Tag: pubmed

Microb Cell Fact. 2024 Dec 17;23(1):330. doi: 10.1186/s12934-024-02600-0.

ABSTRACT

BACKGROUND: The main obstacle facing the utilization of microbial enzymes in industrial applications is the high cost of production substrates. As a result of the mentioned different wastes (coffee powder waste, dates nawah powder, molokhia stems, pea peels, lemon peels, and corn cobs) were investigated as low-cost nutritional substrates for the production of microbial β-galactosidase in this study. The purification of the enzyme and its kinetic and thermodynamics were investigated.

RESULTS: β-galactosidase was effectively produced by Aspergillus foetidus utilizing lemon peels and coffee powder waste by solid-state fermentation technique. The production yield was improved through Plackett-Burman Design declaring the significant effect of lemon peels and coffee waste powder, and beef extract quantities on A. foetidus β-galactosidase production. Followed by Central Composite Design investigating each factor with five levels resulting in 37363.1 U.ml^{– 1} production. The enzyme was fully purified by gel filtration technique through Sephadex G-150 giving one band with a molecular weight 40 KDa on SDS-PAGE gel. The maximal β-galactosidase activity was obtained at 50 °C with 0.4% ONPG. Cu²⁺, Fe²⁺, and Hg²⁺ showed severe inhibitory effect on pure enzyme activity. Energy required for enzyme activation (E_a) and denaturation (E_d) were determined to be 17.40, and 43.86 KJ.mol^{– 1}, respectively. Parameters reflecting β-galactosidase thermal stability at 40, 45, and 50 °C as T_1/2 and D-values values were determined to be 283.92, 209.43, and 168.56 min, and 943.34, 695.84, and 560.06 min, respectively.

PMID:39681866 | DOI:10.1186/s12934-024-02600-0

BMC Med Res Methodol. 2024 Dec 16;24(1):301. doi: 10.1186/s12874-024-02436-7.

ABSTRACT

BACKGROUND: Transitivity assumption is the cornerstone of network meta-analysis (NMA). Investigating the plausibility of transitivity can unveil the credibility of NMA results. The commonness of transitivity was examined based on study dissimilarities regarding several study-level aggregate clinical and methodological characteristics reported in the systematic reviews. The present study also demonstrated the disadvantages of using multiple statistical tests to assess transitivity and compared the conclusions drawn from multiple statistical tests with those from the approach of study dissimilarities for transitivity assessment.

METHODS: An empirical study was conducted using 209 published systematic reviews with NMA to create a database of study-level aggregate clinical and methodological characteristics found in the tracenma R package. For each systematic review, the network of the primary outcome was considered to create a dataset with extracted study-level aggregate clinical and methodological characteristics reported in the systematic review that may act as effect modifiers. Transitivity was evaluated by calculating study dissimilarities based on the extracted characteristics to provide a measure of overall dissimilarity within and between the observed treatment comparisons. Empirically driven thresholds of low dissimilarity were employed to determine the proportion of datasets with evidence of likely intransitivity. One-way ANOVA and chi-squared test were employed for each characteristic to investigate comparison dissimilarity at a significance level of 5%.

RESULTS: Study dissimilarities covered a wide range of possible values across the datasets. A ‘likely concerning’ extent of study dissimilarities, both intra-comparison and inter-comparison, dominated the analysed datasets. Using a higher dissimilarity threshold, a ‘likely concerning’ extent of study dissimilarities persisted for objective outcomes but decreased substantially for subjective outcomes. A likely intransitivity prevailed in all datasets; however, using a higher dissimilarity threshold resulted in few networks with transitivity for semi-objective and subjective outcomes. Statistical tests were feasible in 127 (61%) datasets, yielding conflicting conclusions with the approach of study dissimilarities in many datasets.

CONCLUSIONS: Study dissimilarity, manifested from variations in the effect modifiers’ distribution across the studies, should be expected and properly quantified. Measuring the overall study dissimilarity between observed comparisons and comparing it with a proper threshold can aid in determining whether concerns of likely intransitivity are warranted.

PMID:39681853 | DOI:10.1186/s12874-024-02436-7

BMC Palliat Care. 2024 Dec 16;23(1):283. doi: 10.1186/s12904-024-01615-z.

ABSTRACT

BACKGROUND: With an increased number of people living with multiple progressive diseases, online education courses have been created to address the growing need for competence in palliative care. However, there is limited knowledge about the form and content of these courses, or of participants’ experiences. This study aims to map the status, content, and evaluation of online palliative care courses in Sweden.

METHODS: This exploratory study used both quantitative and qualitative methods. The study process involved searching for online palliative care courses on the web and through contact with Swedish palliative care organisations, and then participating in these courses, surveying education providers, and analysing and validating responses. Quantitative data were analysed using descriptive statistics, while thematic analysis was applied to the free-text responses.

RESULTS: Nine online courses provided by five different organisations were mapped. These courses educated over 30 000 healthcare professionals, predominantly assistant nurses and registered nurses. There was a large discrepancy between the number of people who enrolled in and the number who completed the online courses. Shortcomings identified related to lack of systematic evaluation from the participants’ perspectives, if and how knowledge was integrated into clinical practice, and difficulties in making the courses sustainable.

CONCLUSION: Overarching and national systems for online education are needed. These would require sustainability considerations and guidelines for implementation, evaluation and follow-up of non-university-based online educational initiatives in palliative care. In addition, it is crucial for employers to support professionals undergoing such education, ensuring that they are given opportunities to share their feelings and discuss any challenging thoughts that arise during and after the course.

PMID:39681847 | DOI:10.1186/s12904-024-01615-z

BMC Public Health. 2024 Dec 16;24(1):3400. doi: 10.1186/s12889-024-20971-2.

ABSTRACT

BACKGROUND: Motivation levels for exercise vary widely among individuals and are influenced by various factors. This study aimed to compare exercise motivation levels and explore influencing factors among university students.

METHODS: A cross-sectional research design targeted university students aged range 18 to 32 years. Participants (n = 148) were selected via cluster random sampling. Motivation for exercise was determine by the Exercise Motivation Inventory (EMI-2). EMI-2 comprises fourteen different subscales of motivation, with each subscale containing three to four items. All items were rated on a scale of 0 to 5, with 0 indicating “not at all true for me” and 5 indicating “very true for me.” Statistical analyses included ANOVA and Pearson correlation coefficient to assess differences among demographic variables (year of study, age, gender, marital status, location, and family size) and relationships between motivational aspects.

RESULTS: The average exercise motivation level among all students was 166.94 ± 32.20. Fifth-year students exhibited the highest motivation 178.33 ± 30.37. No significant gender differences were found (p = 0.149). However, age (p = 0.024), location (p = 0.015), marital status (p = 0.050), and family size (p = 0.030) significantly influenced exercise motivation.

CONCLUSION: University students demonstrate inherent motivation for physical activity, with significant variations observed across demographic factors. These findings underscore the importance of tailored interventions to promote exercise and enhance student well-being. Further research, including longitudinal studies, is warranted to comprehensively understand exercise motivation dynamics in this population.

PMID:39681844 | DOI:10.1186/s12889-024-20971-2

BMC Prim Care. 2024 Dec 16;25(1):416. doi: 10.1186/s12875-024-02677-x.

ABSTRACT

BACKGROUND: Rural areas are increasingly moving back into the focus of social research, especially in the context of health care. As the shortage of general practitioners (GP) in rural areas is a significant challenge in Germany, there are several programs to counteract underuse effectively, acutely, and sustainably. One of those programs is ‘Beste Landpartie Allgemeinmedizin’ (BeLA), which was developed to strengthen primary care in rural areas and to sustainably promote young doctors to work as general practitioners in rural regions through didactical and financial support. The program includes an accompanying qualitative study exploring the motivational structures of medical students from a sociological perspective. For this study, the nexus of working in rural areas from the perspective of medical students with different forms of rural experiences was of interest.

METHODS: Qualitative interviews have been conducted at regular intervals on an ongoing basis since 2020 to investigate motivational retention effects during the program. The current 33 interviews were analysed using the sociological conceptual framework of spatial methods.

RESULTS: The images and experiences of working in rural areas condition medical education in various ways. In addition to general images of living and working in rural areas in a biographical dimension, the idea of working as a GP in rural areas includes images of specific medical competencies and is conditioned by different medical tasks. From such a perspective, the images and attributions of working in primary care in a rural region demonstrate particularities, challenges, and the potential attractiveness of working in rural regions.

DISCUSSION: The images and experiences of rural areas condition medical education in various ways and shape the expectations and the decision-making of possibly working in rural areas. The particularities, opportunities, and challenges of working in rural areas, which relate to both professional aspects and social life, are a major factor in the attractiveness of a potential rural practice. Didactical and educational curricula need to adapt the various attributions of working in rural areas.

PMID:39681841 | DOI:10.1186/s12875-024-02677-x

Childs Nerv Syst. 2024 Dec 16;41(1):58. doi: 10.1007/s00381-024-06716-x.

ABSTRACT

PURPOSE: Pediatric cervical spine injury (pCSI) is rare. Physiological differences necessitate alternate management from adults. Yet, no standardized pediatric protocols exist. Previous investigations applying adult-validated clinical decision rules (CDRs)-NEXUS Criteria (NX) and Canadian C-spine Rules (CCR)-to children are mixed. We hypothesized a combined NX + CCR approach applied at a delayed 24-h time point would enhance screening efficacy in select patients.

METHODS: We conducted a retrospective review of a prospectively-collected database over 15 months at a pediatric-capable Level-1 trauma center. Age and mechanism determined initial inclusion. NX and CCR criteria were collected and retroactively applied on arrival (T0) and 24 h later (T1). Statistical analyses were performed in SPSS.

RESULTS: A total of 306 patients met inclusion. Current practices compel computed tomography (CT) overuse for craniocervical evaluations: 298 (97.4%) underwent ≥ 1 CT. Of cervical spines imaged (n = 175), 161 (92.0%) underwent CT while 74 (42.3%) underwent magnetic resonance imaging with 14 (18.9%) completed after 72 h. Of collars placed on arrival (n = 181), 136 (75.1%) were cleared before discharge with 86 (63.2%) CTs denoting preferred clearance modality; CT utilization was unchanged when stratified by age < 5 years (p = 0.819). Notably, we found more patients met NX + CCR criteria at T1 versus T0 (p = 0.008) without missed pCSI resulting in imaging overutilization in 15 (8.6%) patients.

CONCLUSION: We showed incorporating a 24-h time delay before a second CDR reapplication may enhance screening efficacy in pCSI. Our new algorithm combines these findings with other literature-based recommendations and may represent a standardizable option for evaluating pCSI in the acute trauma setting.

PMID:39681802 | DOI:10.1007/s00381-024-06716-x

Prenat Diagn. 2024 Dec 16. doi: 10.1002/pd.6717. Online ahead of print.

ABSTRACT

OBJECTIVES: Umbilical artery Doppler intermittent absent and reversed end-diastolic flow (iAREDF) is associated with increased perinatal morbidity and mortality in monochorionic twins with selective fetal growth restriction. The clinical significance of umbilical artery iAREDF in appropriately grown monochorionic twins is not well described.

METHODS: This is a single-institution retrospective cohort study describing characteristics and outcomes of monochorionic diamniotic twins with appropriate for gestational age growth and umbilical artery iAREDF in comparison to monochorionic diamniotic twins with selective fetal growth restriction and iAREDF, or sFGR type III. The cohorts were compared for antenatal resolution of iAREDF, estimated gestational age at delivery, fetal and maternal complications, delivery characteristics, and survival outcomes.

RESULTS: Ten appropriately grown monochorionic diamniotic twin pairs with umbilical artery iAREDF and 23 with sFGR Type III delivered at a mean gestational age of 30.4 (± 5) weeks and 30.7 (± 4) weeks, respectively (p = 0.93). No significant differences were observed in the Doppler course (deterioration or improvement) prior to delivery, fetal or maternal complications, delivery characteristics (with the exception of the persistence of the growth differences), or survival outcomes between groups.

CONCLUSIONS: Monochorionic diamniotic twins with intermittent absent and reversed end-diastolic umbilical artery velocity may be at increased risk for adverse perinatal outcomes even if criteria for selective fetal growth restriction are not met.

PMID:39681800 | DOI:10.1002/pd.6717

EBioMedicine. 2024 Dec 15;111:105508. doi: 10.1016/j.ebiom.2024.105508. Online ahead of print.

ABSTRACT

BACKGROUND: Sepsis remains a leading cause of mortality in intensive care units. Understanding the dynamics of the plasma proteome of patients with sepsis is critical for improving prognostic and therapeutic strategies.

METHODS: This prospective, multicentre observational cohort study included 363 patients with sepsis recruited from five university hospitals in Germany between March 2018 and April 2023. Plasma samples were collected on days 1 and 4 after sepsis diagnosis, and proteome analysis was performed using mass spectrometry. Classical statistical methods and machine learning (random forest) were employed to identify proteins associated with 30-day survival outcomes.

FINDINGS: Out of 363 patients, 224 (62%) survived, and 139 (38%) did not survive the 30-day period. Proteomic analysis revealed significant differences in 87 proteins on day 1 and 95 proteins on day 4 between survivors and non-survivors. Additionally, 63 proteins were differentially regulated between day 1 and day 4 in the two groups. The identified protein networks were primarily related to blood coagulation, immune response, and complement activation. The random forest classifier achieved an area under the receiver operating characteristic curve of 0.75 for predicting 30-day survival. The results were compared and partially validated with an external sepsis cohort.

INTERPRETATION: This study describes temporal changes in the plasma proteome associated with mortality in sepsis. These findings offer new insights into sepsis pathophysiology, emphasizing the innate immune system as an underexplored network, and may inform the development of targeted therapeutic strategies.

FUNDING: European Regional Development Fund of the European Union. The State of North Rhine-Westphalia, Germany.

PMID:39681038 | DOI:10.1016/j.ebiom.2024.105508

J Radiol Prot. 2024 Dec 16. doi: 10.1088/1361-6498/ad9f73. Online ahead of print.

ABSTRACT

In short terms, a society’s available resources are finite and must be prioritised. The more resources that are spent on radiological protection, the lesser resources are available for other needs. The ALARA principle states that exposure of ionizing radiation should be kept as low as reasonably achievable, taking into account economic and societal factors. In practice, one of several approaches to determine what is considered as reasonably achievable is cost-benefit analysis. A demanding part of cost-benefit analysis is to decide on an α value, which stipulates the value of radiological protection. There are different conversion methods on how to convert societal costs into an α value. However, with the assistance of recent developments within both health economics and radiological protection room for improvements was found. Therefore, the aims of the present study were to develop a new conversion method (on how to convert societal costs into an α value) and to provide recommendations of α values for each member country of The Organisation for Economic Co-operation and Development (OECD). With the help of systematic reviews of societal costs (the value of a statistical life, productivity losses and healthcare costs) and discount rates, as well as Monte Carlo simulations of the number of years between exposure and cancer diagnosis, a new conversion method and recommendations of α values could be presented. The new conversion method was expressed as a discounted nominal risk of exposure with a median (interquartile range) of 175 (136-222) per 10 000 persons per Sv for the public and 169 (134-207) per 10 000 persons per Sv for workers. For OECD in general, recommendations of α values were determined to be $56-170 per man.mSv for the public and $61-162 per man.mSv for workers (2023-USD).

PMID:39681002 | DOI:10.1088/1361-6498/ad9f73

J Med Internet Res. 2024 Dec 16;26:e63476. doi: 10.2196/63476.

ABSTRACT

BACKGROUND: The number of confirmed COVID-19 cases is a crucial indicator of policies and lifestyles. Previous studies have attempted to forecast cases using machine learning techniques that use a previous number of case counts and search engine queries predetermined by experts. However, they have limitations in reflecting temporal variations in queries associated with pandemic dynamics.

OBJECTIVE: This study aims to propose a novel framework to extract keywords highly associated with COVID-19, considering their temporal occurrence. We aim to extract relevant keywords based on pandemic variations using query expansion. Additionally, we examine time-delayed web-based search behavior related to public interest in COVID-19 and adjust for better prediction performance.

METHODS: To capture temporal semantics regarding COVID-19, word embedding models were trained on a news corpus, and the top 100 words related to “Corona” were extracted over 4-month windows. Time-lagged cross-correlation was applied to select optimal time lags correlated to confirmed cases from the expanded queries. Subsequently, ElasticNet regression models were trained after reducing the feature dimensions using principal component analysis of the time-lagged features to predict future daily case counts.

RESULTS: Our approach successfully extracted relevant keywords depending on the pandemic phase, encompassing keywords directly related to COVID-19, such as its symptoms, and its societal impact. Specifically, during the first outbreak, keywords directly linked to COVID-19 and past infectious disease outbreaks similar to those of COVID-19 exhibited a high positive correlation. In the second phase of the pandemic, as community infections emerged, keywords related to the government’s pandemic control policies were frequently observed with a high positive correlation. In the third phase of the pandemic, during the delta variant outbreak, keywords such as “economic crisis” and “anxiety” appeared, reflecting public fatigue. Consequently, prediction models trained by the extracted queries over 4-month windows outperformed previous methods for most predictions 1-14 days ahead. Notably, our approach showed significantly higher Pearson correlation coefficients than models based solely on the number of past cases for predictions 9-11 days ahead (P=.02, P<.01, and P<.01), in contrast to heuristic- and symptom-based query sets.

CONCLUSIONS: This study proposes a novel COVID-19 case-prediction model that automatically extracts relevant queries over time using word embedding. The model outperformed previous methods that relied on static symptom-based or heuristic queries, even without prior expert knowledge. The results demonstrate the capability of our approach to track temporal shifts in public interest regarding changes in the pandemic.

PMID:39680913 | DOI:10.2196/63476