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Association between cardiometabolic index and overactive bladder in adult American women: A cross-sectional study
Background Overactive bladder (OAB) is a common disorder, particularly in women, and its symptoms, including urgency, frequency, and nocturia, can significantly affect quality of life. The cardiometabolic index (CMI) is a novel metabolic risk indicator that has been receiving more attention lately. This study investigated the association between CMI and OAB in adult women. Methods A cross-sectional analysis was performed using data from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007 to 2018, including 6323 female participants. CMI was calculated based on waist-to-height ratio, triglyceride, and HDL cholesterol levels, while OAB was assessed using the overactive bladder symptom score (OABSS). The association between CMI and OAB was evaluated through multivariate logistic regression, generalized additive models (GAM), smoothing curve fitting, and subgroup analysis. We finally included male participants for sensitivity analysis. Results A significant positive association was found between female CMI and OAB prevalence (OR = 1.46, 95% CI: 1.29–1.65). When compared to the lowest CMI quartile (Q1), women in the highest CMI quartile were 70% more likely to have OAB (OR = 1.70, 95% CI: 1.42–2.04). Smoothed curve fitting analysis showed a linear association between CMI and OAB. Subgroup analysis revealed that the association between CMI and OAB was stronger in women aged 20–50 years as well as in women without hypertension. Sensitivity analysis confirmed the robustness of our result. Conclusion CMI was significantly and positively associated with the prevalence of OAB, especially in women aged 20–50 years without hypertension. This finding provides a new perspective on metabolic risk management and may contribute to the early prevention and improvement of bladder function in women.
The relationship between social safeness and pleasure and resilience levels among university athletes: A descriptive study
This study investigates the correlation between social safeness and pleasure and resilience among university students engaged in sports. A total of 350 participants (mean age, 21.09 ± 3.12 years), comprising 239 females and 111 males, were included in the sample. Data collection utilized the "Social Safeness and Pleasure and Resilience Scales". Normality of data was assessed using skewness and kurtosis tests, confirming normal distribution. Pairwise comparisons were conducted using t-tests, multiple comparisons via one-way ANOVA, and relationship analysis employed Pearson Product Moment Correlation. Findings indicate participants scored above mid-level on the social safeness and pleasure scale (Mean = 2.6), and resilience scale (Mean = 3.7). Specifically, social support dimension mean score was above mid-level (Mean = 4.01), emotional coping (Mean = 3.4), and situational coping (Mean = 3.8). Pearson Product Moment Correlation revealed a statistically significant positive relationship between social safeness and pleasure scale scores and resilience scale scores (r = .652, p < .001). This descriptive study sheds light on the interplay between social and emotional factors and resilience among university athletes.
Nutritional assessment of adolescents: A cross-sectional study from public schools of North India
Background Technological advancements and globalization have shifted dietary behaviours, contributing to increased chronic disease prevalence in Low- and Middle-Income Countries (LMICs) like India. Adolescents are particularly vulnerable due to these changes, which can impact their lifelong health. This study aimed to assess the nutritional status of adolescents in public schools in Chandigarh, India. Methodology Conducted as part of a cluster randomized control trial, the study used two-stage random sampling to select 12 schools and eighth-grade classes, recruiting 453 adolescents aged 10–16 years. Nutritional status was evaluated through dietary behaviour assessments, anthropometric measurements, and 24-hour urinary salt-level analysis. Dietary patterns were recorded using two 24-hour recalls, and analyzed with PURE study software based on 2010 Indian dietary data from ICMR-NIN. Anthropometric measures followed standardized protocols, and salt levels were assessed in laboratories. Results The mean age of the adolescents was 13.06 years, with 55% being boys. Among them, 32% had high salt intake, and 55% had high sugar intake. Additionally, 90% had low fruit intake, and 83% had low vegetable intake. The adolescents were deficient in several macro and micronutrients, including energy, fats, fibre, iron, zinc, iodine, riboflavin, and vitamins B-6 and B-12. A higher proportion of boys (10%) were classified as thin compared to girls (2%), while a greater proportion of girls (36%) had abdominal obesity. In contrast, a larger proportion of boys (23%) were severely acutely malnourished. Nearly all adolescents exhibited high urinary excretory salt levels. Conclusion Most adolescents exhibited dietary risk factors, including high salt and sugar intake, along with low consumption of fruits and vegetables. Many were deficient in various macro and micronutrients, with the coexistence of both thinness and obesity. Regular nutritional assessments in schools are essential to address the dual burden of undernutrition and overnutrition. Furthermore, health-promoting interventions should be developed within school settings to encourage healthy dietary practices.
Does curcumin supplementation affect inflammation, blood count and serum brain-derived neurotropic factor concentration in amateur long-distance runners?
Curcumin is known for its potential health benefits; however, the evidence remains inconclusive regarding its necessity as a supplement for athletes during the preparatory phase of training. This study aimed to assess the effect of 6-week curcumin supplementation at a dose of 2g/day on selected inflammatory markers, blood count, and brain-derived neurotropic factor (BDNF) levels in middle-aged amateur long-distance runners during the preparatory period of a macrocycle. Thirty runners were randomly assigned to either a curcumin-supplemented group (CUR, n = 15) or a placebo group (PLA, n = 15). Venous blood samples were collected at rest, immediately post-exercise, and 1h post-exercise. The participants underwent a graded exercise stress test, with an increasing inclination angle after reaching a speed of 14 km/h, both before and after the 6-week supplementation period. Blood samples were collected at rest, 3 minutes post-stress test, and after 1 hour of recovery. The results showed no significant changes in C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), interleukin-1 β (IL-1β), or blood morphology due to curcumin supplementation. However, BDNF levels increased by 21% in the CUR group post-supplementation, while a 5% decrease was observed in the PLA group. These findings do not support a significant effect of curcumin supplementation on inflammatory markers, blood count, or BDNF concentration. Further research is warranted to determine the potential benefits of curcumin supplementation for endurance athletes during the preparatory period for a training cycle.
Ankle muscle strength and activation are associated with walking patterns in preschool and school-age children
Walking patterns can differ between children and adults, both kinematically and kinetically. However, the detailed nature of the ankle pattern has not been clarified. We investigated musculature, biomechanics, and muscle activation strategies and their relevance to walking performance in preschool (PS) and school children (SC), with adults (AD) as reference. Twenty-six PS (3–5 yr), 20 SC (6–8 yr), and 17 AD (18–30 yr) participated. Tibialis anterior (TA) and medial gastrocnemius (MG) thicknesses, fascicle lengths, and maximal voluntary dorsi- and plantar flexion isometric torques were measured. Hip, knee, and ankle kinematics, ground reaction forces (GRFs), and TA and MG electromyographic activities were recorded during shod walking at each participant’s preferred speed. Walking speed, step length, and cadence were correlated with age in PS. These walking performance measures were also correlated with muscle thickness and fascicle length, showing higher speed in individuals with thicker muscles and longer TA and MG fascicles (conversely, higher cadence with thinner muscles and shorter fascicles). AD demonstrated the largest values for muscle thickness (p<0.001), fascicle length (p<0.001), strength (p<0.001), and walking performance (speed p = 0.004; step length p<0.001; cadence p<0.001), followed by SC then PS. Both PS and SC exhibited higher TA activities than AD during the stance phase, resulting in a higher co-activation index. The GRFs relative to body weight were lower in both horizontal and vertical components in PS compared to SC and AD, while the relative lateral force during stance was greatest in PS followed by SC and then AD. Differences in preferred walking speed and step length were associated with age and muscle size. Children, particularly preschool-aged, employed a co-activation strategy of dorsi- and plantar flexors for stabilization, which resulted in sideways steps even at a preferred walking speed.
Machine learning approach to student performance prediction of online learning
Student performance is crucial for addressing learning process problems and is also an important factor in measuring learning outcomes. The ability to improve educational systems using data knowledge has driven the development of the field of educational data mining research. Here, this paper proposes a machine learning method for the prediction of student performance based on online learning. The critical thought is that eleven learning behavioral indicators are constructed according to online learning process, following that, through analyzing the correlation between the eleven learning behavioral indicators and the scores obtained by students online learning, we filter out those learning behavioral indicators that are weakly correlated with student scores, meanwhile, retain these learning behavior indicators being strongly correlated with student scores, which are used as the eigenvalue indicators. Finally, using the eigenvalue indicators to train the proposed logistic regress model with Taylor expansion. Experimental results show that the proposed logistic regress model defeats against the comparative models in prediction ability. Results also indicate that there is a significant dependency between students’ initiative in learning and learning duration, nevertheless, learning duration has a significant effect on the prediction of student performance.
Study on the effect of water content on physical properties of bentonite
Moisture content profoundly influences the engineering properties of expansive soil, a critical consideration in various geotechnical applications. This study delves into the intricate relationship between water content and the physical properties of bentonite, a key constituent of expansive soil. Through a comprehensive analysis encompassing fundamental physical properties, rheological characteristics, permeability behavior, and microscopic features, we elucidate the complex interplay between water content and bentonite behavior. Our investigation reveals distinct responses to varying moisture levels: at low water content (w = 50%), unsaturated samples undergo incremental density increases attributed to moisture accumulation among particles. Concomitantly, heightened pressure fosters enhanced cohesion between particles, bolstering mechanical properties and augmenting reverse osmosis capacity. Conversely, at higher water content levels (w > w saturated), the escalation of free water within soil particles triggers pronounced particle softening, overshadowing expansion effects. Consequently, cohesion diminishes, and particles exhibit micro-scale flocculation. These findings offer valuable insights into bentonite behavior under differing moisture regimes, thereby providing a robust theoretical foundation for projects requiring bentonite seepage control.
Acceptability of a dapivirine levonorgestrel vaginal ring in two Phase 1 trials (MTN-030/IPM 041 and MTN-044/IPM 053/CCN019): Implications for multipurpose prevention technology development
End-user feedback early in product development is important for optimizing multipurpose prevention technologies for HIV and pregnancy prevention. We evaluated the acceptability of the 90-day dapivirine levonorgestrel ring (DPV-LNG ring) used for 14 days compared to a dapivirine-only ring (DVR-200mg) in MTN-030/IPM 041 (n = 23), and when used for 90 days cyclically or continuously in MTN-044/IPM 053/CCN019 (n = 25). We enrolled healthy, non-pregnant, HIV-negative women aged 18–45 in Pittsburgh, PA and Birmingham, AL (MTN-030 only). Self-reports of vaginal bleeding and adherence (ring removals, expulsions) were collected via daily short message service. Acceptability data were recorded in face-to-face interviews at study exit. We assessed differences in acceptability by product characteristics and adherence; and associations between baseline characteristics/demographics, number of bleeding days, adherence, and overall acceptability. Most (21/23) women in the 14-day MTN-030 study and about half (13/25) in the 90-day MTN-044 study liked their assigned rings. In MTN-030 there were no significant associations between any variables and overall acceptability of either ring. In MTN-044, women who disliked the DPV-LNG ring had a significantly higher incidence of unanticipated vaginal bleeding, and reporting that vaginal bleeding changes were unacceptable than those who liked it. Although we found no overall association between adherence and acceptability, significantly more women who disliked (versus liked) the DPV-LNG ring reported expulsions during toileting. The DPV-LNG ring could meet the needs of women seeking simultaneous protection from HIV and unintended pregnancy. Addressing issues related to vaginal bleeding and expulsions early in product development will likely enhance acceptability of the DPV-LNG ring. Trial registration: Clinical Trial Registration: MTN-030/IPM 041: ClinicalTrials.gov NCT02855346; MTN-044/IPM 053/CCN019: ClinicalTrials.gov NCT03467347.
The intersection of finTech adoption, HR competency potential, service innovation, and firm growth in the banking sectors using Entropy and TOPSIS
The adoption of Financial Technology (FinTech), along with the enhancement of Human Resource (HR) competencies, service innovation, and firm growth, plays a crucial role in the development of the banking sector. Despite their importance, obtaining reliable results is often challenging due to the complex, high-dimensional correlations among various features that affect the industry. To address this issue, this research introduces a hybrid Multi-Criteria Decision-Making (MCDM) model that integrates the Entropy-Weighted Method (EWM) and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). The primary objective of this study is to systematically evaluate and rank multiple alternatives based on key criteria using the EWM-TOPSIS approaches. Specifically, the analysis considers eleven multifaceted characteristics and eight potential alternatives (A1 to A8), revealing the significant influence of the proposed MCDM approaches in assessing FinTech adoption, HR competency, service innovation, and firm growth. The findings underscore the effectiveness of the entropy-TOPSIS approaches in providing a structured analysis for a smarter and well-informed decision-making. Ultimately, this research proposes the best alternative from the evaluated options, contributing valuable insights into the future role of FinTech, HR competencies, service innovation, and firm growth within the banking sector.
Racial/Ethnic inequality & contemporary disparities in mortgage lending
Research over the past two decades has noted significant racial/ethnic wealth inequalities—inequalities with important implications for life chances and institutional access. Home ownership is as a foundational element of such inequality with broad consequences for exposure to crime, quality of public safety services, and access to healthcare, education, and employment. Building on earlier scholarship that has tended to focus on specific forms of mortgages, we draw in this article on over 1.4 million diverse mortgage applications from the largest 100 U.S. metropolitan areas to interrogate racial/ethnic disparities for (1) all home types (mobile homes, condominiums, multi/single-family units), (2) all lien holders (private/government backed), (3) all purposes (vacation/rental/owner-occupied), and (4) all buyer loan sequences (purchase, refinance, home-equity/improvement). Our analyses, which make use of multilevel modeling, reveal durable inequalities for African Americans and Hispanics across time and advantages for Non-Hispanic White and Asian-American applicants. Such disadvantages are likewise observed for those seeking housing in highly concentrated minority locales, although such effects seem to vary by applicant race/ethnicity. Specifically, mortgage originations, while generally less likely in high minority concentrated areas, appear to be more likely for Black/Hispanic borrowers in areas that have been becoming increasingly minority concentrated. Mortgage lending, we conclude, remains a deeply problematic dimension of racial/ethnic inequality with important consequences for persistent segregation, wealth disparities, and the intergenerational transmission of advantage/disadvantage.
Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs
Background A standard questionnaire for generalized anxiety disorders is the GAD-7. Attempts to improve its screening capacity in oncological settings resulted in a discussion about lowering its cut-off. This study examines the diagnostic accuracy of the GAD-7 items depending on applied cut-offs and whether, similar to depressive symptoms, a distinction between somatic-emotional and cognitive items might be relevant. Patients and methods Screening data from 4705 patients with cancer who were treated at the outpatient clinic of the National Centre for Tumour Diseases in Heidelberg were analysed. For the individual GAD-7 items sensitivity, specificity, positive and negative predictive values, and Clinical Utility Index were determined for cut-off ≥ 7, ≥ 8, ≥ 10 and ≥ 15 in the GAD-7 questionnaire. Results The best overall diagnostic accuracy was found for a cut-off ≥ 8. The cognitive items had the best diagnostic accuracy for identifying severe GAD (cut-off ≥ 15), and the somatic-emotional items had the best diagnostic accuracy for identifying mild to moderate GAD (cut-off ≥ 7, ≥ 8 and ≥ 10). Conclusions Our data support the recommendation of lowering the GAD-7 cut-off in oncology settings and suggest that in anxiety disorders, a symptom overlap between the physical illness and a possible mental disorder should be considered.
Unravelling the transcriptomic dynamics of Hyphopichia pseudoburtonii in co-culture with Botrytis cinerea
Hyphopichia pseudoburtonii, is emerging as a potential biocontrol agent against various phytopathogens. These traits have been attributed to the production of various antifungal compounds in the presence of target pathogens. However, the broad molecular mechanisms involved in the antifungal activity are not yet understood. This study employed RNA sequencing to assess the temporal changes in H. pseudoburtonii Y963 gene expression patterns when co-cultivated with Botrytis cinerea. Genes differentially expressed in H. pseudoburtonii in co-culture with B. cinerea, compared to the monoculture were evaluated after 24, 48, and 120 h of growth. Up-regulation of genes encoding major core histones (H2A, H3, H4) and ribosomes in the first 24 h suggested an abundance of cells in the S phase of the cell cycle. At 48 h, the genes up-regulated highlight mitotic cell cycle activity and induction of filamentous growth, while in later stages, up-regulation of genes encoding high affinity transporters of sugars, copper and iron, as well as those involved in the retention and utilization of siderophore-iron was evident. Altogether, the data allude to competition for space and nutrients as key mechanisms activated in H. pseudoburtonii in the presence of B. cinerea. This research offers new insights into H. pseudoburtonii transcriptomic response to B. cinerea and illuminates the adaptive strategies and molecular mechanisms behind its antifungal activity.
Who becomes an entrepreneur after university? Evidence from Canada
In recent decades there has been significant interest among policy makers in supporting entrepreneurship among university students, with the goal to improve labor market outcomes and contribute to the economy through venture creation. Drawing from the 2018 National Graduate Survey in Canada, our study examines who engages in entrepreneurial activity after graduation, investigating differences among demographic groups and between those who participated in entrepreneurship education on campus and those who did not participate. We find that those graduates who participated in entrepreneurship education are more likely to be self-employed and own their own business three years after graduating than the general population of university graduates. We also find differences according to gender, citizenship, and socio-economic status in entrepreneurial activity. Our results are consistent with previous studies documenting demographic disparities in entrepreneurship and provide more generalizable evidence about the relationship between entrepreneurship education and subsequent entrepreneurship.
Safety of hyperbaric oxygen therapy in non-emergent patients with a history of seizures: A retrospective cohort study
Background Hyperbaric oxygen therapy (HBOT) is well established as a treatment for various medical conditions. However, it poses a risk of oxygen toxicity, which can cause seizures particularly in individuals with pre-existing seizure disorders. Consequently, seizure disorders are considered a relative contraindication to HBOT. Despite this, the relative risk of HBOT-induced seizures in this patient population remains unclear. This retrospective cohort study aims to evaluate the safety of HBOT among patients with pre-existing seizure disorders. Methods After obtaining approval from the Research Ethics Board, we retrospectively reviewed the patient charts of individuals with a history of seizures who were referred to the Rouge Valley Hyperbaric Medical Center and Toronto General Hyperbaric Medicine Unit for HBOT between January 2020 and December 2023. Relevant demographic information, past medical history, and HBOT session treatment protocols, such as the treatment pressure set in absolute atmospheric pressure (ATA) and number of air breaks, were recorded. The collected data was analyzed using descriptive statistics. Results A total of 43 patients were referred to HBOT during the study period, and 21 patients did not proceed with the treatments. In total, 634 HBOT sessions were administered to 22 patients in monoplace chambers with five-minute air breaks, and one patient experienced a seizure event. Each patient completed an average of 29 (range 3–60) sessions lasting 90–120 minutes at 1.8 ATA (n = 3), 2.0 ATA (n = 18), or 2.4 ATA (n = 1). Fifteen patients were on oral antiseizure medications during the HBOT course. The overall incidence of seizures was one in 634 treatments. Conclusion While patients with a history of seizures may develop seizure activity during HBOT, the majority can safely undergo treatment when predetermined protocols are followed. With careful management and adherence to established protocols, HBOT can be a viable treatment option for those with seizure histories.
CBGTPy: An extensible cortico-basal ganglia-thalamic framework for modeling biological decision making
Here we introduce CBGTPy, a virtual environment for designing and testing goal-directed agents with internal dynamics that are modeled on the cortico-basal-ganglia-thalamic (CBGT) pathways in the mammalian brain. CBGTPy enables researchers to investigate the internal dynamics of the CBGT system during a variety of tasks, allowing for the formation of testable predictions about animal behavior and neural activity. The framework has been designed around the principle of flexibility, such that many experimental parameters in a decision making paradigm can be easily defined and modified. Here we demonstrate the capabilities of CBGTPy across a range of single and multi-choice tasks, highlighting the ease of set up and the biologically realistic behavior that it produces. We show that CBGTPy is extensible enough to apply to a range of experimental protocols and to allow for the implementation of model extensions with minimal developmental effort.
Epidemiology of gastrointestinal parasites of dogs in four districts of central Ethiopia: Prevalence and risk factors
From February 2022 to April 2023, a cross-sectional study on dog gastrointestinal parasites was conducted in Bishoftu, Dukem, Addis Ababa, and Sheno, Central Ethiopia, with the aim of estimating the prevalence and evaluating risk factors. A total of 701 faecal samples were collected and processed using floatation and McMaster techniques. In dogs that were investigated, the overall prevalence of gastrointestinal parasites was 53.1% (372/701). Nematode (28.2%), cestode (8.4%), and protozoan (5.6%) parasite infections were detected in dogs in both single (42.2%) and combined (10.8%) infections. With respective prevalences of 16%, 9.8%, 5%, 3.9%, and 3.1% Ancylostoma spp., Toxocara canis, Dipylidium caninum, Giardia spp., and Taenia/Echinococcus spp. were the most common parasites. The prevalence of gastrointestinal parasites was significantly higher (P<0.05) in female dogs (73.8%, OR = 0.4), adult dogs (55.3%, OR = 0.4), dogs that were given raw food (57.9%, OR = 2.7), and dogs kept free outdoor (60.9%, OR = 2.4). The incidence of gastrointestinal parasites was also higher in dogs with diarrheal faecal consistency (89.1%, OR = 9.1) and dogs from highland areas (62.1%, OR = 1.8). In contrast, statistically significant variation in the prevalence of gastrointestinal parasites was not recorded among dogs of different breeds. The current study found that dogs in the studied locations had a high overall prevalence of gastrointestinal parasites. In conclusion, gastrointestinal parasites in dogs have the potential to pose a serious threat to public health, so addressing this issue requires a unified approach. Therefore, it is necessary to conduct detailed epidemiological and genetic research on dog parasites in vast study regions across various agro-ecologies zones and seasons in Ethiopia. Additionally, it is crucial to raise public awareness of the prevalence, effects on public health, and financial implications of dog gastrointestinal parasites in Ethiopia.
Analysis of RL electric circuits modeled by fractional Riccati IVP via Jacobi-Broyden Newton algorithm
This paper focuses on modeling Resistor-Inductor (RL) electric circuits using a fractional Riccati initial value problem (IVP) framework. Conventional models frequently neglect the complex dynamics and memory effects intrinsic to actual RL circuits. This study aims to develop a more precise representation using a fractional-order Riccati model. We present a Jacobi collocation method combined with the Jacobi-Newton algorithm to address the fractional Riccati initial value problem. This numerical method utilizes the characteristics of Jacobi polynomials to accurately approximate solutions to the nonlinear fractional differential equation. We obtain the requisite Jacobi operational matrices for the discretization of fractional derivatives, therefore converting the initial value problem into a system of algebraic equations. The convergence and precision of the proposed algorithm are meticulously evaluated by error and residual analysis. The theoretical findings demonstrate that the method attains high-order convergence rates, dependent on suitable criteria related to the fractional-order parameters and the solution’s smoothness. This study not only improves comprehension of RL circuit dynamics but also offers a solid numerical foundation for addressing intricate fractional differential equations.
Vitamin D, acute respiratory infections, and Covid-19: The curse of small-size randomised trials. A critical review with meta-analysis of randomised trials
Background Randomised trials conducted from 2006 to 2021 indicated that vitamin D supplementation (VDS) was able to prevent severe COVID-19 and acute respiratory infections (ARI). However, larger randomised trials published in 2022 did not confirm the health benefits of VDS in COVID-19 patients. Objective To examine through a systematic review with meta-analysis the characteristics of randomised trials on VDS to COVID-19 patients and admission to intensive care unit (ICU), and of randomised trials on VDS for the prevention of ARI. Method A systematic search retrieved randomised trials on VDS to COVID-19 patients and admission to ICU. Data on VDS and ARI were extracted from the meta-analysis of Jolliffe et al. 2021. Groups were formed including trials with total numbers of patients below or above the median size of all trials. The associations between VDS vs no VDS, and admission to ICU were evaluated using random-effects models from which summary odds ratios (SOR) and 95% confidence intervals (CI) were obtained. Meta-analyses were done for all trials and for each group of trials, which allowed testing a possible effect modification of trial size. Publication bias was assessed using the Louis-Furuya-Kanaruori (LFK) index (no bias if index between -1 and +1) and the trim and fill method. Results Nine trials on VDS for preventing admission to ICU were identified, including 50 to 548 patients. The summary odds ratio (SOR) was 0.61 (95% CI: 0.39–0.95) for all trials, 0.34 (0.13–0.93) for trials including 50 to <106 patients and 0.88 (0.62–1.24) for trials including 106 to 548 patients (interaction p = 0.04). The LFK index was -3.79, and after trim and fill, the SOR was 0.80 (0.40–1.61). The SOR for the 37 trials on VDS for ARI prevention included 25 to 16,000 patients. The SOR was 0.92 (0.86–0.99) for all trials, 0.69 (0.57–0.83) for trials including 25 to <248 patients and 0.98 (0.94–1.03) for trials including 248 to 16,000 patients (interaction p = 0.0001). The LFK index was -3.11, and after trim and fill, the SOR was 0.96 (0.88–1.05). Conclusion Strong publication bias affected small randomised trials on VDS for the prevention of severe COVID-19 and of ARI. Systematic reviews should beware of small-size randomised trials that generally exaggerate health benefits.
Efficiency of four trap types and human landing catch in the sampling of Mansonia (Diptera, Culicidae) in Porto Velho, Rondônia, Brazil
Entomological surveillance plays a crucial role in designing and implementing mosquito control measures. In this context, developing more effective collection strategies is essential to accurately estimate the entomological parameters necessary for effective control. In this study, we investigated the effectiveness of four traps: CDC light trap, MosqTent, BG-Sentinel, and SkeeterVac, compared to human landing catch (HLC) in the collection of Mansonia mosquitoes, known to cause discomfort to riverside populations along the Madeira River in the District of Jaci Paraná, Porto Velho, in Rondônia state, Brazil. Sampling was conducted, during three periods corresponding to two seasons, dry and rainy, over five consecutive days for each period. The captures using HLC and the installation of the traps took place on the grounds of five selected residences from 6 to 10 pm. Rotational exchanges between houses ensured that all traps and the HLC were used in each of the five residences, following a predetermined Latin square pattern. A total of 7,080 mosquitoes were collected, of which 90.5% belonged to the Mansonia genus, distributed in four species: Mansonia titillans (75.97%), Mansonia humeralis (18.91%), Mansonia amazonensis (1.90%), and Mansonia indubitans (1.37%). HLC captured the highest number of Mansonia mosquitoes (58.1%), followed by SkeeterVac (21.8%) and MosqTent (18.9%). CDC and BG-Sentinel showed a very low performance (0.92 and 0.23%, respectively). Although HLC performed better in capturing Mansonia, our results suggest that SkeeterVac and MosqTent can serve as valuable additional tools to entomological inventories or sentinels for detecting invasive species in areas with high epidemiological vulnerability, thereby providing evidence-based recommendations for improving mosquito control measures and entomological surveillance.
Analysis of the social-epistemological dimensions of a Clinical Teaching Unit and Small Private Online Course compared to a traditional clerkship Internal Medicine
Clinical workplace learning is often suboptimal due to the dynamics of the clinical learning environment and several challenges encountered in clinical practice. At LUMC, clinical teachers introduced a novel blended learning program that included both the introduction of a Clinical Teaching Unit (CTU) and Small Private Online Course (SPOC). This study aimed to analyze the educational content and design of our educational interventions, by categorizing and comparing the dimensions of the learning program before and after the interventions. The novel blended learning program was integrated into a clerkship internal medicine, aiming to optimize clerks’ clinical workplace learning. Therefore, a traditional inpatient ward was transformed into a CTU, featuring the introduction of learning activities that promoted multidisciplinary and interprofessional learning. It included an integrated SPOC, aiming to improve clinical reasoning skills, feedback and collaboration of the clerks. The authors analyzed the clerkships’ content and design, by categorizing the social-epistemological dimensions of the teaching modes offered before (traditional clerkship) and after (including CTU and SPOC) the intervention. These dimensions consisted of individual versus group (collaborative), and objectivist versus constructive learning categories. The CTU model added eleven group activities to the clinical workplace, of which nine were characterized as constructivist-group activities. It also led to more active learning of the clerks, compared to the traditional clerkship. Analysis of the SPOC revealed 344 teaching modes in total, which included 113 objectivist–individual, 205 constructive–individual and 23 constructive–group activities. Compared to a traditional clerkship, the CTU with SPOC led to more constructivist and collaborative learning and a more diverse educational program. This study illustrates a methodology to address active and collaborative learning activities in an educational program, and offers tools to evaluate and redesign one’s teaching program. The methods and models described can be applied to clinical environments in other areas of medicine.