BACKGROUND: the study of the possible determinants of the rise and fall of infections can be of great relevance, as was experienced during the COVID-19 pandemic. One of the methods to understand whether determinants are simultaneous or develop through contiguity between different areas is the study of the diagnostic replication index RDt among regions.
OBJECTIVE: to introduce the analysis of RDt variability and the subsequent application of a recently introduced functional clustering method as highly useful procedures for recognizing the presence of clusters with similar trends in epidemic curves.
METHODS: within the considered period, trends in regional RDt are analyzed in detail over four different time intervals.
METHODS: to exemplify this methodology, the study of variability in the period from the end of 2021 to the beginning of 2022 may be of interest.
METHODS: the variability in the regional RDt indices is assessed by means of the correlation coefficient weighted with respect to the populations of the individual regions. The clustering procedure is applied to the time series of absolute RDt values.
RESULTS: it emerges that the periods of increasing variability in the RDt correspond to the initial growth or decrease in the number of infections, while functional clustering identifies macro-areas in which the epidemic curves have had similar trends. What caused contagions to increase seems to relate to a factor that is not specific to certain areas, with the contribution in some cases of a contagion dynamic between adjacent areas.
CONCLUSIONS: the variability in the trend of regional diagnostic replication indices, which are calculated with only a few days delay, is a further indicator for the early detection of major changes in the trend of epidemic curves. The clustering of epidemic index curves may be useful to determine whether determinants act simultaneously or by contiguity between adjacent areas.

OBJECTIVE: This study aimed to describe clinical characteristics and sleep quality of Parkinson\'s Diseases (PD) patients and identify associated factors with sleep quality.
METHODS: A cross-sectional study was conducted at the National Geriatric Hospital, Hanoi, Vietnam, from December 2022 to April 2023. A total of 130 Parkinson\'s disease patients undergoing treatment at the hospital were invited. Demographic and clinical characteristics were obtained. The diagnosis of sleep disorders was based on the standards outlined in the DSM-V. A multivariate logistic regression model was employed.
RESULTS: 90.9 % experienced sleep disorder, with the significant types including insomnia (76.2 %) and restless legs syndrome (56.2 %). The majority of patients suffered two (33.1 %) and one kind of sleep disorder (32.3 %). Most patients experienced sleep disorders after diagnosis of PD (80.0 %). Only having shoulder and neck pain was positively associated with a likelihood of having sleep disturbances (OR=4.87, 95 %CI=1.18-20.15).
CONCLUSIONS: This study found a high rate of sleep disorders among PD patients in our sample. Shoulder and neck pain was found to be associated with a risk of sleep disorders. Pain management should be performed to improve the sleep quality of PD patients.

UNASSIGNED: Neonatal deaths are still a major leading cause of social and economic crises. Identifying neonatal near-miss events and identifying their predictors is crucial to developing comprehensive and pertinent strategies to alleviate neonatal morbidity and death. However, neither neonatal near-miss events nor their predictors were analyzed in the study area. Therefore, this study is aimed at assessing the predictors of neonatal near-misses among neonates born at Worabe Comprehensive Specialized Hospital, Southern Ethiopia, in 2021.
UNASSIGNED: A hospital-based unmatched case-control study was conducted from 10 November 2021 to 30 November 2021. A pre-tested, structured, and standard abstraction checklist was used to collect the data. After checking the data for completeness and consistency, it was coded and entered into Epi-Data 3.1 and then exported to Stata version 14 for analysis. All independent variables with a p-value ≤0.25 in bivariable binary logistic regression were entered into a multivariable analysis to control the confounding. Variables with p-values <0.05 were considered statistically significant.
UNASSIGNED: In this study, 134 neonatal near-miss cases and 268 controls were involved. The identified predictors of neonatal near-misses were rural residence [adjusted odds ratio (AOR): 2.01; 95% confidence interval (CI): 1.31-5.84], no antenatal care (ANC) follow-up visits (AOR: 2.98; 95% CI: 1.77-5.56), antepartum hemorrhage (AOR: 2.12; 95% CI: 1.18-4.07), premature rupture of the membrane (AOR: 2.55; 95% CI: 1.54-5.67), and non-vertex fetal presentation (AOR: 3.05; 95% CI: 1.93-5.42).
UNASSIGNED: The current study identified rural residents, no ANC visits, antepartum hemorrhage, premature rupture of membrane, and non-vertex fetal presentation as being significantly associated with neonatal near-miss cases. As a result, local health planners and healthcare practitioners must collaborate in enhancing maternal healthcare services, focusing specifically on the early identification of issues and appropriate treatment.

Land management technology (LMT) adoption is one of Ethiopia\'s crucial strategies to combat soil depletion and promote agricultural production. However, there is scant information concerning the intensity, interdependent nature, and households\' decision to adopt multiple LMTs. Thus, the purpose of this study is to identify factors influencing households\' decisions to adopt multiple LMTs and the intensity and interdependency of the technologies in the Goyrie watershed of southern Ethiopia. The data was collected from 291 randomly selected household heads, focus group discussion participants, and key informant interview respondents. The quantitative data was analyzed using descriptive statistics and econometric methods like multivariate probit and ordered probit modeling, while the qualitative data was presented through content analysis. The result indicated that more than half of respondents (67 %) applied one or two LMTs. The highest complementary effects were observed in mixed soil bunds with desho grasses and manure applications. However, soil bunds and fanya-juu, manure application and agroforestry showed interchangeability with one another. Sex, education, family size, landholding size, access to development agents and credit institutions, training, and village membership increased the probability of adopting multiple LMTs, whereas age, land rent, and crop sharing discouraged the likelihood of households\' decisions to adopt LMT. The results of the ordered probit model revealed that village membership and contact with extension agents highly encouraged the intensity of LMT adoptions. Thus, policymakers and planners should consider social, institutional, human asset, and technological related factors to increase adoption rates and intensity of land management technologies.

Chronic energy deficiency (CED) in pregnant women is a condition of energy and protein deficiency that lasts for years and causes problems in the mother and fetus. Due to its significant consequences, determining the determinants associated with CED incidence is of utmost importance. The aim of this study was to determine the determinants of the incidence of CED in pregnant women in Indonesia. A cross-sectional study was conducted on pregnant women in Banyumas, Central Java, Indonesia, in 2022. Plausible determinants included maternal age, pregnancy interval, parity, educational attainment, nutritional knowledge, employment, frequency of antenatal care (ANC), and nutritional intake. The Chi-squared test followed by multivariate logistic regression were used to determine the factors associated with the incidence of CED. Our data indicated that 32% of the pregnant women had CED. Univariate analysis found that maternal age (p=0.022), pregnancy interval (p=0.009), educational attainment (p=0.012), knowledge of nutrition and CED (p=0.023), frequency of utilization of ANC services (p=0.028), energy intake (p=0.002), protein intake (p=0.006), vitamin C intake (p=0.016), folate intake (p=0.011), and calcium intake (p=0.004) were significantly associated with CED incidence in the pregnant women. Multivariate analysis indicated that extreme maternal age (OR; 3.49; 95%CI: 1.10-11.05), low educational attainment (OR: 4.12; 95%CI: 1.37-12.33), short pregnancy interval (OR; 7.30; 95%CI: 1.84-28.99), low frequency of ANC (OR: 3.06; 95%CI: 1.01-9.19) and low protein intake (OR: 6.80; 95%CI: 1.62-28.59) were associated with CED incidence. This study underscores the importance of increasing nutritional intake, frequency of ANC, and pregnancy interval among pregnant women to reduce the risk of CED and its adverse health outcomes.

OBJECTIVE: To investigate the frequency, determinants, stages, and barriers of patient and public involvement (PPI) in systematic reviews and to explore its association with the dissemination of reviews.
METHODS: We examined systematic reviews that required the inclusion of a PPI declaration, published in The BMJ between January 1, 2015, and December 31, 2022. Multivariable analysis was used to assess the association between PPI and key variables. We investigated the association between PPI and the dissemination of reviews using Altmetric scores, citations, and full-text views.
RESULTS: A total of 217 systematic reviews were included, of which 56 (25.8%, 95% CI 20.0%-31.6%) included PPI, with a steady increase from 5.9% (1/17) in 2015 to 44.4% (4/35) in 2022. Of the 217 systematic reviews, 160 (73.7%) involved methodologists as co-authors. Factors significantly associated with a higher proportion of PPI included the publication year after 2019 (adjusted odds ratio [aOR] 2.46, 95% CI 1.26-4.83), the involvement of methodologist (aOR 3.08; 95% CI 1.27-7.47), and being led by researchers from high-income countries (aOR 5.47; 95% CI 1.23-24.30). Reviews that included PPI had higher Altmetric scores per month (6.6 vs 3.4, P = .002) and more monthly full-text (1048.6 vs 636.5, P < .001) and PDF (217.7 vs 129.0, P < .001) views than reviews without PPI. However, there was no difference in the monthly citations (2.2 vs 2.0, P = .365) between reviews with and without PPI.
CONCLUSIONS: The proportion of systematic reviews reporting PPI in The BMJ has increased over time, possibly due to journal policies, but it still remains at a low level. Reviews led by researchers from high-income countries or involving methodologists are associated with a higher frequency of PPI within The BMJ. Furthermore, reviews incorporating PPI within The BMJ have a higher potential for broad dissemination.

UNASSIGNED: Behaviour change interventions influence behaviour through causal processes called \"mechanisms of action\" (MoAs). Reports of such interventions and their evaluations often use inconsistent or ambiguous terminology, creating problems for searching, evidence synthesis and theory development. This inconsistency includes the reporting of MoAs. An ontology can help address these challenges by serving as a classification system that labels and defines MoAs and their relationships. The aim of this study was to develop an ontology of MoAs of behaviour change interventions.
UNASSIGNED: To develop the MoA Ontology, we (1) defined the ontology\'s scope; (2) identified, labelled and defined the ontology\'s entities; (3) refined the ontology by annotating (i.e., coding) MoAs in intervention reports; (4) refined the ontology via stakeholder review of the ontology\'s comprehensiveness and clarity; (5) tested whether researchers could reliably apply the ontology to annotate MoAs in intervention evaluation reports; (6) refined the relationships between entities; (7) reviewed the alignment of the MoA Ontology with other relevant ontologies, (8) reviewed the ontology\'s alignment with the Theories and Techniques Tool; and (9) published a machine-readable version of the ontology.
UNASSIGNED: An MoA was defined as \"a process that is causally active in the relationship between a behaviour change intervention scenario and its outcome behaviour\". We created an initial MoA Ontology with 261 entities through Steps 2-5. Inter-rater reliability for annotating study reports using these entities was α=0.68 (\"acceptable\") for researchers familiar with the ontology and α=0.47 for researchers unfamiliar with it. As a result of additional revisions (Steps 6-8), 23 further entities were added to the ontology resulting in 284 entities organised in seven hierarchical levels.
UNASSIGNED: The MoA Ontology extensively captures MoAs of behaviour change interventions. The ontology can serve as a controlled vocabulary for MoAs to consistently describe and synthesise evidence about MoAs across diverse sources.

UNASSIGNED: Breast cancer (BC) is the first leading cancer sharing about 25% of the cancer burden among women globally. This study aimed to identify the determinants of BC in Ethiopia.
UNASSIGNED: We comprehensively searched primary studies conducted in Ethiopia on associated factors of BC in PubMed, Cochrane Library, Hinari, Google, and Google Scholar) and available online until 2 June 2023. The necessary data were extracted from relevant studies and exported to STATA version 15 for analysis. The pooled odds ratio with its 95% confidence interval (CI) was estimated using a random effect model. The finding was reported following preferred reporting items for systematic reviews and meta-analyses guidelines.
UNASSIGNED: Five studies with 1,819 participants (792 cases and 1,027 controls) were included. The significant determinants of BC were age at menarche <12 years (adjusted odds ratio (AOR) = 3.36, 95% CI: 1.68-5.04), post-menopause (AOR = 2.37, 95% CI: 1.67-3.06), ever breastfeeding (AOR = 0.28, 95% CI: 0.15-0.42), and family history of cancer (AOR = 2.39, 95% CI: 1.29-3.44).
UNASSIGNED: In Ethiopia, the significant determinants of BC among women were age at menarche <12 years, post-menopause, Ever breastfeeding, and family history of cancer. We recommend that the concerned organizations consider the aforementioned factors in addressing the problem of BC in Ethiopia by increasing community awareness, promoting breast self-examination, and developing programs to reduce the increasing burden of BC in the study setting.

Alzheimer\'s disease (AD) is a heterogeneous age-dependent neurodegenerative disorder. Its hallmarks involve abnormal proteostasis, which triggers proteotoxicity and induces neuronal dysfunction. The 26S proteasome is an ATP-dependent proteolytic nanomachine of the ubiquitin-proteasome system (UPS) and contributes to eliminating these abnormal proteins. This study focused on the relationship between proteasome and AD, the hub genes of proteasome, PSMC6, and 7 genes of α-ring, are selected as targets to study. The following three characteristics were observed: 1. The total number of proteasomes decreased with AD progression because the proteotoxicity damaged the expression of proteasome proteins, as evidenced by the downregulation of hub genes. 2. The existing proteasomes exhibit increased activity and efficiency to counterbalance the decline in total proteasome numbers, as evidenced by enhanced global coordination and reduced systemic disorder of proteasomal subunits as AD advances. 3. The synergy of PSMC6 and α-ring subunits is associated with AD. Synergistic downregulation of PSMC6 and α-ring subunits reflects a high probability of AD risk. Regarding the above discovery, the following hypothesis is proposed: The aggregation of pathogenic proteins intensifies with AD progression, then proteasome becomes more active and facilitates the UPS selectively targets the degradation of abnormal proteins to maintain CNS proteostasis. In this paper, bioinformatics and support vector machine learning methods are applied and combined with multivariate statistical analysis of microarray data. Additionally, the concept of entropy was used to detect the disorder of proteasome system, it was discovered that entropy is down-regulated continually with AD progression against system chaos caused by AD. Another conception of the matrix determinant was used to detect the global coordination of proteasome, it was discovered that the coordination is enhanced to maintain the efficiency of degradation. The features of entropy and determinant suggest that active proteasomes resist the attack caused by AD like defenders, on the one hand, to protect themselves (entropy reduces), and on the other hand, to fight the enemy (determinant reduces). It is noted that these are results from biocomputing and need to be supported by further biological experiments.

BACKGROUND: Depression is a common issue among university students and has been particularly exacerbated during the COVID-19 pandemic. However, limited research has specifically focused on depression among university entrants.
OBJECTIVE: This study aimed to determine the prevalence of depression severity and identify associated factors during different phases of the COVID-19 pandemic using health screening questionnaires completed by matriculated university students in Singapore.
METHODS: A repeated cross-sectional study was conducted at a public university in Singapore. Data from health screening questionnaires administered in 2020 and 2021, involving 15,630 newly enrolled university students, were analyzed. The questionnaires covered students\' sociodemographic information, physical health status, own and family medical history, lifestyle behaviours, and the Patient Health Questionnaire (PHQ-9). The PHQ-9 was used to measure the severity of depressive symptoms, categorizing into moderate to severe depressive symptoms (MSDS), mild depressive symptoms (MDS), or no depressive symptom (NDS). Multinomial logistic regression was used to assess the sociodemographic, physical and behavioural correlates of depression.
RESULTS: The prevalence of MSDS was 1% in both 2020 and 2021, while the rates for MDS were 1.93% in 2020 and 1.64% in 2021. In the 2020 cohort, male freshmen who reported better health had a lower likelihood of experiencing depression. Conversely, students of Malay ethnicity, those majoring in Engineering, those with multiple chronic diseases, monthly alcohol consumers, current smokers, and those with a family history of mental disorder had a higher likelihood of experiencing depression. Moreover, students who lived on-campus in the 2021 cohort were less likely to experience depression than those living off-campus. However, the associations between academic majors, alcohol consumption, and smoking with depression were not significant in the 2021 cohort.
CONCLUSIONS: This study reported a low prevalence of both MSDS and MDS among university entrants in Singapore. The study further identified three categories of factors associated with depression: sociodemographic, physical, and behavioural. This study suggests policy interventions to enhance targeted social support that address each student group\'s specific requirements and susceptibilities. A more extensive and comprehensive study is warranted to assess the changes in student mental health status post-COVID-19 pandemic.