Poor Research Articles

Socioeconomic Disparities in Family Well-Being, Family Communication Quality, and Personal Happiness among Chinese: Findings from Repeated Cross-Sectional Studies in 2016–2023

AbstractSignificant socioeconomic changes in Hong Kong have coincided with a conspicuous knowledge gap regarding the impact of disparities on family well-being, family communication quality, and personal happiness. To examine changes on family well-being, family communication quality, and personal happiness before, during, and after the 2019 social unrest and the COVID-19 pandemic in Hong Kong. Five repeated territory-wide cross-sectional surveys were conducted from 2016 to 2023, using telephone and online surveys on 27,074 adults in Hong Kong. Respondents rated their family health, happiness, harmony (family 3Hs), family communication quality, and personal happiness on scales of 0–10. Family well-being was the sum of family 3Hs divided by three (0–10). Trends by socioeconomic factors were analysed using linear prediction and multiple linear regression, weighted for sex and age. Highest scores for all outcomes were observed in 2016 and 2017, followed by a noticeable decline in 2020 and 2021, with the lowest scores recorded in 2023 except for personal happiness with its lowest score recorded in 2021. The decline since 2021 was most noticeable with low monthly household income (predicted margins in 2023 ranged from 5.55 to 6.46 for ≤ HK$19,999; 5.62 to 6.51 for HK$20,000–39,999; 5.81 to 6.78 for ≥ HK$40,000), but no differences were observed by education level. Female, older age, and higher monthly household income were significantly associated with higher family well-being, family communication quality, and personal happiness (all P < 0.001). Higher education level was only significantly associated with personal happiness (P = 0.008). We have first shown socioeconomic disparities in the declining family well-being, family communication quality, and personal happiness from 2016 to 2023 in Hong Kong. These alarming findings require targeted interventions and policies aimed at addressing these disparities and improving wellbeing in the population.

Socioeconomic and medical determinants of state-level subjective cognitive decline in the United States.

It is important to understand the socioeconomic and medical determinants of subjective cognitive decline (SCD) at a population level in the United States. The primary outcomes are state-level rates of SCD and SCD-related functional impairment in adults aged ≥ 45, both measured in the Behavioral Risk Factor Surveillance System from 2016 to 2022. The exposures are state-level rates of poverty, unemployment, homelessness, college education, racial and ethnic minorities, uninsurance, smoking, hypertension, diabetes, and obesity as well as household income and physician density. The strongest state-level associations with rates of SCD were the prevalence of diabetes (rho=0.64), hypertension (rho=0.59), and poverty (rho=0.58; all p<0.001), and with SCD-related functional impairment were prevalence of poverty (rho=0.71), diabetes (rho=0.68), and hypertension (rho=0.53; all p<0.001). This study highlights critical links between SCD and socioeconomic and medical determinants in adults aged ≥ 45 in the United States, including the prevalence of poverty, diabetes, and hypertension. State-level analysis reveals socioeconomic and medical risk factors for subjective cognitive decline (SCD) at a population level. The prevalence of poverty is a critical contributor to the state-level prevalence of SCD. The prevalence of diabetes and hypertension are also strong state-level determinants of SCD. Addressing the burden of cognitive decline at the population level necessitates targeting socioeconomic and medical factors.

Status of uterine cervix cancer mortality and incidence disparities in Appalachian eastern Kentucky.

132 Background: Cervical cancer continues to affect the Appalachian population to a higher degree than the rest of the American population. Researchers believe the increased prevalence of cervical cancer in the Appalachian area is due to health disparities across the area. Methods: We queried the Kentucky Cancer Registries online public Cancer Incidence and Mortality Inquiry System to determine changes in age adjusted invasive cervical cancer incidence and mortality rates in Appalachian (AK) and Non-Appalachian Kentucky (NAK) counties over time. Incidence rate ratios were used to analyze the difference in cervical cancer incidence and mortality between Appalachian KY and non-Appalachian KY populations across several time periods. Results: In 1995-1999, there was a statistically significant difference in cervical cancer incidence between AK and NAK 14.8 vs. 12.7/100,000 people (p= 0.0035) and mortality 4.6 vs. 4.0/100,000 (p=0.0471). The cervical cancer incidence was 16.9% higher in AK versus NAK and mortality was 18.4% higher in AK versus NAK. In 2016-2020, there was a statistically significant difference in cervical cancer incidence between AK and NAK 12.1 vs. 8.9/100,000 people (p≤ 0.0001) and mortality between AK and NAK 3.6 vs. 2.3/100,000 people (p= 0.0001). The cervical cancer incidence was 36% higher in AK versus NAK and mortality was 55.7% higher in AK versus NAK. Conclusions: Disparities between in Appalachian Kentucky and Non-Appalachian Kentucky in cervical cancer incidence and mortality not only have persisted since the 1990’s, but they have widened proportionally over time as survival gains have lagged in Appalachia. The observed cervical cancer outcome disparities are likely contributed to by not only the lack of general health education in the region, but more importantly barriers to care access contributing to a lower use of Pap testing in the area. Higher rates of poverty, increased rates of smoking and HPV infection also likely play a role. Research has been conducted to observe identified opportunities for intervention and begin collaborative efforts in the region engineered towards a cervical cancer risk reduction program, but the need for improvement clearly remains. Cervical cancer mortality rates in Appalachian Kentucky vs. non-Appalachian Kentucky, 1995-2020. Appalachia Non-Appalachia Population at Risk Deaths Crude Rate/100,000 Age-Adjusted Rate 95% Confidence Interval Population at risk Deaths Crude Rate/100,000 Age-Adjusted Rate 95% Confidence Interval 1995-1999 2928468 145 5 4.6 [3.9-5.4] 7209127 301 4.2 4 [3.6-4.5] 2000-2004 2962204 102 3.4 3.2 [2.6-3.9] 7485965 214 2.9 2.7 [2.3-3.1] 2005-2009 2986284 117 3.9 3.5 [2.9-4.2] 7833348 225 2.9 2.6 [2.3-3.0] 2010-2015 3577269 141 3.9 3.4 [2.8-4.0] 9803897 277 2.8 2.5 [2.2-2.9] 2016-2020 2941022 121 4.1 3.6 [3.0-4.4] 8378683 221 2.6 2.3 [2.0-2.7]

COVID-19 Pandemic Increases the Risk of Anxiety and Depression among Adolescents: A Cross-Sectional Study in Rural West Bengal, India

About 14% of adolescents experience mental illnesses globally. The rate increased after the COVID-19 pandemic. This study aimed to estimate the prevalence of COVID-related major mental illnesses (depression and anxiety) and their predictors among adolescents. This community-based cross-sectional study was conducted among 350 adolescents aged 10–19 years, recruited from rural communities in West Bengal, India. The study areas included 27 subcenters in the Budge Budge II Block, which comprised 191,709 population and 45,333 households. Data were collected from randomly selected households by trained research assistants through house-to-house interviews. Pretested standardized questionnaires, Patient Health Questionnaire (PHQ) for depression, Generalized Anxiety Disorder (GAD) for anxiety, and a demographic questionnaire were used for data collection. The prevalence of anxiety was 35.7% (125 out of 350), and the prevalence of depression was 30.0% (105 out of 350). Females had significantly higher scores of anxiety (6.67 ± 4.76 vs. 3.42 ± 3.17, respectively, p &lt; 0.001) and depression (5.51 ± 4.99 vs. 3.26 ± 3.86, respectively, p &lt; 0.001) compared to males. Adolescents who had COVID-19 cases or deaths in the family had significantly higher scores of anxiety and depression compared to those who did not have these events. In multivariate analysis, the statistically significant predictors of anxiety were COVID-19 death in the family, COVID-19 cases in the family, female gender, and a lower income group (p &lt; 0.001 for all). For depression, the significant predictors included COVID-19 death in the family, COVID-19 cases in the family, female gender, a lower income group, and a higher age group in adolescents (p &lt; 0.001 for all). Based on the study results, we recommend that immediate attention is needed for adolescents’ mental health support and coping with stresses following COVID-19.

Access to healthcare services during the COVID-19 pandemic: a cross-sectional analysis of income and user-access across 16 economically diverse countries

BackgroundNational health systems have different strengths and resilience levels. During the COVID-19 pandemic, resources often had to be reallocated and this impacted the availability of healthcare services in many countries. To date there have been few quantitative contemporary studies of inequalities in access to healthcare within and between countries.In this study, we aim to compare inequality within and between 16 economically diverse countries.MethodsOnline surveys were conducted on 22 150 adults in 16 countries across six continents in 2022. Quota sampling and post-stratification weighting was used to obtain an age, gender, geographically, and educationally representative sample. The study assesses the differences in challenges in access to healthcare during the pandemic (for GP, surgical/clinical and digital GP services) using country-specific expanded health-needs-adjusted Erreygers’ concentration indices and compares these values between countries using a Spearman’s rank correlation coefficient.ResultsResults show wide variation in income-related challenges in access within countries for different types of care. For example, Erreygers’ concentration index for digital services in Colombia exhibited highly regressive inequality at 0·17, compared to Japan with an index of -0·15. Inequalities between countries were also evident, with Spearman rank coefficients of -0·69 and -0·65 (p-values of 0·003 and 0·006) for digital and surgical access, indicating that lower income countries had greater inequality in healthcare access challenges.ConclusionDuring the pandemic, inequalities in challenges to accessing healthcare were greatest in low and middle-income countries. Digital technologies offer a reasonable means to address some of this inequality if adequate support is provided and accessible digital infrastructure exists.

Street tree communities reflect socioeconomic inequalities and legacy effects of colonial planning in Nairobi, Kenya

Street trees provide ecological and social benefits that sustain urban life, yet their distribution frequently mirrors socioeconomic inequalities, meaning underprivileged social groups also have fewer trees. The distribution patterns of urban trees are least documented in the cities of rapidly evolving middle-income countries. We assessed whether street tree abundance, size, condition, diversity, and composition vary across different socioeconomic strata in Nairobi, Kenya. We sampled 2,047 trees across 12 neighborhoods in Nairobi, covering 24km of street, then used linear regression to understand how census-derived socioeconomic strata relate to street tree characteristics. We found substantial disparities in tree abundance, with affluent areas harboring 91.5% of the trees sampled. Low-income areas and informal settlements had comparably few trees. Mean diameter and condition did not vary across socioeconomic strata, but high-income, formerly European neighborhoods had a higher proportion of small trees, indicating a bias in recent urban greening investments further benefiting these areas. Species diversity followed a similar pattern of inequality. High-income neighborhoods had over 30% higher species richness and diversity than low-income areas. Even, so lower income neighborhoods exhibited greater differences in street tree community composition., and a higher proportion of trees that bear edible fruit or are used in traditional medicine. Overall, our results reveal pronounced spatial inequality in the distribution of street trees in Nairobi, reflecting not only socioeconomic differences but the enduring legacies of colonial planning.

Sustainable Development Program: Synergism Integrated Farming System Implementation in Tambrauw, West Papua with A Holistic Approach

Indonesia, as an agricultural country with abundant natural resources, still faces the problem of poverty in various regions, especially in West Papua. The high poverty rate in this area is related to the low access to education, food security, and proper economic resources. In an effort to address these issues, the Integrated Farming System (IFS) is considered a potential solution to improve community welfare and support the Sustainable Development Goals (SDGs) targets. This study aims to identify the benefits, challenges and opportunities of IFS implementation in Tambrauw Regency, West Papua, with a focus on its contribution to the achievement of the five SDGs targets, including poverty and hunger alleviation, and improvement of quality of life and environment. The method used in this research is a descriptive qualitative study through literature review and secondary data analysis. Data were taken from various sources such as scientific journals, books, and official documents relevant to the research topic. The results show that the implementation of IFS in Tambrauw has the potential to increase agricultural and livestock productivity, create new jobs, and promote sustainable food production. In addition, the use of organic fertilizers and a holistic approach can have a positive impact on the environment and local communities. IFS is an effective program in supporting the achievement of SDGs through empowerment of local communities and sustainable use of existing resources. However, further support in the form of technological innovation and sustainable government policies are needed to ensure the long-term success of this program.

Depression risk and resilience in a diverse sample of older adults in the United States

Living in poor and physically deteriorating neighborhoods is associated with heightened likelihood of experiencing depression. At the same time, not all people experience their neighborhoods in the same way. We predicted and tested the possibility that variability in this association can be explained by the social support that people derive both from their personal networks and other people residing in the same neighborhood, and that this moderation varies by race/ethnicity. Health and Retirement Study data (2018/2020 waves) were used to evaluate the role of individual-level and contextual risk and resilience factors in association with depression among US older non-Hispanic white adults (n = 4,986, mean age 67 years), non-Hispanic black adults (n = 1,342, mean age 65 years), and Hispanic adults (n = 937, mean age 64 years). Four notable findings emerged. First, perceived neighborhood disorder was related to increased depression risk for non-Hispanic white and black participants, but not Hispanic participants. Second, participants residing in census tracts with higher poverty rates were more likely to report depression. Third, non-Hispanic white participants residing in census tracts with greater Hispanic resident density had reduced depression risk. This same pattern was not observed among non-Hispanic black participants. Finally, perceived support from family was associated with reduced depression risk among all participants. These data suggest both individual- and contextual-level sources of risk and resiliency for depression. The implications for theories that seek to explain the relative resilience to neighborhood disorder observed among US Hispanic residents are discussed.

Application of waste gypsum as novel selective depressant in the flotation separation of apatite from dolomite

The accumulation of gypsum slag not only causes resource wastage, but also poses serious environmental hazards, therefore, utilizing the resources of the main components in gypsum slag is an imperative task. In this study, gypsum was used as an inorganic depressant for the flotation separation of apatite from dolomite through the selective adsorption of gypsum on the surface of dolomite. Micro-flotation experiments showed that sodium oleate exhibited a good ability to collect apatite and dolomite, but poor ability to collect gypsum. At pH 9.5, when 3.75 g/L gypsum was added to the slurry, the recovery of dolomite decreased from 76.77 % to 18.34 %, whereas that of apatite was 86.45 %. Atomic force microscopy, scanning electron microscopy, and X-ray photoelectron spectroscopy were employed to elucidate the adsorption characteristics of gypsum on the apatite and dolomite surfaces. The results showed that gypsum was selectively adsorbed on the raised particles on the dolomite surface and combined with the active sites of Ca and Mg metal ions. However, the adsorption of gypsum on the surface of apatite was weak and had little effect on the flotation performance. Density functional theory calculations showed that the O in gypsum reacted easily with Ca and Mg metal ions on the mineral surface. The adsorption energies of gypsum at the Ca and Mg sites on the dolomite surface were −81.97 and −86.18 kJ/mol, respectively, whereas the adsorption energy on the apatite surface was only −34.20 kJ/mol. Gypsum is the main component of gypsum slag, and this study provides a potential recycling method for gypsum slag resources.

Predictive Role of Emotional Intelligence in Authenticity and Self-Disgust Levels of University Students

The aim of this study is to investigate the relationships between emotional intelligence, authenticity, and self-disgust levels of university students. 555 students, 440 females and 115 males that studying in various universities in Turkey in 2022 have participated to the study. The research model of this study is a type of quantitative research called relational survey model. Demographic Information Form, Trait Emotional Intelligence Questionnaire–Short Form, Self-Disgust Scale-Revised and Authenticity Scale were used in the study for data collection processes. The results of the research state that emotional intelligence and authenticity levels of males were higher than females, while self-disgust did not show any difference between genders. When the variables were analyzed according to income status, the emotional intelligence level was higher in individuals with higher income, as self-disgust was higher in individuals with lower income. Authenticity level did not show any difference among income groups. When the relationships between variables were analyzed, a positive significant relationship was found between emotional intelligence and authenticity. Self-disgust was found to have a significant negative relationship with both emotional intelligence and authenticity. According to the multiple regression analyses, it was found that the subscales of emotional intelligence were significant predictors of authenticity. The subscales of emotional intelligence including well-being, self-discipline, emotionality, and sociability together explained 53% of the variance in authenticity scores. Lastly, the results indicates that the subscales of emotional intelligence were significant predictors of self-disgust. The subscales of emotional intelligence including well-being, self-discipline, emotionality, and sociability together explained 41% of the variance in self-disgust scores. According to the results obtained, it is recommended to take increasing emotional intelligence skills into account considering that it may be functional in increasing the authenticity and reducing the self-disgust of individuals in terms of psychological health.

Assessment of impacts of air pollution on people living in Ezza North close to quarry operation sites in Ebonyi State, Nigeria

Quarrying activities have become lucrative work for low income people in low income countries most found in Africa. This study aimed assess the impacts of air pollution on people living in Ezza North close to quarry operation sites in Ebonyi State, Nigeria. A descriptive cross sectional study was used and pollution level was determined with the use of calibrated Handheld GPS, Amex multiple gas meter, Sound meter and interview of participants with a questionnaire on the health status. The collected data were entered into the Statistical Package for Social Sciences (SPSS) software (version 21). The one sample T-test was used to test the hypotheses at 95% confidence interval and 0.05 level of significance. The results showed that 31–40 years had 19(5.37%) males and 20(5.65%) females as highest quarrying workers. The concentration of carbon monoxide was highest at 193ppm, Sulphur dioxide at 568ppm, nitrogen dioxide at 1.9ppm, Suspended particulate Matter (SPM) at 1982ppm and sound level at 82.9dB. The concentrations of these pollutants were found to be significantly higher (P&lt;0.05) than normal levels apart from sound level without significant impact at P = 0.285. The 93.3% of the participants reported blasting of rocks produced highest air pollution, 87.5% that reported crushing, conveying, sieving produce a lot of dust. Also, 80% of participants reported high level of noise came from machinery blasting rocks, processing and haulage trucks. In all, 35% reported they had fair health condition when asked about the health status since they started quarrying work. In conclusion, the concentrations of carbon monoxide, carbon dioxide, sulphur dioxide, particulate matter and nitrogen oxides were all higher than normal. It was observed air pollutants had association with respiratory system. Therefore, the air pollution at quarrying site can be mitigated through dust suppression techniques and treating quarry pit with water before discharging.

The status quo and correlational analysis of nursing practices, burnout, and social support among nurses from private hospitals in Dazhou, a less developed area of China

ObjectiveTo investigate the status quo of nursing practices, job burnout and social support among private hospitals in Dazhou, Sichuan Province, and perform correlational analysis.MethodsA cross-sectional study was conducted. A total of 244 nurses were surveyed via convenience sampling from 7 private hospitals, which were randomly selected from Dazhou city. A self-designed demographic sociology questionnaire was applied, and the Chinese versions of the Maslach Burnout Scale and the Social Support scale administered from September to November 2022.ResultsThe investigated nurses were relatively young (26.84 ± 4.90 years), had a short duration of service, a low academic background, a low professional title and a low income; however, they were highly satisfied with their working environment and had a low level of burnout, and their level of personal achievement was low. Overtime work, education level and number of children had significant impacts on the level of nurse burnout. The level of social support was high, and various dimensions were negatively correlated with the emotional exhaustion and depersonalization dimensions of burnout (r=-0.438, P < 0.01; r=-0.372, P < 0.01) and positively correlated with personal achievement (r = 0.291, P < 0.01). However, the level of social support was not significantly associated with burnout (r=-0.060, p = 0.354).ConclusionsNursing managers in private hospitals should consider ways of improving nurses’ education, professional titles, working environment and increasing nurses’ income to stabilize the nursing team. Efforts should be made to relieve the nurses’ pressure, and notice the overtime work and professional development of nurses to enhance the personal sense of achievement. More measures should be taken to improve the level of social support, thereby promoting the continuous improvement of nursing quality. Due to the uneven level of social and economic development in different parts of China, the extensibility of the research needs to be confirmed by more studies, but it still has important reference significance for Northeast Sichuan, which represents areas with similar social and economic levels.

Food consumption in East Kazakhstan region - focus on stability of indicators

Consumption of food products by the population is an important indicator of food security, as this concept includes not only food independence, but also the availability of food products. The aim is to assess the relationship between economic indicators and sustainable development of agro-industrial complex in East Kazakhstan for 2012-2023, with emphasis on the impact of the existing conditions and factors on food consumption patterns. Methods include econometric modeling, statistical estimation, data synthesis and regression analysis to study the obtained data, identify patterns and summarize suggestions and recommendations. Innovative econometric techniques supported by Eviews 12.0 software allow the interaction between different variables to be quantified with precision. Results show that growth in gross regional product per capita is correlated with improvements in dietary diversity and nutritional quality, increasing food security. The authors note that fluctuations in agricultural production significantly affect food availability and prices. An analysis of the level of food utilization is presented, which makes it possible to determine the state and prospects for the development of key branches of the agricultural sector of the region and the achievement of import substitution policy. The negative point is the problem of economic availability of food products in the region in the necessary volumes and assortment for residents with low incomes, which is caused by the growth of inflation and the decline in real money. It is shown that economic parameters explain about 95% of the variability in food consumption. The subsistence minimum plays an important role in food consumption. Its growth leads to an increase in food expenditures, which in turn affects the overall level of food consumption. Regular adjustments to social standards are needed. Conclusions - the possibilities of food stability in the country depend on the demand trends in the food market. There is a direct correlation between the productivity of agricultural production and the structure of consumer demand for food products. The state policy in the sphere of food consumption and provision of the population with food should include mechanisms to reduce income differences, stabilize prices, focus on balanced nutrition, and a comprehensive approach to forecasting consumer preferences.

The relation between socioeconomic status and invasive haemodynamics at evaluation for advanced heart failure.

Socioeconomic deprivation is a risk marker for worse prognosis in patients with heart failure (HF), and a potential barrier to referral for advanced HF evaluation. The relationship between socioeconomic status (SES) and invasive haemodynamics in patients undergoing evaluation for advanced HF therapies is unknown. We combined a consecutive clinical registry of patients evaluated for advanced HF with patient-level data on SES (household income, education, workforce status, cohabitant status and distance from home to tertiary HF centre) derived from nationwide registries. Using this information, the cohort was divided into groups of low-, medium- and high degree of socioeconomic deprivation. The associations between SES and invasive haemodynamics were explored with multiple linear regression adjusted for age and sex. A total of 631 patients were included. The median age was 53years, and 23% were women. Patients in the highest income quartile versus the lowest (Q4 vs. Q1) were older (median age 57 vs. 50years) and more often male (83% vs. 67%), both P<0.001. Increasing household income (per 100000 Danish kroner,1 EUR=7.4 DKK) was associated with lower pulmonary capillary wedge pressure (PCWP)[-0.18mmHg, 95% confidence interval (CI) -0.36 to -0.01, P=0.036] but not significantly associated with central venous pressure (CVP) (-0.07mmHg, 95% CI -0.21 to 0.06, P=0.27), cardiac index (-0.004L/min/m2, 95% CI -0.02 to 0.01, P=0.60), or pulmonary vascular resistance (PVR) (-0.003 Wood units, 95% CI -0.37 to 0.16, P=0.84). Comparing the most deprived with the least deprived group, adjusted mean PVR was higher (0.35 Wood units, 95% CI 0.02 to 0.68, P=0.04), but PCWP (0.66mmHg, 95% CI -1.49 to 2.82, P=0.55), CVP (-0.26mmHg, 95% CI -1.76 to 1.24, P=0.73) and cardiac index (-0.03L/min/m2, 95% CI -0.22 to 0.17, P=0.78) were similar. Most haemodynamic measurements were similar across layers of SES. Nevertheless, there were some indications of worse haemodynamics in patients with lower household income or a high accumulated burden of socioeconomic deprivation. Particular attention may be warranted in socioeconomically deprived patients to ensure timely referral for advanced HF evaluation.

Metabolic syndrome clustering patterns and the association with cardiovascular disease among post-menopausal Korean women

The metabolic syndrome (MetS) is a group of diseases conceptualized as a clustering of risk factors, with the risks of developing MetS in women varying significantly before and after menopause. This study investigated MetS clustering patterns and their association with cardiovascular disease (CVD) risk among post-menopausal women (n = 2479) using data from the Korean Genome Epidemiology Study. Using latent class analysis, three groups emerged: diabetic (5.6%), hypertensive (35.2%), and low-risk (59.2%). Relative to the low-risk group, the diabetic group demonstrated associations with older age, a family history of chronic disease, an increased Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), an elevated white blood cell (WBC) count, experience with hysterectomy, being a non-drinker, more physical activity, and excessive sleep. The hypertensive group was associated with older age, lower monthly income, a family history of chronic disease, increased HOMA-IR, a higher WBC count, more physical activity, and excessive sleep. The diabetic and hypertensive groups had a significantly higher CVD risk than the low-risk group (diabetic: odds ratio [OR] = 2.41 [1.11, 5.27]; hypertensive: OR = 2.46 [1.33, 4.55]). This study identified potential markers for MetS screening in post-menopausal women, highlighting the need for early intervention and personalized healthcare for middle-aged women to reduce CVD risk following menopause.

CDSG-SAM: A cross-domain self-generating prompt few-shot brain tumor segmentation pipeline based on SAM

In clinical practice, accurate segmentation of brain tumor regions is essential for patient treatment and survival. Accurate brain tumor segmentation is an important task and it is based on a large amount of labeled data. Clinical data are from different cities and device protocols, which leads to the poor generalization ability of the model. In addition, the small amount of clinical data also leads to the decline of the segmentation performance. In this paper, a cross-domain self-generating prompt few-shot brain tumor segmentation pipeline called CDSG-SAM is developed. This pipeline is based on the Segment Anything Model (SAM), which integrates a new Cross-domain self-attention (CDS) Adapter module and Self-Generating (SG) Prompt module. The SAM-based segmentation model is more suitable for few-shot medical image segmentation. A dynamic fuzzy support mask decoder module (DFSMD) is proposed in the decoder stage to enhance the accuracy of brain tumor segmentation edges. Furthermore, a Joint Loss function (JL) is designed to comprehensively consider multiple aspects of performance indicators to improve the accuracy and robustness of the model. Experimental results evaluated on the BraTS2021 glioma dataset, Clinical glioma brain tumor data (CBTD), and BraTS2023 metastatic tumor dataset show that the proposed pipeline has achieved excellent performance with an average dice coefficient of 0.918, 0.828, and 0.868 which outperforms than existing methods.

Influence of the covid-19 pandemic on the education and academic performance of university students

Purpose: Investigate the impact of the Covid-19 pandemic on the higher education through the perception of Brazilian undergraduates. Methods: A cross-sectional study was conducted with 1006 students of public and private universities. Data collection happened between September-December 2020 with an online questionnaire addressing socioeconomic characteristics, use of anxiolytics/antidepressants and issues related to the course. Data were analyzed using Poisson regression (α = 5%). Results: Most students (68.7%) perceived an impact on their education and reported a high satisfaction with the course (62.2%). Age (OR = 0.98, 95%CI: 0.96 – 0.99), residing in the northern region of the country (OR= 1.26, 95%CI: 1.06 – 1.50), enrollment at a public university (OR= 1.28, 95%CI: 1.17 – 1.40) and lower satisfaction with the course (OR= 1.13, 95%CI: 1.04 – 1.23) were associated with the perception of impact. Regarding self-rated performance in the courses, 41.7% students reported a very low/low performance. A family income of up to two times the monthly minimum wage (OR= 0.68, 95% CI: 0.48 – 0.97), residing in the northeastern region of the country (OR= 0.68, 95% CI: 0.48 – 0.97) and lower satisfaction with the course (OR= 0.36, 95% CI: 0.23 – 0.53) were associated with this outcome. Conclusions: The pandemic negatively affected two thirds of undergraduates, especially the younger, from the northern region, public universities and those less satisfied with the course. Nearly forty percent of students rated their academic performance during the pandemic as very low/low, especially those with a low family income, from the northeastern region and those less satisfied with the course.

Practical guidelines of the International Working Group on the Diabetic Foot, European Society for Vascular Surgery, Society for Vascular Surgery on the prevention and management of diabetes-related foot disease 2023

Diabetes‑related foot disease results in a major global burden for patients and the healthcare system. The International Working Group on the Diabetic Foot (IWGDF) has been producing evidence‑based guidelines on the prevention and management of diabetes‑related foot disease since 1999. In 2023, all IWGDF Guidelines have been updated, based on systematic reviews of the literature and formulation of recommendations by multidisciplinary experts from all over the world. In addition, a new guideline on acute Charcot neuro‑osteoarthropathy was created. In this document, the IWGDF Practical Guidelines, we describe the basic principles of prevention, classification and management of diabetes‑related foot disease, based on the seven IWGDF Guidelines. We also describe the organizational levels to successfully prevent and treat diabetes‑related foot disease according to these principles and provide addenda to assist with foot screening. The information in these practical guidelines is aimed at the global community of healthcare professionals who are involved in the care of persons with diabetes. Many studies around the world support our belief that implementing these prevention and management principles is associated with a decrease in the frequency of diabetes‑related lower‑extremity amputations. The burden of foot disease and amputations is increasing at a rapid rate, and comparatively more so in middle to lower income countries. These guidelines also assist in defining standards of prevention and care in the these countries. Authors hope that these updated practical guidelines continue to serve as a reference document to aid healthcare providers in reducing the global burden of diabetes‑related foot disease.

The Impact of Non-Agricultural Activities on Poverty Reduction in Rural Communities: A Case of Sumbawanga Rural District, Tanzania

Agriculture is central to Tanzania's rural economy, but its underperformance drives many households in Sumbawanga Rural District to seek non-farm activities to combat poverty. This study investigates the impact of such activities on poverty reduction. It identifies drivers pushing farmers towards non-agricultural work, like low farm earnings and land scarcity, and explores how these activities affect household income. Data from 195 farming households reveals non-farm activities contribute significantly to income, ranging from 43% to 50%. Despite Tanzania's decreasing poverty rate (25.7%) in 2020, around 26 million still live in extreme poverty. The study suggests promoting non-agricultural endeavours like carpentry and animal husbandry to diversify income sources and alleviate poverty. Overall, it highlights the importance of non-farm activities in rural prosperity and recommends their integration into poverty reduction strategies.

Correlation between post-chemotherapy MRI and histopathology of malignant bone tumors treated with extra-articular resection.

Magnetic resonance imaging (MRI) remains the gold standard for diagnosing tumoral joint involvement; however, its interpretation remains uncertain due to the presence of perilesional edema that can lead to unjustified arthrectomy. The aim of the study is to identify precise MRI signs that are predictive of joint involvement. This retrospective multicenter study included 25 patients who underwent extra-articular resection for malignant bone tumor with suspected joint involvement at the shoulder, hip, or knee, between January 2004 and July 2023. Joint resection was indicated based on preoperative MRI examination. MRI signs of joint involvement were joint effusion, capsuloligamentous invasion, disruption of articular cartilage, and intra-articular tumor mass. We then compared histopathological "true" joint involvement of the resected specimen with its preoperative MRI diagnosis. Extra-articular resection was performed in 9 shoulders, 4 hips, and 12 knees. Histological analysis confirmed wide resections for all patients. Based on histopathological analysis, extra-articular resection was unjustified in 40% (44%, 0%, and 50%, respectively). The most specific iconographic criteria were intra-capsular cortical breach and the presence of a tumor mass inside the joint. Articular cartilage disruption is often the most accurate sign. Our results suggest that MRI has a poor ability to accurately diagnose joint involvement. To date, however, this is the best tool available. In addition to obvious signs of joint involvement, MRI analysis must be performed with a thorough understanding of capsular anatomy and its particularities for each joint so as not to miss other signs, such as intra-capsular cortical effraction.