Search Results (18)

Background/Objectives: The growing prevalence of mental health problems among medical students is a global concern, with dietary patterns emerging as potential modifiable factors. This study aimed to explore and evaluate whether higher consumption of ultra-processed foods may be associated with greater symptoms of anxiety and depression. Methods: This was an exploratory cross-sectional study integrated into a previous cohort of medical students, conducted based on the guidelines for Strengthening the Reporting of Observational Studies in Epidemiology. Sixty-seven medical students completed a Food Frequency Questionnaire-based index. Dietary patterns and the associations between these patterns and symptoms of anxiety and/or depression were assessed statistically. Results: There were differences in the consumption of unprocessed or minimally processed foods, including fruits, vegetables, legumes and unsweetened juices between groups with/without anxiety or depression (p < 0.05). A higher intake of ultra-processed foods such as pizza, hot dogs, cereals high in fat and sugar, processed beverages and sweets was linked to greater symptoms (p < 0.05; Cohen’s d = 0.3–0.7). Three to four dietary patterns were identified, explaining between 60% and 86% of the variance. High consumption of cereals with added fat and sugars increased the risk by 7.4 times (OR = 7.4, 95% CI 1.2–12.2, p < 0.05). Conclusions: Dietary intake was associated, but not causally linked, to emotional symptoms among medical students. Lower consumption of unprocessed foods and higher intake of ultra-processed foods formed consistent behavioral profiles associated with anxiety and depression. Consuming more than three daily servings of cereals with added fat and sugar increased the risk of severe depressive symptoms by more than sevenfold, highlighting a strong dietary determinant. Future research should assess nutritional interventions aimed to improve mental health and academic performance in medical students. Full article

Background: Breast cancer polygenic risk scores (PRS) and traditional risk models (e.g., the Gail model [Gail]) are known to contribute largely independent information, but it is unclear how the overlap varies by ancestry, age, disease type (invasive breast cancer, DCIS), and risk threshold. Methods: In a retrospective case–control study, we evaluated risk prediction performance in 180,398 women (161,849 of European ancestry; 18,549 of Asian ancestry). Odds ratios (ORs) from logistic regression models and the area under the receiver operating characteristic curve (AUC) were estimated. Results: PRS for invasive disease showed a stronger association in younger (<50 years) women (OR = 2.51, AUC = 0.622) than in women ≥ 50 years (OR = 2.06, AUC = 0.653) of European ancestry. PRS performance in Asians was lower (OR range = 1.62–1.64, AUC = 0.551–0.600). Gail performance was modest across groups and poor in younger Asian women (OR = 0.94–0.99, AUC = 0.523–0.533). Age interactions were observed for both PRS (p < 0.001) and Gail (p < 0.001) in Europeans, whereas in Asians, age interaction was observed only for Gail (invasive: p < 0.001; DCIS: p = 0.002). PRS identified more high-risk individuals than Gail in Asian populations, especially ≥50 years, while Gail identified more in Europeans. Overlap between PRS, Gail, and family history was limited at higher thresholds. Calibration analysis, comparing empirical and model-based ROC curves, showed divergence for both PRS and Gail (p < 0.001), which indicates miscalibration. In Europeans, family history and prior biopsies drove Gail discrimination. In younger Asians, age at first live birth was influential. Conclusions: PRS adds value to risk stratification beyond traditional tools, especially in younger women and Asian ancestry populations. Full article

Neutropenia is certainly of clinical significance due to its increased risk of infections in most patients. Chronic neutropenia is defined as neutropenia that persists for more than 3 months. Isolated chronic neutropenia is rare in clinical practice, and its differential diagnosis can be challenging. This rare entity is the focus of this review. Here, we examine the common causes (drugs, hereditary, autoimmune, and idiopathic), diagnostic work-up, and management of chronic isolated neutropenia in adults. We also discuss the Duffy-null-associated neutrophil count (DANC), which has a high prevalence (80–100%) in Sub-Saharan Africans and in Arabs and is not considered a medical condition. It should be highlighted that management decisions in patients with chronic isolated neutropenia should be individualized, mainly taking into account their clinical history over the neutrophil count alone. In this narrative review, we exclusively focus on non-malignant, non-cytotoxic and non-chemotherapy-induced forms of isolated chronic neutropenia in adults. Full article

The right to development, an inherent human right for all, emphasizes that all individuals and communities have the right to participate in, contribute to, and benefit from development that ensures the full realization of human rights. In Kenya, where a significant portion of the population faces poverty and vulnerability to climate change, access to rights-based needs such as clean water, healthcare, and education still remains a critical challenge. This study explored the implementation of a Human Rights-Based approach to community development through a Public–Private Development Partnership model (PPDP), with a focus on alleviating poverty and improving access to rights-based services at the community level in Narok and Nakuru counties. The research aimed to identify critical success factors for scaling the PPDP model and explore its effects on socio-economic empowerment. The study employed a mixed-methods approach for data collection, using questionnaires to obtain quantitative data, focus group discussions, and key informant interviews with community members, local leaders, and stakeholders to gather qualitative data. We cleaned and analyzed all our data in R (version 4.4.3) and used the chi-square to establish the significance of differences between areas where the PPDP model was implemented and control areas where it was not. Results reveal that communities with the PPDP model experienced statistically significant improvements in employment, income levels, and access to rights-based services compared to control areas. The outcomes underscore the potential of the PPDP model to address inclusive and sustainable development. This study therefore proposes a scalable pathway beginning with access to rights-based needs, followed by improved service delivery, and culminating in economic empowerment. These findings offer valuable insights for governments, development practitioners, investment agencies, and researchers seeking community-driven developments in similar socio-economic contexts across Africa. For the first time, it can be adopted in the design and implementation of development projects in rural and local communities across Africa bringing into focus the need to integrate rights-based needs at the core of the project. Full article

Low-light image enhancement (LLIE) methods based on Retinex theory often involve complex, multi-stage training and are commonly built on convolutional neural networks (CNNs). However, CNNs suffer from limitations in capturing long-range dependencies and often introduce redundant computations, leading to high computational costs. To address these issues, we propose a lightweight and efficient LLIE framework that incorporates an optimized CNN compression strategy and a novel attention mechanism. Specifically, we design a Spatial-Channel Feature Reconstruction Module (SCFRM) to suppress spatial and channel redundancy via split-reconstruction and separation-fusion strategies. SCFRM is composed of two parts, a Spatial Feature Enhancement Unit (SFEU) and a Channel Refinement Block (CRB), which together enhance feature representation while reducing computational load. Additionally, we introduce a Joint Attention (JOA) mechanism that captures long-range dependencies across spatial dimensions while preserving positional accuracy. Our Retinex-based framework separates the processing of illumination and reflectance components using a Denoising Network (DNNet) and a Light Enhancement Network (LINet). SCFRM is embedded into DNNet for improved denoising, while JOA is applied in LINet for precise brightness adjustment. Extensive experiments on multiple benchmark datasets demonstrate that our method achieves superior or comparable performance to state-of-the-art LLIE approaches, while significantly reducing computational complexity. On the LOL and VE-LOL datasets, our approach achieves the best or second-best scores in terms of PSNR and SSIM metrics, validating its effectiveness and efficiency. Full article

Considering refugees’ employment challenges in their host countries, they often need to create jobs by starting ventures and embracing self-employment. However, this requires financing. This study seeks to assess the roles of formal and informal financing in self-employment while also looking at the drivers of financing decisions and self-employment among refugees in an urban setting. Using the extension of the Blinder–Oaxaca decomposition pioneered by Fairlie, this study found informal financing to be significantly associated with an individual’s decision to be self-employed, while formal financing is not. Male refugees who access informal financing have a higher probability of embracing self-employment than refugee women and Kenyan nationals; this calls for actions that encourage forming community-based organizations that promote affirmative action and steer the use of informal finance. Full article

In this study, GEO-KOMPSAT-2A/Advanced Meteorological Imager (GK2A/AMI) and Lightning NETwork (LINET) data were used for lightning detection. A total of 20 lightning cases from the summer of 2020–2021 were selected, with 14 cases for training and 6 for validation to develop lightning detection algorithms. Since these two datasets have different spatiotemporal resolutions, spatiotemporal matching was performed to use them together. To find the optimal lightning detection algorithm, we designed 25 experiments and selected the best experiment by evaluating the detection level. Although the best experiment had a high POD (>0.9) before post-processing, it also showed over-detection of lightning. To minimize the over-detection problem, statistical and Region-Growing post-processing methods were applied, improving the detection performance (FAR: −19.14~−24.32%; HSS: +76.92~+86.41%; Bias: −59.3~−66.9%). Also, a sensitivity analysis of the collocation criterion between the two datasets showed that the detection level improved when the spatial criterion was relaxed. These results suggest that detecting lightning in mid-latitude regions, including the Korean Peninsula, is possible by using GK2A/AMI data. However, reducing the variability in detection performance and the high FAR associated with anvil clouds and addressing the parallax problem of thunderstorms in mid-latitude regions are necessary to improve the detection performance. Full article

Background and Objectives: In clinical practice, neutropenia is frequently accompanied by other cytopenia; isolated non-chemotherapy-induced severe neutropenia is less frequent and its differential diagnosis can be challenging. In this real-world study with data collected over a 5-year period in a tertiary referral hospital, we primarily sought to identify underlying causes of isolated severe neutropenia (<0.5 × 10⁹/L). Secondly, we aimed to analyze its management and outcomes. Materials and Methods: From 444,926 screened patients, after exclusion of patients with chemotherapy, radiotherapy, hematological neoplasms, additional cytopenia, and benign ethnic neutropenia, we identified and analyzed data from 70 patients (0.015%) with isolated severe neutropenia. We thus confirmed that the occurrence of isolated severe neutropenia is a rare event, even in a tertiary hospital. Results: The median age at diagnosis was 34 years (range 1–81) and 65% were female. Acute neutropenia was more frequently observed (n = 46/70, 65.7%); the main underlying causes in this group were drugs (n = 36/46, 78%) followed by infections (n = 10/46, 21.7%). We identified 24 (34.3%) patients with chronic neutropenia. The majority of them (n = 12/24, 50%) had an idiopathic form (CIN), 8/24 (33%) were autoimmune (AIN), and 4/24 (17%) were congenital. Conclusions: This study demonstrates the rarity and heterogeneity of isolated severe neutropenia and the steps to consider in its diagnostic work-up and management. Epidemiological characteristics, diagnostic work-up, and management including hospitalizations are described. Due to the high frequency of metamizole-induced neutropenia observed in this study, we want to raise awareness about its use, since this complication generates frequent hospitalizations even in young, otherwise healthy patients. Furthermore, recurrent infections in chronic forms of idiopathic neutropenia were quite common, suggesting a difference in phenotypes and need for therapy consideration depending on the clinical course. Full article

Considering the early inequity in global COVID-19 vaccine distribution, we compared the level of population immunity to SARS-CoV-2 with vaccine uptake and refusal between rural and urban Kenya two years after the pandemic onset. A population-based seroprevalence study was conducted in the city of Nairobi (n = 781) and a rural western county (n = 810) between January and February 2022. The overall SARS-CoV-2 seroprevalence was 90.2% (95% CI, 88.6–91.2%), including 96.7% (95% CI, 95.2–97.9%) among urban and 83.6% (95% CI, 80.6–86.0%) among rural populations. A comparison of immunity profiles showed that >50% of the rural population were strongly immunoreactive compared to <20% of the urban population, suggesting more recent infections or vaccinations in the rural population. More than 45% of the vaccine-eligible (≥18 years old) persons had not taken a single dose of the vaccine (hesitancy), including 47.6% and 46.9% of urban and rural participants, respectively. Vaccine refusal was reported in 19.6% of urban and 15.6% of rural participants, attributed to concern about vaccine safety (>75%), inadequate information (26%), and concern about vaccine effectiveness (9%). Less than 2% of vaccine refusers cited religious or cultural beliefs. These findings indicate that despite vaccine inequity, hesitancy, and refusal, herd immunity had been achieved in Kenya and likely other African countries by early 2022, with natural infections likely contributing to most of this immunity. However, vaccine campaigns should be sustained due to the need for repeat boosters associated with waning of SARS-CoV-2 immunity and emergence of immune-evading virus variants. Full article

Typical features of lightning distribution in the mountain area of Mt. Cimone (2165 m a.s.l., Northern-Central Italy) have been studied through detections provided by the ground-based LIghtning NETwork data (LINET) and the Lightning Imaging Sensor (LIS) onboard the International Space Station (ISS-LIS). This study was performed within the context of the Gamma-Flash program, which includes the in situ observation of high-energy radiation (e.g., Terrestrial Gamma-ray Flashes (TGFs), gamma-ray glows) and neutron emissions from thunderstorms at the mountain-top “O. Vittori” climate observatory. LINET VLF/LF radio measurements allowed the characterization of both cloud-to-ground (CG) and intra-cloud (IC) strokes’ geographical distribution and an altitude of occurrence from 2012 through 2020. The lightning distribution showed a remarkable clustering of CGs at the mountain top in contrast to a homogeneous distribution of ICs, highlighting the likely impact of orography. IC strokes peaked around 4 to 6 km altitude, in agreement with the observed typical cloud range. The joint exploitation of ISS-LIS optical observations of LINET detections extended the study to further features of flashes not seen in radio wavelengths and stands as the cross-validation of the two detection methods over such a complex orography. These results gave the quantitative indication of the expected occurrence of lightning and ionizing radiation emissions in the Mt. Cimone area and an example of mountain-driven changes in lightning occurrence. Full article

Children heading households (CHH) in urban informal settlements face specific vulnerabilities shaped by limitations on their opportunities and capabilities within the context of urban inequities, which affect their wellbeing. We implemented photovoice research with CHHs to explore the intersections between their vulnerabilities and the social and environmental context of Nairobi’s informal settlements. We enrolled and trained four CHHs living in two urban informal settlements—Korogocho and Viwandani—to utilise smartphones to take photos that reflected their experiences of marginalisation and what can be done to address their vulnerabilities. Further, we conducted in-depth interviews with eight more CHHs. We applied White’s wellbeing framework to analyse data. We observed intersections between the different dimensions of wellbeing, which caused the CHHs tremendous stress that affected their mental health, social interactions, school performance and attendance. Key experiences of marginalisation were lack of adequate food and nutrition, hazardous living conditions and stigma from peers due to the limited livelihood opportunities available to them. Despite the hardships, we documented resilience among CHH. Policy action is required to take action to intervene in the generational transfer of poverty, both to improve the life chances of CHHs who have inherited their parents’ marginalisation, and to prevent further transfer of vulnerabilities to their children. This calls for investing in CHHs’ capacity for sustaining livelihoods to support their current and future independence and wellbeing. Full article

Gamma-Flash is an Italian program devoted to the realization of both a ground-based and an airborne gamma-ray and neutron detection system, for in situ measurements of high-energy phenomena correlated to thunderstorm activity, such as Terrestrial Gamma-ray Flashes (TGFs), gamma-ray glows, and associated neutron emissions. The ground-based Gamma-Flash experiment is currently under installation at the Osservatorio Climatico “Ottavio Vittori” (CNR-ISAC) on Mt. Cimone, in Northern-Central Italy (2165 m a.s.l.), and it will be operational starting in Summer 2022. We studied the detectability of TGFs in the surroundings of the ground-based Gamma-Flash experiment, to identify an investigable spatial region around the detectors from which typical TGFs can survive and be revealed onground. We carried out numerical simulations of gamma-ray propagation in the mid-latitude atmosphere, and we developed a qualitative analytical model to integrate the results. This analysis allows one to identify a spatial region extending up to 4 km distance on ground and up to 10 km altitude a.s.l., considering typical TGFs emitting ∼${10}^{18}$ gamma-ray photons at the source. Lightning sferics data acquired by the LINET network demonstrate that such a region is interested by frequent cloud-to-ground and intra-cloud lightning, pointing out the suitability of the location for the purposes of the Gamma-Flash program. Full article

Myelodysplastic syndromes (MDS) represent a heterogeneous group of clonal disorders caused by sequential accumulation of somatic driver mutations in hematopoietic stem and progenitor cells (HSPCs). MDS is characterized by ineffective hematopoiesis with cytopenia, dysplasia, inflammation, and a variable risk of transformation into secondary acute myeloid leukemia. The advent of next-generation sequencing has revolutionized our understanding of the genetic basis of the disease. Nevertheless, the biology of clonal evolution remains poorly understood, and the stochastic genetic drift with sequential accumulation of genetic hits in HSPCs is individual, highly dynamic and hardly predictable. These continuously moving genetic targets pose substantial challenges for the implementation of precision medicine, which aims to maximize efficacy with minimal toxicity of treatments. In the current postgenomic era, allogeneic hematopoietic stem cell transplantation remains the only curative option for younger and fit MDS patients. For all unfit patients, regeneration of HSPCs stays out of reach and all available therapies remain palliative, which will eventually lead to refractoriness and progression. In this review, we summarize the recent advances in our understanding of MDS pathophysiology and its impact on diagnosis, risk-assessment and disease monitoring. Moreover, we present ongoing clinical trials with targeting compounds and highlight future perspectives for precision medicine. Full article

Lightning data assimilation (LDA) is a powerful tool to improve the weather forecast of convective events and has been widely applied with this purpose in the past two decades. Most of these applications refer to events hitting coastal and land areas, where people live. However, a weather forecast over the sea has many important practical applications, and this paper focuses on the impact of LDA on the precipitation forecast over the central Mediterranean Sea around Italy. The 3 h rapid update cycle (RUC) configuration of the weather research and forecasting (WRF) model) has been used to simulate the whole month of November 2019. Two sets of forecasts have been considered: CTRL, without lightning data assimilation, and LIGHT, which assimilates data from the LIghtning detection NETwork (LINET). The 3 h precipitation forecast has been compared with observations of the Integrated Multi-satellitE Retrievals for Global Precipitation Mission (GPM) (IMERG) dataset and with rain gauge observations recorded in six small Italian islands. The comparison of CTRL and LIGHT precipitation forecasts with the IMERG dataset shows a positive impact of LDA. The correlation between predicted and observed precipitation improves over wide areas of the Ionian and Adriatic Seas when LDA is applied. Specifically, the correlation coefficient for the whole domain increases from 0.59 to 0.67, and the anomaly correlation (AC) improves by 5% over land and by 8% over the sea when lightning is assimilated. The impact of LDA on the 3 h precipitation forecast over six small islands is also positive. LDA improves the forecast by both decreasing the false alarms and increasing the hits of the precipitation forecast, although with variability among the islands. The case study of 12 November 2019 (time interval 00–03 UTC) has been used to show how important the impact of LDA can be in practice. In particular, the shifting of the main precipitation pattern from land to the sea caused by LDA gives a much better representation of the precipitation field observed by the IMERG precipitation product. Full article

Objectives: This paper describes the development of a physical activity questionnaire (PAQ) designed for Chinese adolescents and their mothers in urban and rural settings, and reports on results of the PAQ, pedometry, and hand grip dynamometry from the Chinese Children and Families Cohort Study pilot investigation (CFCS). Methods: As part of a pilot investigation to evaluate the feasibility to follow-up and obtain detailed nutrition, dietary, physical activity, and ultraviolet radiation (UVR) data from CFCS participants, data were collected in 2013 for 93 adolescent/mother pairs from a rural (n = 41) and an urban site (n = 52) in two provinces. Respondents were asked to wear a pedometer for seven days (Omron HJ-151), use a Takei Digital Grip Strength Dynamometer on (each hand; three trials; two separate days), and complete a 39 item, eight domain PAQ covering the past year. Self-reported physical activity (PA) was linked to metabolic equivalent of task (MET) scores in kcal/kg/hr and used to calculate METs for different domains of PA and intensity categories. Results: Compliance was high (95%) in this measurement protocol administered by health staff during a series of data collection efforts at home and local clinics or health centers. Step counts were highly variable, averaging between 5000 and 10000 per day with somewhat higher step counts in rural adolescent boys. Maximum grip strength (Kgs) was greater in children (Mean = 36.5, SE = 0.8) than mothers (Mean = 28.8, SE = 0.8) and similar in the urban (Mean = 29.6, SE = 0.6) compared to the rural (Mean = 29.6, SE = 0.5) communities overall. Grip strength, step counts, and measures of time spent in different activities or activity intensities were uncorrelated. Conclusion: Device and question-based measurement of PA and strength were readily accepted in these Chinese urban and rural populations. The PAQ on physical activity in the past year produced some plausible population averages, but individual responses suggested recall challenges. If data about specific activities are required, future studies should explore use of standardized survey questions concerning such fewer specific activities or instruments examining shorter time periods such as one, three, or seven day recalls. Full article