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Association between maternal mental health and early childhood development, nutrition, and common childhood illnesses in Khwisero subcounty, Kenya
Background Despite the significant public health burden of maternal mental health disorders in sub-Saharan Africa (SSA), limited data are available on their effects on early childhood development (ECD), nutritional status, and child health in the region. Aims This study investigated the association between maternal mental health and ECD, nutritional status, and common childhood illnesses, while controlling for biological, social, financial, and health-related factors and/or confounders. Method As part of the Innovative Partnership for Universal and Sustainable Healthcare (i-PUSH) program evaluation study, initiated in November 2019, a cohort of low-income rural families, including pregnant women or women of childbearing age with children under five, was recruited for this study. A total of 24 villages were randomly selected from a list of villages near two health facilities. Following a census to identify eligible households, 10 households per village were randomly selected. Data collection included maternal mental health, assessed using Centre for Epidemiological Studies Depression (CES-D) scale, ECD, nutritional status (anthropometric measurements), and common childhood illnesses, their symptoms, and healthcare utilization. This study presents a cross-sectional analysis of the data drawn from endline survey of 299 target mothers and 315 children. Results The majority of the mothers were aged between 25 and 34 years. The mean age of children was 3.2 years, with 53% being male. The overall maternal mental health score, as measured by the CES-D scale, was 28. Children of mothers with higher CES-D scores exhibited poorer ECD domains, lower nutritional status indicators, and increased incidence of ill-health in the previous two weeks, in both unadjusted and adjusted analyses. Individual, parental, and household factors—including maternal age, household wealth index, and decision-making regarding child healthcare—were significantly associated with children’s development, nutrition status, and health outcomes. Conclusion Children of mothers with low mental health scores demonstrated suboptimal developmental outcomes, nutritional status, and overall well-being, particularly for those from impoverished households. These findings suggest that improving the socioeconomic conditions of low-income households is essential for promoting children’s development, nutritional status, and well-being. Longitudinal studies are needed to further investigate the impact of maternal mental health on child development, nutrition, and health outcomes, considering additional factors across the maternal, newborn, and child health continuum. Trial registration for the parent and nested study ClinicalTrials.gov (NCT04068571), AEA Registry (AEARCTR-0006089) and PACTR (PACTR202204635504887).
The impact of shelter-in-place during the COVID-19 pandemic on social support for mental health recovery: A prescribing-oriented qualitative study of patient perspectives
The COVID-19 pandemic created unprecedented challenges for social connectivity and mental health, especially during mandated shelter-in-place periods. For patients engaged in mental health treatment, the social impact of their shelter-in-place experience remains an area of active investigation. This is particularly relevant in the context of social prescribing, a growing area of clinical intervention where healthcare providers actively refer patients to local social resources or activities to enhance mental health and wellbeing. Here, we investigated patient perspectives on their social supports during shelter-in-place, with an eye toward informing future social prescribing and counseling steps that mental health clinicians can take to foster social resiliency of patients. We conducted semi-structured phone interviews with 12 participants receiving mental health treatment at Kaiser Permanente San Jose Adult Psychiatry clinics. Interviews were transcribed and analyzed for themes. The sample consisted of 8 female and 4 male participants between the ages of 21 to 44, who received services including outpatient medication management, outpatient therapy, and/or outpatient group therapy. Analysis revealed two thematic categories that participants identified: (A) Specific ways that shelter-in-place impacted their social experience and (B) specific types of social relationships that participants felt were important to their mental health and wellbeing. In the first category, thematic factors that affected the social experience included (1) COVID-19-related health concerns, (2) participants’ baseline socialization patterns (degree of introversion/extroversion) and (3) the use of online and social media communication channels. For the second category of themes, specific functions of social relationships identified included those centered around (a) instrumental support, (b) emotional support, (c) community connection. Many relationships served more than one function during shelter-in-place, and many participants cited perceived community connection as a particularly important element in their mental health recovery. These themes highlight key contributors to the social experience of the shelter-in-place period for individuals in mental health recovery and inform future ways that clinicians can structure social prescribing practices to better assist the needs of patients.
Applying linear programming in evaluating employees in higher education: A case study
In the past few decades, any type of organization, from factories to government organizations, the banking sector, or educational institutions concentrates on increasing profit margins. To achieve this, one of the key factors is to achieve maximum output with minimum resources (input). Therefore, having an optimal plan to apply the resources has become extremely important for organizations. One of the relevant resources is Human resources. This paper presents a mathematical model as an aid for optimizing human resources in the higher education sector. The model includes seven stages: 1) determining the availability of research and teaching staff, 2) evaluating the research and teaching staff from the perspective of different stakeholders, 3) determining the cost of the availability of research and teaching staff, 4) examining the motivated employees, 5) developing a staff ranking, 6) developing the mathematical model, and 7) implementing the mathematical model.
High-resolution isotope dietary analysis of Mesolithic and Neolithic humans from Franchthi Cave, Greece
Franchthi Cave, in the Greek Peloponnese, is a well-known Paleolithic, Mesolithic and Neolithic site, with several human burials. In many parts of Europe there is clear evidence from archaeological and isotopic studies for a diet change between the Mesolithic and Neolithic periods. This is especially the case in coastal contexts where there is often a shift from predominantly marine food diets in the Mesolithic to terrestrial (presumably domesticated) foods in the Neolithic. However, at Franchthi Cave previous isotope research did not show changes in diets between these two periods, and also showed relatively little input from marine foods in diets in either time period, despite the coastal location of the site and the presence of marine shellfish and fish, including tuna. High-resolution compound specific amino acid isotope analysis reported here from humans from the Lower Mesolithic and Middle Neolithic periods confirms the previous bulk isotope results in showing little or no consumption of marine foods in either time period. However, it is important to note that our isotopic sample does not come from episodes when tuna is abundant and therefore do not cover the whole range of known diets from the site. Conversely, in our sample there is some evidence of marine food consumption (likely seaweed) by sheep in the Neolithic period. We also report here five direct AMS radiocarbon dates for the five analyzed humans from the site.
Retraction: 17β-estradiol upregulates striatin protein levels via Akt pathway in human umbilical vein endothelial cells
Pooled prevalence and subgroup variations of Tetralogy of Fallot among children and adolescents with congenital heart defect in Sub-Saharan Africa: A systematic review and meta-analysis
Background Tetralogy of Fallot is one of the critical congenital heart defects needing intervention within the first year of life. Objective This review aims to systematically assess the prevalence of Tetralogy of Fallot among children and adolescents with congenital heart defects in Sub-Saharan Africa from January 2000 to January 2024. Methods All original observational studies focused on children and adolescent population diagnosed with congenital heart defects within Sub-Saharan Africa; reported the primary outcome of interest were included. Prisma guidelines were utilized to perform this systematic review and meta-analysis. Electronic databases including Medline (PubMed), Scopus, Google Scholar, and African Index Medicus were searched. A weighted inverse variance random-effects model was employed to estimate the pooled prevalence of Tetralogy of Fallot. Results Thirty-one studies included encompassing a total of 11,265 participants from 15 Sub-Saharan African countries with representation from Southern (4 studies, 619 participants), Central (5 studies, 2,220 participants), Eastern (11 studies, 3,384 participants), and Western (11 studies, 5,042 participants). Cross-sectional studies comprised (25 studies, 8,909 participants), and cohort design (6 studies, 2,356 participants). The analysis revealed a pooled prevalence of 10% (95% CI: 9%; 12%) with I2 (77%, p-value < 0.01). The subgroup analysis based on geographic regions revealed statistically significant difference. Conclusions and future implications The prevalence of Tetralogy of Fallot observed was found considerably higher compared to global estimate and reports of developed countries. In a subgroup analysis based on the geographic region, a surprisingly high prevalence was reported across all regions of Sub-Saharan Africa. The substantial disparities and high prevalence observed underscores the complex interplay of factors influencing occurrence of Tetralogy of Fallot. Identifying the true scope of Tetralogy of Fallot burden may help policymakers and healthcare providers to prioritize interventions, optimize resource allocation, and potentially improve its outcomes in Sub-Saharan Africa.
A study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of Bangladesh
Background Maternal tetanus toxoid (MTT) vaccination during pregnancy remains an important factor for reducing infant mortality globally, especially in developing nations, including Bangladesh. Despite commendable progress in reducing child mortality through widespread MTT vaccination during pregnancy, the issue still exists. This analysis explores the impact of MTT vaccination on neonatal mortality in Bangladesh and identifies associated factors. Methods This research utilizes data from the 2019 Bangladesh Multiple Indicator Cluster Survey (MICS). The dataset consists of 23,402 cases; among them, 587 cases resulted in infant death. The outcome variable was infant mortality, which was binary. The independent variables identified as potential contributors to the cause of death included tetanus toxoid vaccination status, mode of delivery (cesarean section or not), and mother’s education level, among others. The Poisson model was employed to analyze the data. Results The analyses showed that the neonatal mortality rate was 2.51%. Notably, 45.90% of mothers received the MTT vaccination during pregnancy. Among them, 23.07% received a single dose, and 22.82% took adequate doses (receiving more than two doses) and adhered to WHO guidelines. The adjusted incidence rate ratio (IRR) was 1.36, which indicates that there was a 36% higher risk of neonatal mortality for those children whose mothers did not take TT (IRR = 1.36, p = 0.081). We also found that women from middle-class households (IRR = 1.58, 95% CI = 0.98, 2.54) and women with higher parity (IRR = 1.96, 95% CI = 0.95, 4.03) also had a higher risk of newborn fatalities. A comparable trend has been observed regarding the correlation between the number of tetanus doses administered and neonatal mortality, where it also emphasizes the importance of receiving adequate doses (a minimum of 2 doses of tetanus vaccine) to mitigate neonatal mortality (adjusted IRR = 0.54, 95% CI = 0.29, 1.01) in comparison to no doses received. Conclusion Administering a minimum of one maternal tetanus dose significantly lowers the risk of neonatal mortality. Other than Maternal Tetanus Toxoid vaccination, the analyses underscore various contributors to neonatal mortality, encompassing maternal healthcare, delivery procedures, socio-economic status, and education. Targeted interventions addressing these factors have the potential to efficiently decrease neonatal mortality rates and improve overall maternal and child health.
Kidney and gallbladder stones and the risk of prostate cancer: Results from the EPICAP study
Background Prostate cancer remains the most frequent cancer among men, representing a significant health burden. Despite its high morbidity and mortality rates, the etiology of prostate cancer remains relatively unknown, with only non-modifiable established risk factors. Chronic inflammation has emerged as a potential factor in prostate carcinogenesis. We investigated the role of kidney and gallbladder stones and the risk of prostate cancer. Methods We used data from EPICAP, a population-based case-control study. A total of 819 diagnosed prostate cancer cases and 879 controls were face-to-face interviewed using a standardized questionnaire that collected information on personal medical history, including history of kidney and gallbladder stones. Odds Ratios (OR) and their 95% confidence interval (CI) were estimated using multivariate unconditional logistic regression. Results Our study revealed intriguing patterns regarding kidney and gallbladder stones in relation to prostate cancer risk. The analysis indicated significant potential associations between kidney stones and the risk of prostate cancer (OR: 1.46 95% CI: 1.13–1.90), particularly in men with a history of kidney infection. Additionally, our data suggested a possible relationship between gallbladder stones and prostate cancer when considering triglyceride (OR: 2.27, 95% CI: 0.99–5.28), although further research is needed for a conclusive understanding. Conclusions Our results suggest an association between calculi and the risk of prostate cancer. Findings from this study underscore the need for a more comprehensive investigation to understand the role of chronic inflammation or metabolism and delineate the mechanisms underlying these potential associations in order to guide the development of targeted preventive strategies for aggressive prostate cancer.
Used economy market insight: Sailboat industry pricing mechanism and regional effects
With the popularity of circular economy around the world, transactions in the second-hand sailboat market are extremely active. Determining pricing strategies and exploring their regional effects is a blank area of existing research and has important practical and statistical significance. Therefore, this article uses the random forest model and XGBoost algorithm to identify core price indicators, and uses an innovative rolling NAR dynamic neural network model to simulate and predict second-hand sailboat price data. On this basis, we also constructed a regional effect multi-level model (RE-MLM) from three levels: geography, economy and country to clarify the impact of geographical areas on sailboat prices. The research results show that, first of all, the price of second-hand sailboats fluctuates greatly, and the predicted value better reflects the overall average price level. Secondly, there are significant regional differences in price levels across regions, economies and ethnic groups. Therefore, the price of second-hand sailboats is affected by many factors and has obvious regional effects. In addition, the model evaluation results show that the model constructed in this study has good accuracy, validity, portability and versatility, and can be extended to price simulation and regional analysis of different markets in different regions.
Metal-organic cage crosslinked nanocomposites with enhanced high-temperature capacitive energy storage performance
Inverse association of oxidative balance score with depression and specific depressive symptoms among cancer population: Insights from the NHANES (2005–2020)
Background The rising prevalence of depression among cancer patients is alarming. This study examines the relationship between the Oxidative Balance Score (OBS)—a composite measure of dietary and lifestyle factors—and depression, including specific depressive symptoms in this population. Methods Data were analyzed from 3,280 adult cancer patients collected in NHANES from 2005–2020. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), where a score of 10 or above indicated depression. Symptoms experienced frequently were classified as specific depressive symptoms. Weighted logistic regression models were utilized to explore the correlation between OBS and depression, along with distinctive depressive symptoms. Results There was a negative correlation between OBS and depression. The highest quartile of OBS (OR 0.313, 95% CI: 0.161–0.609), along with dietary OBS (OR 0.429, 95% CI: 0.234–0.786) and the third quartile of lifestyle OBS (OR 0.404, 95% CI: 0.226–0.722), was associated with reduced depression risk. OBS was correlated with lower risks of all four somatic depressive symptoms and one cognitive symptom. Dietary OBS was associated with fewer risks of three somatic symptoms and one cognitive symptom. Lifestyle OBS showed a negative correlation with two somatic symptoms. Stratified analyses indicated that the inverse relationship between OBS and depression risk was consistent across subgroups, including females and individuals under 65. a nonlinear association was observed between OBS (p = 0.024), dietary OBS (p<0.001), lifestyle OBS (p = 0.021), and depression. Conclusions OBS is inversely related to depression and specific depressive symptoms in cancer patients. Encouraging a diet and lifestyle rich in antioxidants may help reduce the risk of depression in this group.
RIF1 integrates DNA repair and transcriptional requirements during the establishment of humoral immune responses
Abstract The establishment of protective immune responses relies on the ability of terminally differentiated B cells to secrete a broad variety of antigen-specific antibodies with different effector functions. RIF1 is a multifunctional protein that promotes antibody isotype diversification via its DNA end protection activity during class switch recombination. In this study, we showed that RIF1 ablation resulted in increased plasmablast formation ex vivo and enhanced terminal differentiation into plasma cells upon immunization. Mechanistically, this phenotype is independent from RIF1’s role in DNA repair and class switch recombination, and reflects its ability to modulate the transcriptional status of a subset of BLIMP1 target genes. Therefore, here we show that, in addition to promoting antibody diversification, RIF1 fine-tunes the kinetics of late B cell differentiation, thus providing an additional layer of control in the establishment of humoral immunity.
Does financial asset allocation term structure affect audit fees? Evidence from China
The financialization of real enterprises presents a dilemma for China’s economic development. This study examines the impact of the financial asset allocation term structure on audit fees using a sample of Chinese A-share listed companies from 2009 to 2019. It also investigates the mediating role of financial risk and the moderating role of independent director characteristics. The results indicate that higher long-term financial assets is associated with higher audit fees, while short-term financial assets show no significant relationship with audit fees. These findings remain robust after several tests. Financial risk mediates the relationship between long-term financial assets and audit fees. Furthermore, among the characteristics of independent directors, the proportion of female independent directors and those with a financial background negatively moderate the relationship between long-term financial assets and audit fees, while independent directors with an overseas background and academic credentials positively moderate this relationship. Additional analysis reveals that firm size and financing constraints exhibit heterogeneity in their effects. This study contributes to the literature by enhancing our understanding of the factors influencing firms’ financial asset allocation and audit fees, and by expanding the literature on the financial risk and characteristics of independent directors.
Lipidic folding pathway of α-Synuclein via a toxic oligomer
Abstract Aggregation intermediates play a pivotal role in the assembly of amyloid fibrils, which are central to the pathogenesis of neurodegenerative diseases. The structures of filamentous intermediates and mature fibrils are now efficiently determined by single-particle cryo-electron microscopy. By contrast, smaller pre-fibrillar α-Synuclein (αS) oligomers, crucial for initiating amyloidogenesis, remain largely uncharacterized. We report an atomic-resolution structural characterization of a toxic pre-fibrillar aggregation intermediate (I1) on pathway to the formation of lipidic fibrils, which incorporate lipid molecules on protofilament surfaces during fibril growth on membranes. Super-resolution microscopy reveals a tetrameric state, providing insights into the early oligomeric assembly. Time resolved nuclear magnetic resonance (NMR) measurements uncover a structural reorganization essential for the transition of I1 to mature lipidic L2 fibrils. The reorganization involves the transformation of anti-parallel β-strands during the pre-fibrillar I1 state into a β-arc characteristic of amyloid fibrils. This structural reconfiguration occurs in a conserved structural kernel shared by a vast number of αS-fibril polymorphs including extracted fibrils from Parkinson’s and Lewy Body Dementia patients. Consistent with reports of anti-parallel β-strands being a defining feature of toxic αS pre-fibrillar intermediates, I1 impacts viability of neuroblasts and disrupts cell membranes, resulting in an increased calcium influx. Our results integrate the occurrence of anti-parallel β-strands as salient features of toxic oligomers with their significant role in the amyloid fibril assembly pathway. These structural insights have implications for the development of therapies and biomarkers.
Home intravenous diuretic administration for heart failure management: A scoping review
Background Heart failure (HF) significantly impacts healthcare systems due to high rates of hospital bed utilization and readmission rates. Chronic HF often leads to frequent hospitalizations due to recurrent exacerbations and a decline in patient health status. Intravenous (IV) diuretic administration is essential for treating worsening HF. Emerging strategies include home-based IV diuretic therapy administration; however, limited practical implementation guidance is available. This scoping review aims to summarize the literature on home IV diuretic administration for HF patients, focusing on the interventions’ characteristics, and facilitators and barriers to its implementation. Methods This review followed the scoping review framework proposed by Arksey and O’Malley and PRIMSA-ScR. A comprehensive search was conducted across six databases (CINAHL, the Cochrane Library, EMBASE, MEDLINE, PsychINFO and Scopus) and grey literature to identify English studies from inception to April 13, 2024. Two independent reviewers screened articles and resources for inclusion and data was extracted using a form created by the authors in Covidence. Results The search yielded 2,049 results, with nine studies meeting the inclusion criteria. Studies varied in design, including feasibility, pilot, observational, and pre/post-intervention evaluations. The majority were conducted in European countries, with sample sizes ranging from 12 to 96 patients receiving home IV diuretics for HF. Key implementation challenges include appropriate patient selection, IV cannulation competency of healthcare providers, and multi-disciplinary and multi-agency collaboration. Conclusions Evidence on home IV diuretic administration practices for HF management remains limited. However, this scoping review suggests that commonalities across studies could form the basis for developing standard protocols in outpatient settings. Despite the lack of formal evidence-based guidelines, the findings also suggest that tailored, community-specific approaches and safe infusion guidance documents could enhance the efficacy and scalability of home IV diuretic therapy. Future research should focus on refining these strategies and exploring diuretic escalation methods beyond traditional acute care administration to optimize patient outcomes.
Understanding designers’ switching intention to AI painting tools using the PPM framework
Dynamic hydrogen-bonding enables high-performance and mechanically robust organic solar cells processed with non-halogenated solvent
Abstract Developing active-layer systems with both high performance and mechanical robustness is a crucial step towards achieving future commercialization of flexible and stretchable organic solar cells (OSCs). Herein, we design and synthesize a series of acceptors BTA-C6, BTA-E3, BTA-E6, and BTA-E9, featuring the side chains of hexyl, and 3, 6, and 9 carbon-chain with ethyl ester end groups respectively. Benefiting from suitable phase separation and vertical phase distribution, the PM6:BTA-E3-based OSCs processed by o-xylene exhibit lower energy loss and improved charge transport characteristic and achieve a power conversion efficiency of 19.92% (certified 19.57%), which stands as the highest recorded value in binary OSCs processed by green solvents. Moreover, due to the additional hydrogen-bonding provided by ethyl ester side chain, the PM6:BTA-E3-based active-layer systems achieve enhanced stretchability and thermal stability. Our work reveals the significance of dynamic hydrogen-bonding in improving the photovoltaic performance, mechanical robustness, and morphological stability of OSCs.
Safety and effectiveness of an herbal decoction (modified Saengmaeksan) in hypertensive patients: Protocol for a real-world prospective observational study
Objective Hypertension, a common chronic disease, often leads to serious complications. While conventional management relies on antihypertensive drugs, which can cause side effects and adherence issues, alternative treatments like herbal medicine are gaining attention. This study examines the efficacy and safety of modified Saengmaeksan, an East Asian herbal remedy, in treating hypertension. Methods This single-arm, prospective, observational study will be conducted at Kyunghee Bichedam Korean Medicine Clinic from October 23, 2023 to August 30, 2024, enrolling 30 hypertensive patients. Over 12 weeks, participants will undergo 4 visits, receiving modified Saengmaeksan twice daily for 8 weeks, with a subsequent 4-week follow-up. Primary outcome is the change in systolic blood pressure from the baseline to week 8. Secondary outcomes include diastolic blood pressure changes, radial artery tonometry, and quality of life evaluations. Safety assessments will include monitoring hematologic parameters and adverse events. Data will be analyzed using an ANCOVA model for adjusting confounders. Discussion Modified Saengmaeksan has shown potential for lowering blood pressure in clinical settings, supported by animal and cell studies. However, human studies are scarce. This research will employ radial artery tonometry to analyze blood pressure comprehensively, exploring Saengmaeksan’s hemodynamic effects. The study’s goal is to support the approval of modified Saengmaeksan as a hypertension treatment by the South Korean Food and Drug Administration and to promote the industrialization of traditional herbal medicine in managing hypertension. The findings will provide essential data for future clinical research, aiding in feasibility assessments and sample size determinations for randomized controlled trials.