In the paper, by convolution theorem for the Laplace transforms and analytic techniques, the author finds necessary and sufficient conditions for complete monotonicity, monotonicity, and inequalities of several functions involving polygamma functions. By these results, the author derives a lower bound of a function related to the sectional curvature of the manifold of the beta distributions. Finally, the author poses several guesses and open problems related to monotonicity, complete monotonicity, and inequalities of several functions involving polygamma functions.

Background: Abdominal wall hernias are a common condition that is seen in daily general surgery patients. However, still more researches are needed to be conducted regarding hernias. The aim of this study is to see the prevalence of hernias among patients admitted to the Department of Surgery of a tertiary care center. Methods: A descriptive cross-sectional study was performed among patients who admitted to the department of surgery in a tertiary care center between 1 August 2023 and 20 September 2023. All patients data were extracted to an excel sheet. Results: We had 760 patients who visited in this period. Only 272 patients (27.9 %) were diagnosed with hernias. We found 52.6 % of patients were male and 47.4 % of patients were female. The age between 46- 60 years old was the most to have hernias (97 patients). Inguinal hernias were the common among other types. Diabetes mellitus, hypertension, COPD, and hydrocele were found in 10.7 % of all patients. Conclusion: The prevalence of hernias in this study was nearly to other studies that conducted in the same conditions. Early diagnosis and patient’s education are the corner stone to prevent morbidities and mortalities.

For a long time, the transition to adulthood was seen as a troubled period where good development was synonymous with the absence of problems. Positive Youth Development (PYD) emerged as a holistic and strength-based perspective that focuses on the fact that young people may have the internal and external resources for healthy and successful development through five dimensions (5C’s) that empower them: Perceived Competence, Confidence, Character, Connection, and Caring. The aim of this study was to examine the relationship between the global PYD factor (and the 5C’s) and risk behaviors, in addition to analyzing gender differences. This study showed the results of a cross-sectional study of 1044 emerging adults from 11 Spanish universities in 2021. Data collection was performed by applying an online self-report measure. The results showed that the Character was protective against substance abuse, mainly in women, while the connection was related to the participation of betting money and online betting in men. Caring was protective against money bets in the men’s sample. However, controversial results were found regarding Perceived competence, which had a positive association with substance abuse, money bets, and drunk driving. It seems that high levels of Perceived competence, rather than objective competence, were associated with engagement in various risk behaviors, especially in the absence of other C´s. These results are discussed regarding the promotion of PYD to improve successful development and may suggest the need to foster healthy lifestyles and prevent risky behaviors in youth through the 5C's promotion programs within the university context.

Background: Cardiovascular disease (CVD) has been one of the leading causes of death and disability-adjusted life years lost worldwide. Blood pressure, lipid, and cholesterol are good predictors of CVD risk and correspond upon age and physical fitness. However, few studies have explored the variation trend of CVD risk factors across different populations upon age and their muscle strength. Objective: to analysis the variation tendency of CVD risk factors in blood according to age and relative grip strength among different populations. Method: 25363 participants were recruited in this cross-sectional study and 24709 were included in the analysis. A logistic regression and a Bayesian probabilistic analysis based on Markov Chain Monte Carlo (MCMC) Modeling is conducted to build probability prediction models of hypertension, hyperlipidemia, and hypercholesterolemia according to age, relative grip strength, body weight conditions, and physical activity levels. Results: 1) age might be the main influence factor of hypertension, which is regarded as one of the primary CVD risk factors. However, although keeping a high level of physical activity might have positive effect on preventing hypertension because that individuals with normal body weight and higher physical activity shows a lower probability of being diagnosed with hypertension, it might could not prevent individuals from getting hypertension with age. 2) After 60, individuals of normal body weight seem more likely to have hyperlipidemia than those are overweight or obese. 3) Larger relative grip strength might not be able to offset the negative effects of obesity, overweight and physical inactivity on hyperlipidemia. 4) The probability of getting hypercholesterolemia varies less with age and relative grip strength. Conclusion: Body weight management and keeping high levels of physical activity are recommended at any age. It might benefit to increase some bodyweight after 60 years old.

(1) Background: We aimed to identify factors associated with the presence of apical lesions (AL) on panoramic radiographs and to evaluate the predictive value of the identified factors. (2) Methodology: Panoramic radiographs from 1071 patients (age: 11-93 a, mean: 50.6 a ± 19.7 a) with 27532 teeth were included. Each radiograph was independently assessed by five experienced dentists for AL. A range of shallow machine learning algorithms (logistic regression, k-nearest neighbor, decision tree, random forest, support vector machine, adaptive and gradient boosting) were employed to identify factors on patient and tooth level associated with AL and to predict AL. (3) Results: AL were detected in 522 patients (48.7%) and 1133 teeth (4.1%), whereas males showed a significantly higher prevalence than females (52.5%/44.8%; p<0.05). Logistic regression found that an existing root canal treatment was the most important risk factor (adjusted Odds Ratio 16.89; 95% CI: 13.98-20.41), followed by the tooth type ‘molar’ (2.54; 2.1-3.08) and the restoration with a crown (2.1; 1.67-2.63). Associations between factors and AL were stronger and accuracy higher when using less complex models like decision tree (F1 score: 0.9 (0.89-0.9)). (4) Conclusions: The presence of AL was higher in root-canal treated teeth, those with crowns and molars. More complex machine learning models did not outperform less complex ones.

Introduction: This study explores exposure to misinformation, COVID-19 risk perception, and confidence towards the government as predictors to negative attitudes toward the COVID-19 vaccine. Methods: A cross-sectional survey was carried out from 30 June to 30 August 2021 involving 775 respondents. The survey instrument for the questionnaire is an adaptation from various different studies consisting of five main variables: 1) misinformation about vaccination; 2) risk perception toward COVID-19; 3) attitudes toward the vaccination programme; 4) intention to get vaccinated; and 5) public confidence in the government in executing the vaccination programme. Results: The results of this study indicate that higher exposure to misinformation led to higher levels of negative attitudes toward the COVID-19 vaccine. When the perceived risk of COVID-19 infection was high, mistrust of vaccine benefits was low but there were also higher worries about the future effects of the vaccine. Confidence in government was associated with lower negative attitudes toward the COVID-19 vaccine. Conclusion: The results of this study may help develop an understanding of negative attitudes toward vaccinations in Malaysia and its contributing factors.

Mass crises are disruptive to people's mental health. The study aimed to explore mental distress during COVID-19 quarantine in a sample of university workers in Brazil. The survey included sets of questions about demographics, health, and support, an open question about major concerns, and the Clinical Outcome Routine Evaluation (CORE-OM), a measure of mental distress. 407 professionals participated in the study: mean age of 40 years (SD = 11.2), mostly female (67.8%), married (64.8%) and fulfilling social distancing to avoid COVID-19 infection (99%). Using the Consensual Qualitative Research for simple qualitative data (CQR-M) the main areas of concern were grouped into six domains, as follows: Work, Health, Isolation, Personal life and routine, Social environment, and Future. Many responses were multiple. They form categories indicating specific concerns within these domains. Quantitative data were analyzed by identifying the simple effects of potential predictors of mental distress. The results indicated medium effects of help with household chores, psychiatric treatment, age and physical exercise. Having someone available to listen was the only variable with a large effect in reducing mental suffering. The hybrid approach showed that the psychological experience during the pandemic is quite multifaceted and complex pointing new clues for public mental health.

Background: Public misconception and demand for the indication of antibiotics could lead to inappropriate prescribing and consumption. Successful treatment can only be achieved when the public and industrial users have knowledge on antibiotic use and resistance. This survey is aimed to assess antibiotic usage and knowledge regarding antibiotics and antimicrobial resistance (AMR) among undergraduate students of Universiti Brunei Darussalam (UBD), public university located in Brunei Darussalam. Methods: A cross-sectional study was performed using a self-administered questionnaire. The questionnaire was adapted from the World Health Organization (WHO) Antibiotic Resistance, Multi-country public awareness survey distributed online. Students at UBD were invited to participate in the online survey through internal email. The questionnaire consisted of 5 sections: demographic information, antibiotic usage, knowledge on antibiotics, antibiotic resistance (AMR) and use of antibiotics in agriculture. Data were analyzed descriptively and appropriate inferential statistics was used accordingly. Cronbach’s alpha was also done to determine the internal consistency. The section on antibiotic use and knowledge showed good internal consistency of Cronbach’s alpha 0.66 and 0.86 respectively. Research ethics approval was obtained from the PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam (UBD). Results: A total of 145 students returned the complete questionnaire. The result of the study found that 50% of the students had good level of knowledge of antibiotic and antimicrobial resistance with a mean total knowledge score of 11.4 out of 14. Respondents reported the use of antibiotic in the past (69%). Many of the students could identify the use of antibiotics for the treatment of bacterial infection. However, there were also students who incorrectly thought that antibiotics can be used for cold and flu (43%) and fever (41%). Moreover, 76% of the respondents mistakenly believed that antibiotic resistance is the result of the body becoming resistant to antibiotics. Only 12% of the respondents were found to have poor knowledge in the study. Conclusions: Misconceptions in regards to the use of antibiotics for conditions related to viral illnesses was noticed among the respondents in our study. Thus, improving knowledge on antibiotics is crucial to address those beliefs.

Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be routinely captured through standard surveillance activities. This study aimed to characterize the prevalence and demographic profile of dyslipidemia in T2D patients in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and blood tests. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (p = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (p = .013 and p = .036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (p = .029 and p = .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.

The objectives of the research are to investigate the characteristics of the board of directors on the financial performance of the enterprise. Using a sample data from 52 construction and real estate enterprises listed on Vietnam stock exchange in the period 2006-2020. Using typical regression methods such as pooled OLS, FEM, REM and assessing the defects of the research model, the FGLS method is selected. At the same time, due to the existence of endogenous phenomena and the nature of interdependence among enterprises in Vietnam, research using the instrumental variables two-step generalized method of moments (IV-GMM) in order to correct for cross-sectional dependence, autocorrelation, endogeneity, and heteroskedasticity in the analysis. Research results suggest that board size, female board members, meeting frequency, and board members' education have a positive influence on financial performance. Moreover, the independence of the Board of Directors increases, the business efficiency decreases. The research also found a positive relationship of tangible fixed assets, and a negative relationship between capital structure choice, firm size and corporate financial performance.

In recent years, metabolomics has been used as a powerful tool to better understand the physiology of neurodegenerative diseases and identify potential biomarkers for progression. We used targeted and untargeted aqueous, and lipidomic profiles of the metabolome from human cerebrospinal fluid to build multivariate predictive models distinguishing patients with Alzheimer’s disease (AD), Parkinson’s disease (PD), and healthy age-matched controls. We emphasize several statistical challenges associated with metabolomic studies where the number of measured metabolites far exceeds sample size. We found strong separation in the metabolome between PD and controls, as well as between PD and AD, with weaker separation between AD and controls. Consistent with existing literature, we found alanine, kynurenine, tryptophan, and serine to be associated with PD classification against controls, while alanine, creatine, and long chain ceramides were associated with AD classification against controls. We conducted a univariate pathway analysis of untargeted and targeted metabolite profiles and find that vitamin E and urea cycle metabolism pathways are associated with PD, while the aspartate/asparagine and c21-steroid hormone biosynthesis pathways are associated with AD. We also found that the amount of metabolite missingness varied by phenotype, highlighting the importance of examining missing data in future metabolomic studies.

We consider a four-dimensional Riemannian manifold M with an additional structure S, whose fourth power is minus identity. In a local coordinate system the components of the metric g and the structure S form skew-circulant matrices. Both structures S and g are compatible, such that an isometry is induced in every tangent space of M. By a special identity for the curvature tensor, generated by the Riemannian connection of g, we determine classes of Einstein and almost Einstein manifolds. For such manifolds we obtain propositions for the sectional curvatures of some characteristic 2-planes in a tangent space of M. We consider a Hermitian manifold associated with the studied manifold and find conditions for g, under which it is a K\"{a}hler manifold. We construct some examples of the considered manifolds on Lie groups.

Background: This study aimed to assess the dementia literacy (DL) level of community-dwelling adults in the four cities (Hong Kong, Guangzhou, Macau and Zhuhai) of the Greater Bay Area of China and to determine the preferred mass media for receiving dementia information. Methods: A multi-city cross-sectional study with 788 community-dwelling adults completed the survey. Dementia literacy was indirectly measured by two validated scales, 30-item Alzhiemer’s Disease Knowledge Scale (ADKS) and 20-item Dementia Attitudes Scale (DAS). When the ADKS total score was <15 and DAS total score was <70, it was considered as ‘inadequate dementia literacy’. Participants were also asked to indicate whether they would like to receive dementia information via digital media or traditional media. Chi-square tests and logistic regressions were undertaken. Results: About one-third of the participants had inadequate dementia literacy. Those with young age or secondary education preferred to get dementia information from social media. But people living in public housing would like to get information from government or hospital websites. Middle-aged participants inclined to learn dementia from television or radio. Conclusion: It is worthy to conduct territory-wide public education in dementia and develop strategies according to their preferences in the types of mass media.

This study aims to quantify carotenoids and tocopherols in human milk from healthy Chinese women, and to explore their associations with region, lactation stage, and maternal socio-economic and obstetric factors. Human milk was obtained from 509 healthy mothers and the compounds of carotenoids and tocopherols were analyzed by high-performance liquid chromatography after mild saponification and solvent extraction. Socio-economic and obstetric characteristics of the mothers and their dietary intakes through a single 24-hour dietary recall were evaluated. The median content of each component [μg/100mL, median (interquartile range)] in colostrum and mature milk was, respectively, β-carotene 8.0 (4.7-15.2) and 1.8 (1.4-2.7), β-cryptoxanthin 6.2 (2.4-12.9) and 1.8 (1.1-3.4), lutein 5.7 (2.9-10.2) and 3.4 (1.5-6.0), lycopene 6.3 (4.0-9.9) and 1.4 (1.1-2.0), zeaxanthin 1.0 (0.6-1.5) and 1.0 (0.6-1.4), α-tocopherol 645 (388-1176) and 211 (131-321), γ-tocopherol 68 (48-121) and 77 (45-120). The levels of all those vitamins presented regional differences, and decreased as lactation stage increased except for zeaxanthin and γ-tocopherol. Associations of carotenoid contents with maternal education, delivery mode, and present body mass index were found in multivariate analyses. These results suggest that some region, lactation stage, obstetric and socio-economic factors are associated with human milk concentrations of carotenoids and tocopherols in healthy Chinese mothers.

Only cross-sectional studies have demonstrated muscle deficits in children with spastic cerebral palsy (SCP). The impact of functional impairments on altered muscle growth remains unclear. This prospective longitudinal study modelled the morphological muscle growth in 87 children with SCP (age range 6 months to 11 years, Gross Motor Function Classification System [GMFCS] level I/II/III=47/22/18). Repeated ultrasound assessments were performed during 2-year (y) follow-up with an interval of minimal 6 months. Three-dimensional freehand ultrasound was applied to assess medial gastrocnemius muscle volume (MV), mid-belly cross-sectional area (CSA) and muscle belly length (ML). Non-linear mixed models compared trajectories of (normalized) muscle growth between GMFCS-I versus GMFCS-II&amp;III. MV and CSA growth trajectories showed piecewise model with 2 breakpoints, with the highest growth before 2y and negative growth rates after 6-9y. Before 2y, children with GMFCS-II&amp;III already showed lower growth rates compared to GMFCS-I. From 2-9y, the growth rates did not differ between GMFCS-levels. After 9y, a more pronounced reduction in normalized CSA was observed in GMFCS-II&amp;III. Different trajectories in ML growth were shown between the GMFCS-level subgroups. These longitudinal trajectories could be used to monitor the SCP muscle pathology during childhood and to optimize treatment planning and goals aiming to stimulate muscle growth

Nighttime lights (NTL) are a popular type of data for evaluating economic performance of regions and economic impacts of various shocks and interventions. Several validation studies use traditional statistics on economic activity like national or regional Gross Domestic Product (GDP) as a benchmark to evaluate the usefulness of NTL data. Many of these studies rely on dated and imprecise Defence Meteorological Satellite Program (DMSP) data and use aggregated units such as nation-states or the first sub-national level. Yet applied researchers who draw support from validation studies to justify their use of NTL data as a proxy for economic activity increasingly focus on smaller and lower level spatial units. This study uses a 2001-19 time-series of GDP for over 3100 US counties as a benchmark to examine the usefulness of the recently released version 2 VIIRS nighttime lights (V.2 VNL) products as proxies for local economic activity. Contrasts are made between cross-sectional predictions for GDP differences between areas and time-series predictions of GDP changes within areas. Disaggregated GDP data for various industries are used to examine what types of economic activity are best proxied by NTL data and comparisons are also made with the predictive performance of earlier NTL data products.

Background and Objectives: The prevalence of osteoporosis is high, reportedly affecting 200 million people worldwide. A major problem associated with osteoporosis is that femoral fractures cause a decline in general function and loss of independence, greatly reducing patients’ quality of life. Notably, osteoporosis is an asymptomatic chronic metabolic disease, and its detection is thus often delayed. Interestingly, mandibular cortical index (MCI) classification using dental panoramic radiography is reportedly useful for early detection of osteoporosis. However, this visual classification method can lead to differences in diagnosis among surgeons. Therefore, this preliminary study was performed to analyze cone-beam computed tomography (CBCT) data and examine an objective MCI classification using the findings obtained. Materials and Methods: MCI classification (classified as C1, C2, or C3) was performed by three examiners on 70 women (91 sites) aged ≥20 years. The mandibular cortical width of all sites was measured using CBCT images. Results: The results showed that the mandibular cortical width was not particularly correlated with age or number of present teeth, and no significant quantitative differences were found between C1 and C2. However, coronal CBCT images of C2 revealed multiple characteristic bone trabecular structures. Conclusions: These structures may be an important finding affecting the classification of two-dimensional dental panoramic radiography images.

Irrigation and fertilizer are two essential factors affecting rice root traits and yield. In this respect, a pot experiment was performed at the boro (dry season irrigated) season of 2021-22 in the Department of Agronomy of Bangladesh Agricultural University, Mymensingh, Bangladesh. The variety Binadhan-10 was planted at two irrigation conditions i.e. saturation (S) and continuous flooding (CF); two potassium (K) dose e.g. 65 kg ha-1 (K65) and 98 kg ha-1 (K98) and two nitrogen (N) dose i.e. 140 kg ha-1 (N140) and 210 kg ha-1 (N210). The experiment was laid in split plot design and replicated thrice. The findings confirmed the effectiveness of irrigation, K and N on root number (RN), root length (RL), root volume (RV), leaf area index (LAI), total dry matter (TDM), yield attributes and yield. Considering interaction among irrigation, K and N, S condition with K65 and N140 showed best performance. At 80 DAT, the highest RN (373.00), RL (1700.00 cm), RV (8.90 cm3 hill-1), LAI (4.94) and TDM (25.83 g plant-1) was obtained from this combination. Grain yield (GY) and root traits except root porosity, showed a significant positive association. Grain yield (GY) was highest (27.12 g pot-1) in S condition with K65 and N140.

Background Due to the Covid-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter in place during the current pandemic. Methods This study was part of a wider cross-sectional online survey conducted in Norway, UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free text component of the study asking about the challenges of social media users during the Covid-19 pandemic in UK, USA and Australia. 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions from which was difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning which was positive and stressful and the same time. Conclusion Using social media while in shelter in place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.

The transition from undergraduate dental student to the actual practicing dentist is a crucial phase and ensuring the preparedness of graduates for the complexity and demands of contempo-rary dental practice is a challenging task. This study aimed to evaluate the self-perceived prepar-edness of undergraduate dental students and house officers in the dental colleges of Pakistan. Cross-sectional national study was planned to collect the information from dental students and new graduates in Pakistan. The pre-validated Dental Undergraduates Preparedness Assessment Scale (DU-PAS) was used. Purposive sampling technique was utilized to recruit house officers and undergraduate dental students from 27 dental schools in Pakistan. The data analysis was car-ried out using the R statistical environment for Windows (R Core Team, 2015). The total of 862 responses with 642 females and 219 males were analyzed in the study. Overall, clinical skills score was 30.56+9.08 and score for soft skills was 30.54+10.6. The mean age of the participants was 23.42+1.28. Deficiencies were reported in various soft skills and clinical skills attributes.The results highlighted the strengths and weaknesses of dental students and new graduates in Pakistani den-tal institutions. The findings may be used to further develop and strengthen teaching and training of dental students in Pakistan.

COVID-19 is an infectious disease spreading through human touch. This study explored the risk perception and knowledge towards COVID-19 infection among Bangladeshi adult participants. Two self-administered online surveys were administered at two different time points from 26-31 March 2020 (Early lockdown) and 11-16 May 2020 (Late lockdown) through social media on 1005 respondents (322 and 683 participants, respectively) during COVID-19 lockdown period in Bangladesh. Univariate and multiple linear regression models were used to examine factors associated with risk perception and knowledge towards COVID-19. The mean knowledge (8.4 vs. 8.1, P=0.022) and risk perception (11.2 vs. 10.6, P < 0.001) scores differ significantly between early and late lockdown. Compared to the early lockdown period, the scores for perceived risk of contracting COVID-19 decreased significantly while public knowledge about COVID-19 was lower but not statistically significant. Female participants who practiced high quarantine particularly those who did so at the public health order during the lockdown reported increased knowledge towards the spread of COVID-19 and perceived high risk of contracting COVID-19. Education intervention using awareness to increase public knowledge and perception towards COVID-19 in Bangladesh should target male participants who practiced low quarantine and are less worried about the spread of such novel coronavirus even as the physical distancing persists.

This study investigated the intersecting influence of socioeconomic status and cooking behavior on dietary habits using nationwide Japanese data. The study measured the frequency of balanced meals and breakfast intake as indicators of healthy eating habits and used subjective economic status, subjective spare time, and cooking behavior as the independent variables. It employed multivariate logistic regression analyses to elucidate the relationships among these variables. The results demonstrated that even among economically poor or time-constrained individuals, those preparing meals from ingredients were more likely to eat balanced meals and breakfast than those relying on commercial food or rarely cooking. This finding suggested that cooking behavior can mitigate disparity in healthful eating due to socioeconomic conditions. The study added new insights into the impact of combining socioeconomic status and cooking behavior on dietary habits, which highlights the potential of promoting cooking behaviors, such as teaching cooking skills, as a strategy for reducing socioeconomic dietary disparities.

Background: Multiple system atrophy (MSA) is a rapidly progressive neurodegenerative disorder that has no curative treatment. Diagnosis is based on a set of criteria established by Gilman (1998 and 2008) and recently updated by Wenning (2022). We aim to determine the effectiveness of [123I]Ioflupane SPECT in MSA, especially at the initial clinical suspicion. Methods: Cross-sectional study of patients at initial clinical suspicion of MSA, referred for [123I]Ioflupane SPECT. Results: 139 patients (68 men, 71 women) were included, 104 being MSA-probable and 35 MSA-possible. MRI was normal in 89.2% while SPECT was positive in 78.45%. SPECT showed high sensitivity (82.46%) and positive predictive value (86.24), reaching maximum sensitivity in MSA-P (97.26%). Significant differences were found when relating both SPECT assessments in the healthy-sick and inconclusive-sick groups. We also found an association when relating SPECT to the subtype (MSA-C or MSA-P), as well as to the presence of parkinsonian symptoms. Lateralization of striatal involvement was detected (left side). Conclusions: [123I]Ioflupane SPECT is a useful and reliable tool for diagnosing MSA, with good effectiveness and accuracy. Qualitative assessment shows a clear superiority when distinguishing between the healthy-sick categories, as well as between the parkinsonian (MSA-P) and cerebellar (MSA-C) subtypes at initial clinical suspicion.

Coronavirus disease (COVID-19) has had devastating impacts on the global economy and public health. This study aimed to assess the level of COVID-19 vaccine acceptance, hesitancy, and associated factors among staff and students of the Federal University of Health Sciences Otukpo, Benue State, Nigeria. A web-based cross-sectional survey was conducted between November 2021 and April 2022, and data were collected and analyzed using descriptive and inferential statistics. Of the 150 completed and analyzed questionnaires, the majority of respondents (80.0%) were between 16 and 45 years old. The study found that 58.4% of participants indicated vaccine hesitancy, with skepticism about the vaccine's fast production/rollout and fear of vaccine side effects being the most common reasons for hesitation. Respondents' age, religion, and category were significant factors influencing vaccine acceptance and hesitancy (P < 0.05). The university community has a high level of awareness of COVID-19 but low vaccine acceptance, resulting in high levels of vaccine hesitancy. The study recommends that policymakers and public health officials should prioritize testing and vaccination for job categories with higher risk of exposure to COVID-19. They should provide accurate information about COVID-19 testing and vaccination and implement workplace-based testing and vaccination programs. These interventions can help to increase COVID-19 testing and vaccination uptake among the university community and mitigate the spread of COVID-19.

To reduce the risk of infection of SARS-CoV-2 during the commute to the clinic or due to the contact with medical staff, The American College of Obstetricians and Gynecologists recommended ar-ranging part of the appointments in the form of “telehealth”. The aim of the study was to assess the access to medical care in pregnancy during the Sars-Cov-2 pandemic and the role of telehealth in implementation of prenatal care standards. This is a cross-sectional study. The study group in-cluded 618 women that were pregnant and or gave birth during the COVID-19 pandemic in Poland. The majority of participants experienced difficulties in access to medical care because of the pandemic. Correlation between this experience and the use of hybrid healthcare model was es-tablished. However, affiliation to public or private healthcare group was irrelevant. There was no relationship between healthcare (private/public or in-person/hybrid) and implementation of the prenatal care standards. To ensure safe access to prenatal care for pregnant women, recommen-dations for a hybrid pregnancy management model should be created with detailed information for which appointments patients must be present and which can be done remotely. To reduce movement risk and interpersonal contact, all visits during which tests and screenings take place should be done in-person. Other appointments can be arranged in the form of telehealth

Background: The methods used in low- and middle-income countries (LMICs) household surveys have not changed in four decades; however, LMIC societies have changed substantially and now face unprecedented rates of urbanisation and urbanisation of poverty. This mismatch may result in unintentional exclusion of vulnerable and mobile urban populations. We compare three survey method innovations with standard survey methods in Kathmandu, Dhaka, and Hanoi, and summarize feasibility of our innovative methods in terms of time, cost, skill requirements, and experiences. Methods: We used descriptive statistics and regression techniques to compare respondent characteristics in samples drawn with innovative versus standard survey designs and household definitions, adjusting for sample probability weights and clustering. Feasibility of innovative methods was evaluated using a thematic framework analysis of focus group discussions with survey field staff, and via survey planner budgets. Results: We found that a common household definition excluded single adult (46.9%) and migrant headed households (6.7%), as well as non-married (8.5%), unemployed (10.5%), disabled (9.3%), and studying adults (14.3%). Further, standard two-stage sampling resulted in fewer single adult and non-family households than an innovative area-microcensus design; however, two-stage sampling resulted in more tent and shack dwellers. Our survey innovations provided good value for money and field staff experiences were neutral or positive. Staff recommended streamlining field tools and pairing technical and survey content experts during fieldwork. Conclusions: This evidence of exclusion of vulnerable and mobile urban populations in LMIC household surveys is deeply concerning, and underscores the need to modernize survey methods and practices.

Limited observational studies have described the relationship between sleep duration and overall diet. The present study investigated the association between sleep duration at weekdays and empirically derived dietary patterns in a nationally representative sample of UK adults, aged 19-64 years old, participating in the 2008-2012 UK National Diet and Nutrition Survey Rolling Programme. Survey members completed between three to four days of dietary records. Sleep duration at weekdays was categorised into tertiles to reflect short, normal and long sleep duration. Social jetlag was calculated as the difference between sleep duration at weekends and weekdays. The association between sleep duration/ social jetlag and dietary patterns, derived by principal components analysis, was assessed regressing diet on sleep whilst accounting for the complex survey design and adjusting for relevant confounders. Survey members in the highest tertile of sleep duration had on average 0.45 (95% CI -0.78, -0.12) lower healthy dietary pattern score compared to middle tertile (p =0.007). There was an inverted u-shaped association between social jetlag and a healthy dietary pattern, such that when sleep at weekends exceeded weekday sleep by 1h 45min, scores for indicating a healthy dietary pattern declined (p =0.005). In conclusion, long sleep duration at weekdays and an increased social jetlag are associated with a lower healthy dietary pattern score. Further research is required to address factors influencing dietary patterns in long sleepers.

Studies employing Arellano-Bond and Blundell-Bond GMM estimation for single linear dynamic panel data models are growing exponentially in number. However, for researchers it is hard to make a reasoned choice between many different possible implementations of these estimators and associated tests. By simulation the effects are examined of many options regarding: (i) reducing, extending or modifying the set of instruments; (ii) specifying the weighting matrix in relation to the type of heteroskedasticity; (iii) using (robustified) 1-step or (corrected) 2-step variance estimators; (iv) employing 1-step or 2-step residuals in Sargan-Hansen overall or incremental overidentification restrictions tests. This is all done for models in which some regressors may be either strictly exogenous, predetermined or endogenous. Surprisingly, particular asymptotically optimal and relatively robust weighting matrices are found to be superior in finite samples to ostensibly more appropriate versions. Most of the variants of tests for overidentification restrictions show serious deficiencies. A recently developed modification of GMM is found to have great potential when the cross-sectional heteroskedasticity is pronounced and the time-series dimension of the sample not too small. Finally all techniques are employed to actual data and lead to some profound insights.

Background and Objectives: Ultrasound (US) is a non-invasive tool for the in-vivo detection of peripheral nerve alterations. Materials and Methods: In this study we applied nerve US to assist the discrimination between the spectrum of Amyotrophic Lateral Sclerosis (ALS, n=11), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP, n=5) and genetically confirmed Charcot-Marie-Tooth disease (CMT, n=5). All participants and n=15 controls without neurological diseases underwent high-resolution US of the bilateral tibial nerve. Nerve cross-sectional area (CSA) and nerve microvascular blood flow were compared between the groups and related to cerebrospinal fluid (CSF) measures, clinical symptoms and nerve conduction studies. Analyses are part of a larger multimodal study on the comparison between US and 7 Tesla (T) magnetic resonance neurography (MRN). Results: Patients and controls were matched with respect to their demographical data. CMT had the longest disease duration, followed by CIDP and ALS. CSA was related to age, weight and disease duration. CSA was larger in CMT and CIDP compared to ALS and controls. Blood flow was greatest in CIDP, and higher than in CMT, ALS and controls. In ALS, greater CSA was correlated with greater CSF total protein and higher albumin quotient. US measures did not correlate with clinical scores or nerve conduction studies in any of the subgroups. Conclusion: Our results point towards the feasibility of CSA and blood flow to discriminate between ALS, CIDP and CMT, even in small sample sized groups. In ALS, larger CSA could indicate an inflammatory disease subtype characterized by reduced blood-nerve barrier integrity. Our upcoming analysis will focus on the additive value of 7T MRN in combination with US to disentangle the spectrum between more inflammatory or more degenerative disease variants along the disease groups.

Enhanced food and nutrition security remains a primary goal for every community. Several interventions have been promoted in dry areas to improve issues on food and nutrition security. However, studies on the level of knowledge, cultural norms, perceptions and attitudes that are key drivers in adoption and uptake to highlight gaps and provide evidence for improvement are limited. This study investigated variables influencing the adoption and implementation of an integrated crop-dairy goat farming system in Elgeyo Marakwet. A descriptive cross-sectional survey entailing qualitative and quantitative approaches among farmers practicing integrated farming was undertaken. A thematic questionnaire was used to collect quantitative data, while key informant interviews and focus groups discussions were used in qualitative research. This study utilized the multi-stage sampling procedure to sample the farmers and sample size was calculated based on Krejcie and Morgan table. Data analysis for quantitative data was done using SPSS software while qualitative data utilized N-vivo software The findings show that farmers have knowledge on the integrated farming system. Age, level of education, land size, gender, perceptions and attitudes influence adoption. Small animals like dairy goats are associated to women in this community hence increasing their participation in access, control and decision making of agricultural resources. The key findings of this study provide baseline data that can form evidence to help inform policy on the indicators contributing to adoption of integrated crop-dairy goat systems to enhance food and nutrition security

Background: Acceleration of mass vaccination strategies is the only pathway to overcome the COVID-19 pandemic. Healthcare professionals and students have a key role in shaping public opinion about vaccines. This study aimed to evaluate the attitudes of dental students globally towards COVID-19 vaccines and explore the potential drivers for students' acceptance levels; Methods: A global cross-sectional study was carried out in February 2021 using an online ques-tionnaire. The study was liaised by the scientific committee of the International Association of Dental Students (IADS), and data was collected through the national and local coordinators of IADS member organizations. The dependent variable was the willingness to take the COVID-19 vaccine, and the independent variables included demographic characteristics, COVID-19-related experi-ence, and the drivers of COVID-19 vaccine-related attitude suggested by the WHO-SAGE; Results: A total of 6639 students from 22 countries representing all world regions responded to the ques-tionnaire properly. Their mean age was 22.06 ± 2.79 (17-40) years, and the majority were females (70.5%), in clinical years (66.8%), and from upper-middle-income economies (45.7%). In general, 22.5% of dental students worldwide were hesitant, and 13.9% rejected COVID-19 vaccines. The students in low- and lower-middle-income (LLMI) economies had significantly higher levels of vaccine hesitancy compared to their peers in upper-middle- and high-income (UMHI) economies (30.4% vs 19.8%; p < 0.001); Conclusions: The global acceptance level of dental students for COVID-19 vaccines was suboptimal, and their worrisome level of vaccine hesitancy was influenced by the socioeconomic context where the dental students live and study. The media and social media, public figures, insufficient knowledge about vaccines, and mistrust of governments and the pharmaceutical industry were barriers to vaccination. The findings of this study call for further implementation of epidemiology (infectious diseases) education within undergraduate dental curricula.