products with machine learning
Trade in wood and forest products spans the global supply chain. Illegal logging and associated trade in forest products present a persistent threat to vulnerable ecosystems and communities. Illegal timber trade has been linked to violations of tax and conservation laws, as well as broader transnational crimes. The United States is the largest importer globally of wood and forest products, such as pulp, paper, flooring, and furniture—importing $78 billion in 2021. Transaction-level data such as shipping container manifests and bills of lading provide a comprehensive data source that can be used to detect and disrupt trade that may be suspected of containing illegally harvested or traded forest products. Owing to the volume, velocity, and complexity of shipment data, an automated decision support system is required for the purposes of detecting suspicious forest product shipments. We present a proof of concept framework using machine learning and big data approaches—combining domain expertise with automation—to achieve this objective. We formulated the underlying machine learning problem as an anomaly detection problem and collected and collated forest sector-specific domain knowledge to filter and target shipments of interest. In this work, we provide the overview of our framework, with the details of domain knowledge extraction and machine learning models, and discuss initial results and analysis of flagged anomalous and potentially suspicious records to demonstrate the efficacy of this approach. The proof of concept work presented here provides the groundwork for an actionable and feasible approach to assisting enforcement agencies with the detection of suspicious shipments that may contain illegally harvested or traded wood.
How is maternal employment associated with infant and young child feeding in Bangladesh? A systematic literature review and meta-analysis
Background In the last three decades, the increasing trend in female employment in Bangladesh has been critically analyzed from a socioeconomic point of view; however, its impact on infant and young child feeding (IYCF) practices has yet to be systematically reviewed. The aim of this systematic review and meta-analysis is to investigate the association between these variables. Methods A systematic literature search was conducted in PubMed, Medline, Web of Science, Embase, CINAHL, and Google Scholar to retrieve relevant records with no restriction of publication period. The Covidence tool was used for screening and data extraction. Meta-analysis was carried out using random effect models. The Newcastle-Ottawa scale was used for the quality assessment of the included articles. Results A total of 24 articles were included. Of these, 16 focused on breastfeeding-related indicators, 6 focused on complementary feeding-related indicators, and 2 focused on both. Maternal employment was found to have both positive (protective) and negative (detrimental) associations with exclusive breastfeeding, whereas it was mainly positively associated with complementary feeding practices. Meta-analysis showed the pooled odds ratio of recommended early initiation of breastfeeding, exclusive breastfeeding, and complementary feeding among employed mothers were 0.79 (95% CI: 0.49, 1.27; p = 0.33), 0.32 (95% CI:0.16, 0.67; p = 0.002), and 1.07 (95% CI: 0.81, 1.42; p = 0.63) compared to their counterparts, respectively. Conclusions Maternal employment appears not to be a protective factor for some important breastfeeding indicators in Bangladesh. For example, there was a statistically significant lower likelihood of exclusive breastfeeding practice among employed mothers as compared to those who were not employed. Therefore, these issues should be taken into consideration when formulating relevant policies and interventions, e.g., breastfeeding-friendly workplace.
Phase angle in bioelectrical impedance analysis for assessing congestion in acute heart failure
Background The phase angle (PhA) in bioelectrical impedance analysis (BIA) reflects the cell membrane integrity or body fluid equilibrium. We examined how the PhA aligns with previously known markers of acute heart failure (HF) and assessed its value as a screening tool. Methods PhA was measured in 50 patients with HF and 20 non-HF controls along with the edema index (EI), another BIA parameter suggestive of edema. Chest computed tomography-measured lung fluid content (LFC) was used to assess pulmonary congestion. A correlation analysis was conducted to evaluate the relationships between PhA and EI, NT-proBNP, and LFC. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off values for PhA and EI for classifying patients with HF. The area under the curve (AUC) was compared using the DeLong test to evaluate the performance of PhA and EI compared to that of LFC in correctly classifying HF. Results The PhA levels were significantly lower in the HF group. Whole-body PhA was 4.49° in the HF group and 5.68° in the control group. Moderate and significant correlation was observed between PhA measured at 50-kHz and both NT-proBNP (-0.56 to -0.27, all p-values<0.05) and LFC (-0.52 to -0.41, all p-values <0.05). The AUC for whole-body PhA was 0.827 (confidence interval [CI] 0.724–0.931, p<0.01) and was 0.883 (CI 0.806–0.961, p<0.01) for EI, and the optimal cutoffs were estimated as 5° (sensitivity 0.84, specificity 0.80) and 0.394 (sensitivity 0.78, specificity 0.95), respectively. When both PhA and EI were included in the model, the AUC increased to 0.905, and this was comparable to that of LFC (AUC = 0.913, p = 0.857). Conclusions PhA exhibited a correlation with known markers of HF and demonstrated its potential as a non-invasive screening tool for the early detection of HF exacerbation. The combined use of PhA and EI can provide a robust alternative for routine self-monitoring in patients with HF, thereby enhancing early intervention.
Cross- analyzing the opinions and experiences of nurses, physiotherapists, dentists, midwives, and pharmacists with respect to addictive disorder screening in primary care: A qualitative study
Early addiction disorders screening is recommended in primary care. The goal of health system reform is to include allied health professionals in this screening. The appropriation of their new role has not yet been explored. The main aim of this study was to examine the perspective of allied health professionals in primary care on the screening of addictive disorders. This qualitative study inspired by the grounded theory was carried out between August 2018 and July 2019. Semi-structured individual interviews and focus groups were organized to include of primary care health professionals (physiotherapist, nurse, midwife, pharmacist, and dentist). Thirteen semi-structured individual interviews and four focus groups were recorded and coded. The paramedics described the advantages of their professions for the detection of addictions: home visits, prescription history, habit of intimate subjects, close consultations, etc. Despite daily practice-specific observation posts, they sometimes remained silent witnesses, and their helplessness hindered identification. They felt both closer to the patients and less legitimate than the doctors in dealing with addictions. Finally, their desire for a multidisciplinary approach was limited by the fear of disturbing the doctor and the confusion between betrayal and medical secrecy. Paramedical professionals claimed to have a complementary role to play in identifying addictions. Their reluctance echoed the concept of self-censorship, already described in studies with addictologists and patients. These results must be compared with the opinions of general practitioners and patients.
Patient adherence, satisfaction and changes in anthropometric parameters with e-health versus in-person monitoring in metabolic bariatric surgery patients: A study protocol for a systematic review and non-inferiority meta-analysis of cohort studies
Background Obesity is a risk factor for cardiovascular diseases and associated with reduced life expectancy metabolic bariatric surgery (MBS) is the treatment indicated when patients are unable to lose weight through lifestyle changes and medication alone. However, more evidence is necessary to show non-inferiority of e-health compared to in-person monitoring with regard to important parameters for the success of surgical treatment of obesity such as anthropometric changes. Methods and analyses This review study will include cohort studies involving individuals with obesity and e-health or in-person patient monitoring before and after MBS. This study protocol was registered in the PROSPERO (CRD42023491051). We will conduct searches in the following databases: PubMed, EMBASE (Elsevier), Cochrane (CENTRAL), Web of Science, SCOPUS and CINAHL (EBSCO) and LILACS-VHL. We will also search databases in the gray literature. The primary outcomes will be changes in body mass index (BMI), body weight (kg) and body fat percentage (BF%) and patient adherence and satisfaction. The risk of bias of individual eligible studies will be assessed using the Newcastle-Ottawa Scale and the overall quality will be assessed using the GRADE tool. Our analyses will involve comparisons of mean differences or standardized mean differences across the groups using random-effects models and 95% confidence intervals. Statistical analyses will be performed with RStudio for Windows (v1.3.959) using R package meta (v3.6.1). Discussion and conclusion Our study can offer evidence that shows the benefits of e-health patient monitoring of individuals undergoing MBS and supports scaling up this care modality to reduce waiting times and health care costs.
Insulin therapy adherence and its associated factors among diabetic patients in a Ghanaian primary care hospital
Background Diabetes mellitus (DM) is a global health problem. Adherence to intensive insulin therapy is necessary to achieve better glycemic control in types 1 and 2 DM. This study aimed to evaluate the extent of adherence to insulin therapy, its predictors and to identify barriers to its adherence. Method This was a cross-sectional survey among adult (≥18 years) diabetic patients who are currently using insulin, either alone or in combination with an oral antidiabetic regimen, and seeking primary care at Kwame Nkrumah University of Science and Technology Hospital in Ghana. A total of one hundred and eight-six patients were conveniently sampled, and interviewed. Insulin adherence was determined using the Medication Adherence Reporting Scale-5. Descriptive statistics, a chi-square test of independence, and a multiple logistic regression analysis were performed using STATA version 14 (StataCorp, TX USA). Results The majority of the patients interviewed were over 60 years (40.32%); female (61.83%); married (68.82%); and had completed secondary education (48.39%). 67.20% of the patients were adherent to insulin therapy. Adherence level was associated with age (p = 0.020), marital status (p = 0.001), employment status (p = 0.012), type of DM (p<0.001), regular follow-up (p = 0.007) and comorbidities (p = 0.002) and was only predicted by the type of DM (aOR = 14.82 C.I 1.34–163.50, p-value = 0.028). Conclusion Adherence to insulin therapy among our study population was suboptimal, which is a concern considering the associated increased risk of complications. Adherence assessment and counselling by healthcare professionals to address barriers to poor adherence must be continually undertaken to achieve optimal glycemic control. Impact of findings on practice statements Continuous adherence assessment and counselling must be offered to all diabetes mellitus patients on insulin therapy as part of their ambulatory care to help improve outcomes. Using the Medication Adherence Reporting Scale-5 to determine patient adherence levels is an easy-to-use and an inexpensive method; however, it should be used with caution due to the potential for misclassification. Efforts must be made to provide appropriate strategies to deal with barriers to insulin adherence at ambulatory care clinics as part of the individualized comprehensive diabetic care to reduce diabetic complications.
Genotype x environment interaction effect on grain yield of cowpea (Vigna unguiculata (L.) Walp) in Deciduous forest and Sudan savanna ecologies of Ghana
Cowpea is deemed as a food security crop due to its ability to produce significant yields under conditions where other staples fail. Its resilience in harsh environments; such as drought, heat and marginal soils; along with its nitrogen-fixing capabilities and suitability as livestock feed make cowpea a preferred choice in many farming systems across sub-Saharan Africa (SSA). Despite its importance, Cowpea yields in farmers’ fields remain suboptimal, primarily due to biotic and abiotic factors and the use of either unimproved varieties or improved varieties that are not well-suited to local conditions. Multi environment testing of genotypes is essential for recommending varieties suited for either specific or for wide cultivation. This study aimed, to identify and recommend cowpea breeding lines for wide or specific cultivation in the Sudan Savanna and Deciduous Forest zones of Ghana. The research utilized twenty early-maturing advance cowpea breeding lines and three check varieties (released varieties). The experiment was conducted in two locations: Bunso in the Deciduous Forest zone and Manga in the Sudan Savanna zone over 2020/2021 and 2021/2022 cropping seasons. Combined analysis of variance revealed a significant genotype-environment interaction (GEI) which accounted for 35.12% of the variation in yield. The environments were classified into three mega environments, with Bunso_2021 identified as the near-ideal environment where the genotypes exhibited their maximum genetic potentials. In terms of adaption, genotype UG_04 demonstrated broad adaption, showing high yield and stability across all test environments. Genotypes UG_01 and UG_02 performed particularly well in Bunso_2021 and Bunso_2022, while UG_04 and UG_14 excelled in Manga_2021. These findings provide valuable insights for selecting cowpea varieties that can enhance productivity and stability in diverse agro-ecological zones.
Metabolic profiling of endophytic fungi acting as antagonists of the banana pathogen Colletotrichum musae
Three endophytic strains, Phomopsis sp., Fusarium proliferatum, and Tinctoporellus epimiltinus, isolated from various plants in the rainforest of the Philippines, were investigated regarding their ability to repress growth of the pathogenic fungus Colletotrichum musae on banana fruits causing anthracnose disease. An in vitro plate-to-plate assay and an in vivo sealed box assay were conducted, using commercial versus natural potato dextrose medium (PDA). All tested endophytes were able to significantly reduce C. musae growth compared to the control. However, the type of medium had no significant effect on lesion size of C. musae on banana. An interaction effect between fungal strain and medium could be shown. On the commercial medium, no differences between the biocontrol ability of the fungi and control treatments could be found, while there were significant differences between the fungal strains on natural medium. Lesions on banana incubated with Phomopsis sp. on natural medium were significantly but only slightly larger than those on banana incubated with F. proliferatum. Volatiles released by these two strains and one pathogenic strain of F. graminearum were collected using polydimethylsiloxane tubes and analyzed via gas chromatography mass spectrometry (GC-MS). Twelve volatile metabolites were detected. Benzaldehyde was the most prominent volatile emitted from the commercial and plain medium. 2-Undecanone, 2-nonanone, and phenylethyl-alcohol were detected in individual samples in both media. 1-Decanol and acoradiene were exclusive to the commercial medium, with acoradiene also being unique to F. proliferatum. Five volatileorganic compounds (VOCs)were emitted from all tested fungal species: 2-heptanone, 2-nonanone, 2-undecanone, 2-tridecanone, and phenylethyl-alcohol. Beta-acorenol was detected in F. proliferatum grown on both media. To reveal whether the medium (commercial PDA versus potato extract) affected the metabolism of the fungi, metabolic footprints were assessed via high performance liquid chromatography with quadrupole time of flight mass spectrometry MS (HPLC-QTOF-MS). A total of 388 metabolic signals were recorded. The intensities of 80–90% of these signals differed significantly between the two types of media. Metabolic footprints varied in response to different potato dextrose medium preparations. The two promising fungal strains may be used to reduce postharvest decay and losses in fruits.