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Diabetes knowledge and glycemic control among type 2 diabetes patients at public hospitals in Debre Berhan, Ethiopia

Background Diabetes mellitus is a growing global health issue, especially in low- and middle-income countries like Ethiopia. To the best of our knowledge, the impact of diabetes knowledge on glycemic control in Ethiopia has not been documented. This study assessed diabetes knowledge and its relationship with glycemic control among Type 2 diabetes (T2DM) patients in Debre Berhan, Ethiopia. Methods A cross-sectional study was conducted involving 380 patients diagnosed with T2DM who were receiving care at two hospitals in Debre Berhan from January 1 to March 30, 2024. Patients’ knowledge was assessed using the modified Diabetes Knowledge Questionnaire (DKQ-18), categorizing outcomes as either good or poor. Glycemic control was evaluated using hemoglobin A1c (HbA1c) levels. Logistic regression analyses were conducted to identify predictors of poor diabetes knowledge. Correlation analysis was used to evaluate the relationship between knowledge and glycemic control. Results Among the 380 participants, 75.2% were older than 45 years, and 51.3% were male. Overall, 62.4% of participants had poor knowledge of diabetes. Additionally, 72.6% had poor glycemic control, with HbA1C levels ≥7%. The mean average diabetes knowledge score was 7.9 (SD = 3.49) out of 18, and the median HbA1C was 8%. Diabetes knowledge was significantly associated (p < 0.05) with patients’ educational level, occupation, family history of diabetes, and glycemic control. The Spearman correlation coefficient between HbA1C and diabetes knowledge scores was -0.166 (p = 0.001), suggesting a weak but statistically significant inverse relationship between knowledge scores and HbA1C levels. Conclusions The study found that the majority of patients had a low level of diabetes knowledge. Enhancing diabetes education and identifying additional factors that influence glycemic control are crucial for achieving optimal diabetes management in Ethiopia. Public health initiatives should prioritize enhancing diabetes knowledge through targeted educational programs and resources to support effective diabetes management and achieve optimal glycemic control.

Subclinical patterns of cardiac involvement by transthoracic echocardiography in individuals with mild initial COVID-19

Abstract The aim of this study was to evaluate the subclinical patterns and evolution of cardiac abnormalities via transthoracic echocardiography (TTE) in patients with mild initial COVID-19 illness. A total of 343 infected individuals (163 males; age 44 (interquartile range, IQR 35–52) years) years) underwent serial TTE assessments at a median of 109 (interquartile range (IQR), 77–177) and 327 (276–379) days after infection. Compared with those of non-COVID-19-infected controls (n = 94, male n = 49), baseline systolic (LVEF, TAPSE) and diastolic function (eʹ, aʹ, E/eʹ) were significantly different in infected participants (p < 0.05 for all). Compared with baseline assessments, there was a reduction in global longitudinal strain (GLS) and an increase in the E wave, E/A ratio and E/eʹ at follow-up. At baseline, symptomatic participants had a lower LVEF and TAPSE and increased IVRT, eʹ and E/eʹ. At follow-up, symptomatic patients had a lower LV end-diastolic diameter (LVEDd). Symptoms were independently associated with E/eʹ at baseline (OR (95% CI) 1.45 (1.12–1.87), p = 0.005). Symptoms at follow-up were associated with LVEDd, measured either at baseline (OR: 0.91 (0.86, 0.96), p < 0.001) or follow-up (OR (95% CI) 0.91 (0.86–0.96), p < 0.001). There were significant associations for GLS and troponin and E/eʹ with CRP and NTproBNP at baseline. In the present cohort of COVID-19-infected individuals with mild initial illness, echocardiographic measurements revealed significant yet subclinical differences in systolic and diastolic function compared with controls, as well as between individuals with cardiac symptoms and those without. All the measured differences were small in magnitude and thus unlikely to be detectable clinically at the individual level.

Introduced substrates trigger colonization by reef-associated fish in a degraded coastal system

Coastal reefs benefit the survival and growth of mobile organisms by providing shelter and increased food availability. Under increasing pressure from human activities, the coverage of subtidal reefs has decreased along the world’s coasts. This decline is motivating efforts to restore these important habitats by re-introducing hard substrates into the coastal zone. However, many such projects use artificial substrates, such as concrete or metal, that are not naturally occurring in the marine environment. We experimentally introduced hard substrates that were either historically common in a soft sediment-dominated ecosystem, or are mimicking these substrates with biodegradable material, and monitored the substrates for mobile species use (fish and invertebrates). Six substrates were tested: cockle shells, rocks of two sizes (cobbles and pebbles), wood, artificial reefs of calcium carbonate with shell fragments, and biodegradable structures based on potato starch. Within one year, fish and prawns were already attracted to all of the introduced substrates. On average, fish were nearly five times as abundant and prawn abundance increased nearly 30-fold on the artificial reefs, compared to the bare sand bottom control. The community composition on the reefs differed significantly from the sand bottom community, but there were no differences between the types of introduced substrates. Interestingly, the substrates attracted reef-associated fish, but also soft-sediment dependent species, such as different species of flatfish and gobies. Our results show that, even over shorter timespans, introductions of hard substrates provide opportunities to support associated mobile communities in degraded soft-sediment systems.

Superconducting quantum computing optimization based on multi-objective deep reinforcement learning

Effects of gastrointestinal parasites on fecal glucocorticoids and behaviour in vervet monkeys (Chlorocebus pygerythrus)

Relationships between parasites, host physiology, and behaviours are complex. Parasites can influence host hormonal microenvironment and behaviour through “sickness behaviours” that generally conserve energy. Using a parasite removal experiment, we examined the effects of gastrointestinal parasites on fecal glucocorticoid metabolites (fGC) and behaviours of vervet monkeys (Chlorocebus pygerythrus) at Lake Nabugabo, Uganda. We collected parasitological, hormonal, and behavioural data from adult and subadult male and female vervets (N = 19) in 2014 across four study phases: pre-deworming, post-deworming, early reinfection, and late reinfection as well as in 2015. Overall, there was no decrease in fGC after deworming, but there was an increase following natural reinfection. There was no change in feeding across study phases; however, moving, grooming, and resting changed between the post-deworming and late reinfection phases, but not always in the predicted direction. Comparing behaviour across the same months in the following year as in the 2014 experimental study period, we found no differences in moving, feeding, grooming, and resting events. Despite behavioural variation between study phases, we cannot conclude that behavioural changes are due to parasitism rather than other seasonal variation. However, fGC increased following reinfection, which is consistent with parasitism being costly for hosts.

Tofacitinib and budesonide treatment affect stemness and chemokine release in IBD patient-derived colonoids

Abstract Restoration of the intestinal epithelial barrier is crucial for achieving mucosal healing, the therapeutic goal for inflammatory bowel disease (IBD). During homeostasis, epithelial renewal is maintained by crypt stem cells and progenitors that cease to divide as they differentiate into mature colonocytes. Inflammation is a major effector of mucosal damage in IBD and has been found to affect epithelial stemness, regeneration and cellular functions. However, the impact of immune cell-modulating IBD drugs on epithelial homeostasis and repair is poorly understood. It is likely that these drugs will have distinct mechanisms of action (MOA) in intestinal epithelium relevant for homeostasis that will vary among patients. We investigated cellular effects of pan-Janus Kinase (JAK) inhibitor tofacitinib and the corticosteroid budesonide on uninflamed and TNF + Poly(I:C) stimulated human colon organoids (colonoids) from healthy donors and IBD-patients. Our findings reveal that although both tofacitinib and budesonide exhibit anti-inflammatory effects, tofacitinib increased colonoid size and proliferation during differentiation, and promoted epithelial stemness. In contrast, budesonide decreased colonoid size and showed no consistent effect on proliferation or stemness. Our study demonstrates the value of employing human colonoids to investigate how IBD drugs affect intestinal epithelial cells and inter-individual variations relevant to mucosal healing and personalized IBD treatment.

Incorporating preference uncertainty in best worst scaling

In this paper, we enhance the Best-Worst Scaling (BWS) method by incorporating participants’ preference uncertainty into the conventional BWS, known as case 1. In this context, respondents are tasked with making trade-offs among a set of items of interest. Applying this novel extended BWS method to a sample of Argentinian wine consumers (n = 342), we aim to a) provide a more informative elicitation of consumers’ relative preferences for 16 wine attributes; b) identify the level of uncertainty with each of the attributes, exploring differences between the most and least important wine attributes influencing purchasing wine; and c) compare the results of the extended BWS with the standard BWS. Our findings indicate variability in uncertainty levels on the importance of wine attributes when purchasing wine within and across attributes. Moreover, accounting for participants’ preference uncertainty can alter the ranking of preferences obtained through the standard approach. This alteration is due to both accounting for preference uncertainty itself as well as the uncertainty indicator used. Although this approach is a way to mitigate biases associated with respondents’ preference certainty, it is recommended that preference uncertainty heterogeneity is investigated using different indicators.

Change point detection in brucellosis time series from 2010 to 2023 in Xinjiang China using the BEAST algorithm

Influence of Messa di Voce speed on vocal stability of untrained, healthy subjects

Introduction Despite its importance in voice training, comprehensive research into sustained vowel phonation with constant pitch and increasing and decreasing loudness, the so-called Messa di Voce, is lacking. The study examines the laryngeal behavior during Messa di Voce, regarding the impact of the speed of execution on voice stability parameters. Materials and methods Nine untrained, healthy subjects (5 female, 4 male) were asked to perform Messa di Voce exercises on the vowel [i:], involving a gradual increase and decrease of volume. During the first task, each phase should take 3 s, whereas in the second task, each phase should take 1 s. Female subjects sang pitch B3 (fundamental frequency fo ≈ 247 Hz), and male subjects pitch B2 (fo ≈ 124 Hz). Throughout phonation, synchronous recordings were captured through high-speed videolaryngoscopy (HSV), electroglottography, and audio signals. Subsequently, the Glottal Area Waveform was extracted from the HSV data. The tasks’ duration and calculated parameters (including, e.g., Open Quotient (OQ), Closing Quotient (ClQ), Relative Average Perturbation (RAP)), excluding parts of the signal with stationary sound pressure level (SPL), were analyzed with correlation analysis and statistical analysis (Analysis of Variance and subsequent multiple comparisons). Results Subjects shortened the requested task length by factor ≈ 0.5. The fo remained almost stable for most subjects and tasks. There were strong negative correlations between SPL and both OQ and ClQ. The median RAP appears to decrease towards the SPL apex and then increase again. Statistical effects were shown especially for females during the fast task, which may be due to raised SPL. Conclusion There was no specific effect on stability found corresponding to the task’s speed. Also, no major vocal instabilities at a specific sound pressure level were apparent, indicating no transitions as they exist for fo regions with registration events.

Improved constructs for bait RNA display in a bacterial three-hybrid assay

Research on technological innovation decision-making considering government subsidies and corporate reputation

Aiming at the information asymmetry between pharmaceutical enterprises’ technological innovation decisions and government subsidy strategy, this paper establishes a differential game model consisting of the government and a single pharmaceutical company, proposes three different government subsidy strategies, and obtains an equilibrium solution with the help of the Hamilton-Jacobi-Bellman equation, taking into consideration of the transmission effect of the enterprise’s reputation. First, the innovation decisions of pharmaceutical firms without government subsidies are analysed, and based on this, the optimal strategies with government subsidies for non-cooperative pacts and cooperation between the government and enterprises are analysed separately. In addition, the effects of different subsidy strategies on the government’s investment efficiency, corporate reputation, and the choice of corporate innovation strategies are compared, and the results are verified by numerical analysis. Finally, based on the results of the study, references and suggestions are provided for the formulation of government subsidy policies as well as corporate innovation decisions. The results show that: government subsidies can effectively stimulate the innovation ability of pharmaceutical enterprises and improve their reputation; the more sensitive an enterprise’s reputation is to the coefficient of technological innovation, the more it can improve the enterprise’s innovation level; and the coordination contract of government-enterprise cooperation can realize the Pareto improvement of the benefits of the government and enterprises.

Author Correction: Genome resequencing and genome-wide polymorphisms in mosquito vectors Aedes aegypti and Aedes albopictus from south India

Multi-session tDCS over the posterior parietal cortex and associative memory

Associative memory (AM) plays a crucial role in our ability to link disparate elements of our experiences, yet it is especially vulnerable to age-related decline and pathological conditions. Non-invasive brain stimulation (NIBS), particularly transcranial direct current stimulation (tDCS), has been investigated as a potential intervention to enhance cognitive functions, including AM. Previous tDCS studies yielded inconsistent results, often due to variations in stimulation sites and protocols. Nonetheless, enough evidence suggests that tDCS over the posterior parietal cortex (PPC) can improve AM performance. This study aimed to investigate the cumulative effects of multiple anodal tDCS over the PPC on AM performance alongside item memory and verbal fluency. In a randomized sham-controlled trial, 59 healthy young adults were assigned to either anodal or sham stimulation group, receiving tDCS (1.5 mA, for 20 minutes, at P3) over three consecutive days. Memory performance was assessed at four timepoints: pretest, immediately after the first session, posttest (Day 5), and follow-up (Day 9). Although tDCS was well tolerated, the anticipated enhancement of memory performance was not observed. We interpret these findings in the light of methodological considerations and propose potential explanations for the observed results emphasizing the large between-participants variability in memory performance as a significant factor that may have hindered the detection of tDCS effects.

An analytical cross-sectional study on optimal (timely or cumulative age-appropriate) routine childhood immunization coverage in the communities of Ebonyi state, Nigeria

Author Correction: An endosomal tether undergoes an entropic collapse to bring vesicles together

Modelling epidemiological dynamics with pseudo-recovery via fractional-order derivative operator and optimal control measures

In this study, a new deterministic mathematical model based on fractional-order derivative operator that describes the pseudo-recovery dynamics of an epidemiological process is developed. Fractional-order derivative of Caputo type is used to examine the effect of memory in the spread process of infectious diseases with pseudo-recovery. The well-posedness of the model is qualitatively investigated through Banach fixed point theory technique. The spread of the disease in the population is measured by analysing the basic reproduction of the model with respect to its parameters through the sensitivity analysis. Consequently, the analysis is extended to the fractional optimal control model where time-dependent preventive strategy and treatment measure are characterized by Pontryagin’s maximum principle. The resulting Caputo fractional-order optimality system is simulated to understand how both preventive and treatment controls affect the pseudo-recovery dynamics of infectious diseases in the presence of memory. Graphical illustrations are shown to corroborate the qualitative results, and to demonstrate the importance of memory effects in infectious disease modelling. It is shown that time-dependent preventive strategy and treatment measure in the presence of memory engenders significant reduction in the spread of the disease when compared with memoryless situation.

Attention deficit/hyperactivity disorder (ADHD) dimensions mediate the relationship between adverse childhood experiences and adult aggression depending on cognitive reappraisal

Abstract Associations between adverse childhood experiences (ACEs) and aggressive behavior have often been demonstrated, but the mechanisms underneath these relations are yet unclear. As high levels of ACEs and aggression have been found among individuals with attention deficit/hyperactivity disorder (ADHD), ADHD dimensions might explain this association. Moreover, maladaptive emotion regulation is common in ADHD and was associated with aggressive behavior. The present study investigated the dynamics among these constructs in a mixed sample of 287 adults. We found partially mediating effects of current ADHD on the associations of ACEs with adult aggression, especially regarding the hyperactive/impulsive dimension. Cognitive reappraisal moderated the indirect effect between hyperactivity/impulsivity and aggression, especially for females. Hence, the unfavourable dynamics found in the present study might explain the increased risk for aggressive behavior in individuals affected by both, ACEs and ADHD. Respective gender-sensitive prevention and treatment for aggressive behavior should include adequate pharmacological and psychological approaches that address ADHD core symptoms, whilst also aiming to improve emotion regulation techniques.

Long-term Double-J stenting is superior to short-term Single-J stenting in kidney transplantation

Background and objectives Urological complications after kidney transplantation, due to the ureteroneocystostomy, are associated with significant morbidity, prolonged hospital stay and even mortality. Ureteral stents can minimize the number of complications but are not consistently used, as previous studies were retrospective in nature. We aim to prospectively determine the most effective stenting approach. Methods We performed a non-blinded single-centre randomised controlled trial in an academic hospital. Kidney transplant recipients were randomised to either a Single-J stent or a Double-J stent, removed according to respective protocols. Primary outcome was PCN placement within six months. Secondary outcomes encompassed urinary tract infections, cost-effectiveness, and hospital admission time. The study was conducted from November 2018 to August 2023, during which 300 recipients were included with complete follow-up. Results PCN was performed in 14.5% in the Single-J group (21/145) and 4.5% in the Double-J group (7/155), p = 0.003. Multivariable logistic regression, corrected for recipient age, BMI, sex, and donor type, showed an OR of 0.26 [0.10, 0.61] (OR [95%CI]). To prevent PCN in one recipient, 10 would have to receive the Double-J. All secondary outcomes were comparable, whereas hospital admission time and cost-effectiveness analysis heavily favoured Double-J stenting. An important limitation was that Single-J participants were unable to leave, even if their recovery allowed earlier discharge. Conclusion This trial showed that Double-J stenting consistently reduced urological complications from 14.5% to 4.5%, while being highly cost-effective. Transplant surgeons should favour Double-J stenting to minimise the risk of complications.

Parallel median consensus clustering in complex networks

The effects of integrated traditional Chinese and western medicine rehabilitation programs on post-acute ankle sprain: A randomized controlled trial study protocol

Background Ankle sprain is a common clinical disease, which has the highest incidence rate among joint and ligament injuries. And acute ankle sprains can easily develop into chronic ankle instability, thereby increasing the difficulty of treatment. The current clinical guidelines for post-acute ankle sprains are still controversial. Pain and functional impairment are the most significant symptoms after ankle sprain. The main purpose of this study is to explore the safety and effectiveness of the intervention of integrated traditional Chinese and Western medicine rehabilitation programs on post-acute ankle sprains. Methods This study is a single center, prospective, intervention randomized controlled trial with a control group. 174 patients of 18–35 years old with post-acute ankle sprain will be included. A randomized controlled study is conducted and divided into a control group and an experimental group. The control group receive routine treatment, while the experimental group receive integrated traditional Chinese and western medicine rehabilitation programs. The intervention lasted for a total of 2 weeks. The main outcome measures are Visual Analog Scale and Short Form McGill Pain Questionnaire; the secondary outcome measures are the Foot Ankle Ability Assessment Scale, AOFAS Ankle Posterior Foot Scale, torque and gait. This study protocol aims to evaluate the safety and effectiveness of integrated traditional Chinese and western medicine rehabilitation programs by comparing the results of two groups before and after treatment. This protocol will follow the SPIRIT guidance. Discussion At present, there is a lack of rehabilitation management for post-acute ankle sprains. Therefore, this study has the potential to improve the healthcare for post-acute ankle sprains patients and might be used for future standardized evidence-based rehabilitation concepts. Trial registration The trial was registered at Chinese Clinical Trial Registry https://www.chictr.org.cn/showproj.html?proj=234465 (Registration No.: ChiCTR2400087456). Date: 2024-07-29.