TriCAFFNet: A Tri-Cross-Attention Transformer with a Multi-Feature Fusion Network for Facial Expression Recognition.

In recent years, significant progress has been made in facial expression recognition methods. However, tasks related to facial expression recognition in real environments still require further research. This paper proposes a tri-cross-attention transformer with a multi-feature fusion network (TriCAFFNet) to improve facial expression recognition performance under challenging conditions. By combining LBP (Local Binary Pattern) features, HOG (Histogram of Oriented Gradients) features, landmark features, and CNN (convolutional neural network) features from facial images, the model is provided with a rich input to improve its ability to discern subtle differences between images. Additionally, tri-cross-attention blocks are designed to facilitate information exchange between different features, enabling mutual guidance among different features to capture salient attention. Extensive experiments on several widely used datasets show that our TriCAFFNet achieves the SOTA performance on RAF-DB with 92.17%, AffectNet (7 cls) with 67.40%, and AffectNet (8 cls) with 63.49%, respectively.

Occlusion Robust Cognitive Engagement Detection in Real-World Classroom.

Cognitive engagement involves mental and physical involvement, with observable behaviors as indicators. Automatically measuring cognitive engagement can offer valuable insights for instructors. However, object occlusion, inter-class similarity, and intra-class variance make designing an effective detection method challenging. To deal with these problems, we propose the Object-Enhanced-You Only Look Once version 8 nano (OE-YOLOv8n) model. This model employs the YOLOv8n framework with an improved Inner Minimum Point Distance Intersection over Union (IMPDIoU) Loss to detect cognitive engagement. To evaluate the proposed methodology, we construct a real-world Students' Cognitive Engagement (SCE) dataset. Extensive experiments on the self-built dataset show the superior performance of the proposed model, which improves the detection performance of the five distinct classes with a precision of 92.5%.

Transcriptional regulation of the yersiniabactin receptor fyuA gene by the ferric uptake regulator in Klebsiella pneumoniae NTUH-K2044.

The ferric uptake regulator (Fur) is a global regulator that influences the expression of virulence genes in Klebsiella pneumoniae. Bioinformatics analysis suggests Fur may involve in iron acquisition via the identified regulatory box upstream of the yersiniabactin receptor gene fyuA. To observe the impact of the gene fyuA on the virulence of K. pneumoniae, the gene fyuA knockout strain and complementation strain were constructed and then conducted a series of phenotypic experiments including chrome azurol S (CAS) detection, crystal violet staining, and wax moth virulence experiment. To examine the regulatory relationship between Fur and the gene fyuA, green fluorescent protein (GFP) reporter gene fusion assay, real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR), gel migration assay (EMSA), and DNase I footprinting assay were used to clarify the regulatory mechanism of Fur on fyuA. CAS detection revealed that the gene fyuA could affect the generation of iron carriers in K. pneumoniae. Crystal violet staining experiment showed that fyuA could positively influence biofilm formation. Wax moth virulence experiment indicated that the deletion of the fyuA could weaken bacterial virulence. GFP reporter gene fusion experiment and RT-qPCR analysis revealed that Fur negatively regulated the expression of fyuA in iron-sufficient environment. EMSA experiment demonstrated that Fur could directly bind to the promoter region of fyuA, and DNase I footprinting assay further identified the specific binding site sequences. The study showed that Fur negatively regulated the transcriptional expression of fyuA by binding to upstream of the gene promoter region, and then affected the virulence of K. pneumoniae.

Facial Expression Recognition Based on Fine-Tuned Channel-Spatial Attention Transformer.

Facial expressions help individuals convey their emotions. In recent years, thanks to the development of computer vision technology, facial expression recognition (FER) has become a research hotspot and made remarkable progress. However, human faces in real-world environments are affected by various unfavorable factors, such as facial occlusion and head pose changes, which are seldom encountered in controlled laboratory settings. These factors often lead to a reduction in expression recognition accuracy. Inspired by the recent success of transformers in many computer vision tasks, we propose a model called the fine-tuned channel-spatial attention transformer (FT-CSAT) to improve the accuracy of recognition of FER in the wild. FT-CSAT consists of two crucial components: channel-spatial attention module and fine-tuning module. In the channel-spatial attention module, the feature map is input into the channel attention module and the spatial attention module sequentially. The final output feature map will effectively incorporate both channel information and spatial information. Consequently, the network becomes adept at focusing on relevant and meaningful features associated with facial expressions. To further improve the model's performance while controlling the number of excessive parameters, we employ a fine-tuning method. Extensive experimental results demonstrate that our FT-CSAT outperforms the state-of-the-art methods on two benchmark datasets: RAF-DB and FERPlus. The achieved recognition accuracy is 88.61% and 89.26%, respectively. Furthermore, to evaluate the robustness of FT-CSAT in the case of facial occlusion and head pose changes, we take tests on Occlusion-RAF-DB and Pose-RAF-DB data sets, and the results also show that the superior recognition performance of the proposed method under such conditions.

Bimodal Learning Engagement Recognition from Videos in the Classroom.

Engagement plays an essential role in the learning process. Recognition of learning engagement in the classroom helps us understand the student's learning state and optimize the teaching and study processes. Traditional recognition methods such as self-report and teacher observation are time-consuming and obtrusive to satisfy the needs of large-scale classrooms. With the development of big data analysis and artificial intelligence, applying intelligent methods such as deep learning to recognize learning engagement has become the research hotspot in education. In this paper, based on non-invasive classroom videos, first, a multi-cues classroom learning engagement database was constructed. Then, we introduced the power IoU loss function to You Only Look Once version 5 (YOLOv5) to detect the students and obtained a precision of 95.4%. Finally, we designed a bimodal learning engagement recognition method based on ResNet50 and CoAtNet. Our proposed bimodal learning engagement method obtained an accuracy of 93.94% using the KNN classifier. The experimental results confirmed that the proposed method outperforms most state-of-the-art techniques.

Protective Effect of 1,25-Dihydroxy Vitamin D3 on Pepsin-Trypsin-Resistant Gliadin-Induced Tight Junction Injuries.

BACKGROUND: Tight junction (TJ) injuries induced by pepsin-trypsin-resistant gliadin (PT-G) play an important role in the pathogenesis of celiac disease. Previously, 1,25-dihydroxy vitamin D3 (VD3) was reported to be a TJ regulator that attenuates lipopolysaccharide- and alcohol-induced TJ injuries. However, whether VD3 can attenuate PT-G-induced TJ injuries is unknown. AIM: The aim of this study was to evaluate the effects of VD3 on PT-G-induced TJ injuries. METHODS: Caco-2 monolayers were used as in vitro models. After being cultured for 21 days, the monolayers were treated with PT-G plus different concentrations of VD3. Then, the changes in trans-epithelial electrical resistance and FITC-dextran 4000 (FD-4) flux were determined to evaluate the monolayer barrier function. TJ protein levels were measured to assess TJ injury severity, and myeloid differentiation factor 88 (MyD88) expression and zonulin release levels were determined to estimate zonulin release signaling pathway activity. Additionally, a gluten-sensitized mouse model was established as an in vivo model. After the mice were treated with VD3 for 7 days, we measured serum FD-4 concentrations, TJ protein levels, MyD88 expression, and zonulin release levels to confirm the effect of VD3. RESULTS: Both in vitro and in vivo, VD3 significantly attenuated the TJ injury-related increase in intestinal mucosa barrier permeability. Moreover, VD3 treatment up-regulated TJ protein expression levels and significantly decreased MyD88 expression and zonulin release levels. CONCLUSIONS: VD3 has protective effects against PT-G-induced TJ injuries both in vitro and in vivo, which may correlate with the disturbance of the MyD88-dependent zonulin release signaling pathway.

Review: A Japanese population-based meta-analysis of vonoprazan versus PPI for Helicobacter pylori eradication therapy: Is superiority an illusion?

BACKGROUND: Vonoprazan (VPZ) is a novel acid suppressant that has been used in Helicobacter pylori (H. pylori) eradication therapies in recent years. However, the efficacy and safety of VPZ vs proton-pump inhibitor (PPI) in H. pylori eradication therapies remain controversial. OBJECTIVE: To perform a meta-analysis in order to assess the efficacy and safety of VPZ vs PPI for H. pylori eradication. MATERIALS AND METHODS: The PubMed, EMBASE, and Cochrane Library databases were searched up to July 10, 2017, for relevant randomized controlled trials (RCTs) and nonrandomized clinical studies (NRCTs). The pooled eradication rate (ER) and pooled occurrence rates of adverse events were used to compare the efficacy and safety of VPZ - and PPI-containing regimens. RESULT: A total of 14 studies with 14 636 patients were included in this meta-analysis. The results showed that the pooled ER of VPZ -containing regimens was much higher than that of PPI-containing regimens when used as first-line therapies. This difference was significant for both intention-to-treat (85.1% vs 68.0%, P < .00001) and per-protocol analyses (89.0% vs 74.2%, P < .00001). Moreover, subgroup analysis indicated significant superiority of VPZ in both patients with clarithromycin-resistant strains (81.5% vs 40.9%, P < .00001) and those with clarithromycin-susceptible strains (94.9% vs 89.6%, P = .006). However, VPZ did not show superiority to PPI as part of a second-line triple therapy based on both intention-to-treat (83.4% vs 82.0%, P = .79) and per-protocol analyses (89.3% vs 90.1%, P = .06). Finally, RCT subgroup analysis showed the safety of VPZ -containing regimens to be better than PPI-containing regimens (26.4% vs 33.3%, P = .008), whereas there was no significant difference in this regard for the NRCT subgroup analysis (5.7% vs 4.7%, P = .08). CONCLUSIONS: The efficacy of VPZ is superior to PPI in first-line H. pylori triple eradication therapies but not in second-line therapies. The safety of VPZ -containing regimens appears to be equal or even superior to that of PPI. However, most reports included in this study had low levels of evidence. Hence, adequate and high-quality RCTs will be needed to support our results.

Artificial intelligence in lung cancer screening: Detection, classification, prediction, and prognosis.

BACKGROUND: The exceptional capabilities of artificial intelligence (AI) in extracting image information and processing complex models have led to its recognition across various medical fields. With the continuous evolution of AI technologies based on deep learning, particularly the advent of convolutional neural networks (CNNs), AI presents an expanded horizon of applications in lung cancer screening, including lung segmentation, nodule detection, false-positive reduction, nodule classification, and prognosis. METHODOLOGY: This review initially analyzes the current status of AI technologies. It then explores the applications of AI in lung cancer screening, including lung segmentation, nodule detection, and classification, and assesses the potential of AI in enhancing the sensitivity of nodule detection and reducing false-positive rates. Finally, it addresses the challenges and future directions of AI in lung cancer screening. RESULTS: AI holds substantial prospects in lung cancer screening. It demonstrates significant potential in improving nodule detection sensitivity, reducing false-positive rates, and classifying nodules, while also showing value in predicting nodule growth and pathological/genetic typing. CONCLUSIONS: AI offers a promising supportive approach to lung cancer screening, presenting considerable potential in enhancing nodule detection sensitivity, reducing false-positive rates, and classifying nodules. However, the universality and interpretability of AI results need further enhancement. Future research should focus on the large-scale validation of new deep learning-based algorithms and multi-center studies to improve the efficacy of AI in lung cancer screening.

Application of computer-aided detection for NCCN-based follow-up recommendation in subsolid nodules: Effect on inter-observer agreement.

RATIONALE AND OBJECTIVES: Computer-aided detection (CAD) of pulmonary nodules reduces the impact of observer variability, improving the reliability and reproducibility of nodule assessments in clinical practice. Therefore, this study aimed to assess the impact of CAD on inter-observer agreement in the follow-up management of subsolid nodules. MATERIALS AND METHODS: A dataset comprising 60 subsolid nodule cases was constructed based on the National Cancer Center lung cancer screening data. Five observers independently assessed all low-dose computed tomography scans and assigned follow-up management strategies to each case according to the National Comprehensive Cancer Network (NCCN) guidelines, using both manual measurements and CAD assistance. The linearly weighted Cohen's kappa test was used to measure agreement between paired observers. Agreement among multiple observers was evaluated using the Fleiss kappa statistic. RESULTS: The agreement of the five observers for NCCN follow-up management categorization was moderate when measured manually, with a Fleiss kappa score of 0.437. Utilizing CAD led to a notable enhancement in agreement, achieving a substantial consensus with a Fleiss kappa value of 0.623. After using CAD, the proportion of major and substantial management discrepancies decreased from 27.5% to 15.8% and 4.8% to 1.5%, respectively (p < 0.01). In 23 lung cancer cases presenting as part-solid nodules, CAD significantly elevates the average sensitivity in detecting lung cancer cases presenting as part-solid nodules (overall sensitivity, 82.6% vs. 92.2%; p < 0.05). CONCLUSION: The application of CAD significantly improves inter-observer agreement in the follow-up management strategy for subsolid nodules. It also demonstrates the potential to reduce substantial management discrepancies and increase detection sensitivity in lung cancer cases presenting as part-solid nodules.

Psychosocial characteristics associated with frequent physical fighting: findings from the 2009 National Youth Risk Behavior Survey.

The goal of the current study was to determine the prevalence and psychosocial correlates associated with frequent fighting among US high school students. Cross-sectional analyses were conducted using the 2009 Youth Risk Behavior Survey (N=16 410). Multivariate logistic regression analyses determined associations between demographic and psychosocial correlates of frequent fighting. Among students, 13.6% reported fighting once, 15.3% reported fighting 2-11 times and 2.6% reported fighting 12 or more times in the past year. Risk factors associated with frequent fighting were weapon carrying (adjusted OR=10.55; 95% CI 7.40 to 15.05), suicide attempt (adjusted OR=6.16; 95% CI 3.70 to 10.28), binge drinking (adjusted OR=3.15; 95% CI 2.16 to 4.59) and feeling too unsafe to go to school (adjusted OR=3.09; 95% CI 2.00 to 4.77). There is a clear need to better understand the patterns and psychosocial characteristics of frequent physical fighting and the prevention and interventions strategies that may be most relevant for these vulnerable youth.

Microbial Fuel Cell-Based Organic Matter Sensors: Principles, Structures and Applications.

Wastewater contains a significant quantity of organic matter, continuously causing environmental pollution. Timely and accurate detection of organic content in water can facilitate improved wastewater treatment and better protect the environment. Microbial fuel cells (MFCs) are increasingly recognized as valuable biological monitoring systems, due to their ability to swiftly detect organic indicators such as biological oxygen demand (BOD) and chemical oxygen demand (COD) in water quality. Different types of MFC sensors are used for BOD and COD detection, each with unique features and benefits. This review focuses on different types of MFC sensors used for BOD and COD detection, discussing their benefits and structural optimization, as well as the influencing factors of MFC-based biomonitoring systems. Additionally, the challenges and prospects associated with the development of reliable MFC sensing systems are discussed.

Constructing model-averaging species sensitivity distributions of Phenanthrene based on reproductive fitness: Implications for assessing ecological risk in urban watershed.

The challenge in optimizing the method of constructing species sensitivity distribution (SSD) remains. In this study, a model-averaging SSD was created to evaluate the ecological risk of Phenanthrene (PHE) in urban watershed based on reproductive fitness. Specifically, concentrations of PHE were measured in surface water samples collected from various watersheds of Wuhan, including five lake watersheds and the Wuhan reach of the Yangtze River and Han River. The reproductive endpoint of aquatic species was calculated to be most sensitive to PHE exposure, with the value of predict no-effect concentration (PNEC) at 0.19 µg/L. The results of probabilistic assessment methods, including joint probability curve (JPC), overall risk probability (ORP), and distribution-based quotient (DBQ), indicated that the ecological risks of PHE in large lakes have dropped significantly with distance from the downtown area of Wuhan, and the long-term effects of industrial activities may increase the risks in the lake watersheds. Basically, the ecological risks in Yangtze River are negligible; however, there is a relatively high risk of PHE in the Han River and some lake watersheds. The cos Î¸ similarity analysis indicated the Yangtze River is strongly connected to the low-risk lake watersheds, and that in part reflects the risk in the Yangtze River being controlled by its surrounding these lake watersheds.

Efficacy and safety of proprioceptive neuromuscular facilitation for chronic low back pain: A meta-analysis of randomized controlled trials.

Objectives: This study aimed to evaluate the effectiveness and safety of proprioceptive neuromuscular facilitation for chronic low back pain.Materials and methods: Eleven databases were searched from their inception through January 2021. The primary outcomes were pain intensity, individual activities, quality of life, and adverse events. Results: Four randomized controlled trials (RCTs) with 184 patients (mean age: 37.8±3.1 years; range, 35 to 50 years) met the inclusion criteria. The pooled effect size showed proprioceptive neuromuscular facilitation, relieved pain (standard means difference [SMD]: -0.835, 95% CI: -1.139 to -0.531, p<0.001, n=4), and improved individual activity (Roland Morris Disability Questionnaire, SMD: -1.765, 95% CI: -2.642 to -0.888, p<0.001, n=2; Oswestry Disability Index, SMD: -0.893, 95% CI: -1.434 to -0.352, p=0.001, n=1) for chronic low back pain (CLBP). Conclusion: This study verified that proprioceptive neuromuscular facilitation could relieve pain and improve individual activities without serious adverse events in patients with CLBP; however, it should be cautiously recommended due to the small number of included RCTs.

The status of anxiety state among cancer patients and their relatives during coronavirus disease 2019 (COVID-19) in Hubei, China.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) epidemic, tumor patients and their families might suffer from greater psychological stress as a result of anxiety or other psychological disorders. We conducted an online study during the epidemic to explore the mental state of tumor patients and their families during this extraordinary time. METHODS: A cross-sectional survey was carried out. Questionnaires were distributed through the WeChat "Questionnaire Star" network. The snowball sampling technique was adopted and further promoted by subjects who had completed the questionnaire. RESULTS: A total of 1,030 valid questionnaires were collected. There were 609 (59.13%) tumor patients and 421 (40.87%) family members. One hundred and fifty-six (15.15%) subjects had anxiety, among which 65 (6.31%) had moderate to severe anxiety. Single-factor analysis indicated that age (>60 years old), the farmer occupation, and a high sleep disorder assessment score were risk factors for anxiety, while the latter two might also be independent risk factors, as suggested by multi-factor analysis. Infrequent contact with doctors was an independent risk factor for cancer patients, while uninterrupted anti-tumor therapy was an independent protective factor. 40.19% of the subjects expressed a need for psychosocial support during the COVID-19 period. CONCLUSIONS: The COVID-19 outbreak resulted in tumor patients and their relatives experiencing greater psychological pressure than usual, and patients were more worried about anti-tumor treatment and disease progression impacted by the epidemic. Both groups had a significant need for psychosocial help.

The application of new biosynthetic artificial skin for long-term temporary wound coverage.

Temporary dressings protect wounds from desiccation and infection. In our previous study, we used meshed acellular porcine dermis (APD) to enhance wound healing and decrease wound contraction; however, the wounds showed meshed scar. In this study, we produced an artificial skin composed of a cross-linked silicon sheet on the surface of APD which we have called silicone acellular porcine dermis (SAPD). This new artificial skin can protect the wound long enough to promote wound healing either by second intention or covered long enough until cultured epithelium autograft (CEA) or autologous skin graft can be harvested for permanent coverage. We delivered 4 cm x 5 cm full-thickness wound on the back of 350 g Sprague-Dawley rats. Thirty-six rats were divided into two groups. Eighteen rats had SAPD and the other 18 were covered with Biobrane. The wounds were first examined 2 weeks after grafting and followed weekly for an additional 4 weeks to evaluate the wound and study pathological changes by using H.E. and Masson's stains. Wound size was calculated by ruler and analyzed by Student's t-test. At the 2-week inspection, both SAPD and Biobrane showed tight adherence to the wound with no change of wound size. Both the SAPD and Biobrane dermal templates were pink. In the Biobrane-covered group, the wounds contracted soon after the tie-over dressing was removed. Its dermal layer is a layer of thin porcine dermal substance, which was promptly digested by tissue hyaluronidase and provides no real dermal template. In the SAPD-covered group however, the wound size was maintained significantly from third to sixth week after grafting (p<0.001). SAPD was designed with thick epidermal silicone and a well-organized porcine dermis so that it incorporates into the recipient wound. Clinically the silicone layer of SAPD dislodged from APD about 6-7 weeks after grafting and was followed by dermal matrix exposure and infection. In pathological examination, much like a human skin graft, new vessels were found in APD about 1 week after grafting with minimal inflammatory cells infiltrated in the graft and wound. Six weeks after grafting, the collagen of APD incorporated into the wound, showing palisade arrangement and no sign of rejection. In the Biobrane group however, the wounds showed severe inflammation, the porcine dermal matrix was digested and disappeared 3 weeks after coverage. In conclusion, SAPD is a thick biosynthetic artificial skin, which protects the rat wound significantly longer than Biobrane and prevents contraction. We expect that using of SAPD for temporary wound coverage will provide enough time to grow autologous-cultured epithelium or to reharvest skin grafts.

Co-Occurring Physical Fighting and Suicide Attempts among U.S. High School Students: Examining Patterns of Early Alcohol Use Initiation and Current Binge Drinking.

INTRODUCTION: A growing body of empirical research documents a significant co-occurrence of suicide attempts and interpersonal violence among youth. However, the potential role of early alcohol use initiation and current heavy alcohol use as correlates of this comorbidity has not been examined in a nationally representative sample of high school students. METHODS: We based our analyses on cross-sectional data from the 2009 Youth Risk Behavior Survey, which includes a nationally representative sample (n=16,410) of high school students in grades 9 through 12 in the United States. Multinomial logistic regression analyses were conducted to test the associations between measures of alcohol use (early alcohol use initiation and heavy drinking) and comorbid suicidal and violent behavior while controlling for potential confounders. RESULTS: Among high school students, 3.6% reported comorbid physical fighting and suicide attempt in the past year. Early alcohol use (prior to age 13) and heavy drinking (5 or more drinks in a row) were strongly associated with comorbid reports of physical fighting and suicide attempts (Adj. odds ratio [OR]=3.12; 95% confidence interval [CI]:2.49-3.89) and (Adj. OR=3.45; 95%CI:2.63-4.52). CONCLUSION: These findings underscore the importance of both early alcohol use initiation and heavy drinking as statistically significant correlates of comorbid fighting and suicide attempts among youth. While future research is needed to determine the temporal ordering between problem drinking and violent or suicidal behaviors, existing prevention programs may benefit from including components aimed at reducing and delaying alcohol use.

The prevalence of very frequent physical fighting among boys and girls in 27 countries and cities: regional and gender differences.

OBJECTIVE: Using nationally representative data, this study examined the prevalence of very frequent physical fighting (≥12 times per year) among youth in 27 countries and cities. Frequent physical fighting has rarely been reported in the previous literature despite the implications for research and practice. METHODS: Analyses were based on the Global School-based Student Health Survey (2003-2008) and the 2009 US Youth Risk Behavior Survey. Multinomial regression analyses were conducted to determine gender differences in frequent fighting. Countries were categorized into five regions (Sub-Saharan Africa, Central and South America, Asia, Eastern Mediterranean, and the United States), and one-way ANOVA tests were used to determine regional differences. RESULTS: The prevalence of frequent fighting was highest in Zambia (7.7%) and lowest in Myanmar (0.5%). Gender differences were found in 20 countries, with boys being more likely to report frequent fighting than girls. The prevalence of frequent fighting varied by region (F(3,22) = 4.78, P = .01), with the Eastern Mediterranean having a significantly higher prevalence of frequent fighting than Asia (P < .01). CONCLUSION: The prevalence of frequent fighting varies by gender in many countries and varies across world regions. More cross-national research is needed to better understand the sociocultural context of frequent fighting and to inform youth violence prevention efforts.

Correlates of suicide ideation and attempt among youth living in the slums of Kampala.

While suicidal behavior is recognized as a growing public health problem world-wide, little is known about the prevalence and risk factors for suicidal behaviors among street and slum youth in Africa, and in Uganda, specifically. The number of youth who live on the streets and in the slums of Kampala appears to be growing rapidly, but their mental health needs have not been documented, which has hampered resource allocation and service implementation. This study of youth, ages 14-24, was conducted in May and June of 2011, to assess the prevalence and correlates of suicidal behavior. Participants (N = 457) were recruited for a 30-minute interviewer-administered survey through eight drop-in centers operated by the Uganda Youth Development Link for youth in need of services. Bivariate and multivariate logistic regression analyses were computed to determine associations between psychosocial correlates and suicide ideation and suicide attempt. Reporting both parents deceased Adj.OR = 2.36; 95% CI: 1.23-4.52), parental neglect due to alcohol use (Adj.OR = 2.09; 95% CI: 1.16-3.77), trading sex for food, shelter or money (Adj.OR = 1.95; 95% CI: 1.09-3.51), sadnesss (Adj.OR = 2.42; 95% CI: 1.20-4.89), loneliness (Adj.OR = 2.67; 95% CI: 1.12-6.40) and expectations of dying prior to age 30 (Adj.OR = 2.54; 95% CI: 1.53-4.23) were significantly associated with suicide ideation in multivariate analyses. Parental neglect due to alcohol use (Adj.OR = 2.04; 95% CI: 1.11-3.76), sadness (Adj.OR = 2.42; 95% CI: 1.30-7.87), and expectations of dying prior to age 30 (Adj.OR = 2.18; 95% CI: 1.25-3.79) were significantly associated with suicide attempt in multivariate analyses. Given the dire circumstances of this vulnerable population, increased services and primary prevention efforts to address the risk factors for suicidal behavior are urgently needed.

Serious Violence Victimization and Perpetration among Youth Living in the Slums of Kampala, Uganda.

INTRODUCTION: Violence among youth is a major public health issue globally. Despite these concerns, youth violence surveillance and prevention research are either scarce or non-existent, particularly in developing regions, such as sub-Saharan Africa. The purpose of this study is to quantitatively determine the prevalence of violence involving weapons in a convenience sample of service-seeking youth in Kampala. Moreover, the study will seek to determine the overlap between violence victimization and perpetration among these youth and the potentially shared risk factors for these experiences. METHODS: We conducted this study of youth in May and June of 2011 to quantify and describe high-risk behaviors and exposures in a convenience sample (N=457) of urban youth, 14-24 years of age, living on the streets or in the slums and who were participating in a Uganda Youth Development Link drop-in center for disadvantaged street youth. We computed bivariate and multivariate logistic regression analyses to determine associations between psychosocial factors and violence victimization and perpetration. RESULTS: The overall prevalence of reporting violence victimization involving a weapon was 36%, and violence perpetration with a weapon was 19%. In terms of the overlap between victimization and perpetration, 16.6% of youth (11.6% of boys and 24.1% of girls) reported both. In multivariate analyses, parental neglect due to alcohol use (Adj.OR=2.28;95%CI: 1.12-4.62) and sadness (Adj.OR=4.36 ;95%CI: 1.81-10.53) were the statistically significant correlates of victimization only. Reporting hunger (Adj.OR=2.87 ;95%CI:1.30-6.33), any drunkenness (Adj.OR=2.35 ;95%CI:1.12-4.92) and any drug use (Adj.OR=3.02 ;95%CI:1.16-7.82) were significantly associated with both perpetration and victimization. CONCLUSION: The findings underscore the differential experiences associated with victimization and perpetration of violence involving weapons among these vulnerable youth. In particular, reporting hunger, drunkenness and drug use were specifically associated with victimization and perpetration. These are all modifiable risk factors that can be prevented. It is clear that these vulnerable youth are in need of additional services and guidance to ameliorate their adverse childhood experiences, current health risk behaviors and disadvantaged living context.

The investigation of demographic characteristics and the health-related quality of life in patients with diabetic foot ulcers at first presentation.

To investigate the characteristics of diabetic patients with foot ulcers, their health-related quality of life (HRQoL), and the link between them. The study population included 131 consecutive patients presenting in a diabetic foot clinic with a new foot ulcer between December 1, 2011, and May 1, 2012. The authors collected sociodemographic data, foot and ulcer characteristics using the Wagner Grade, and HRQoL (using the SF-36 Scale) information; 54.2% of the patients were in Wagner 2 or Wagner 3 categories. In all the 8 SF-36 subscales and in the SF-36 summary scales, the patients with diabetic foot ulcer had significantly poorer HRQoL than the general population in China (P < .01). Their Wagner Grade had negative correlation with all the SF-36 subscales and the summary scales (P < .05). In conclusion, new diabetic foot ulcers were already in poor condition when patients first visited the diabetic foot clinic. Concomitantly, patients had worse HRQoL compared with the general population. More effective interventions are needed to improve their self-care level and HRQoL.