bluuebunny/crossref_metadata_2025 huggingface dataset:
The feasibility and impact of deploying a four-tests panel at antenatal care in primary health care facilities of a developing country, Kenya
Authors: Ochwoto Missiani , Matiang’i Micah , Machuki Onchieku Noah , Ndoria Simon , Matoke Lydia , Otinga Maureen , Zablon Jeremiah , Mathebula Evans , Matoke-Muhia Damaris
Published: November 2024

Introduction

Contracting HIV, syphilis, hepatitis B virus (HBV), and malaria during pregnancy significantly affects the health of the woman, the pregnancy, and the unborn child. The World Health Organization (WHO) recommends testing pregnant women for these infections to achieve triple elimination of mother-to-child transmissions. However, this goal has not been fully realized in low- to medium-income countries, primarily due to segmented testing practices. This study aimed to investigate the effect of introducing a four-tests panel on the quality of antenatal care (ANC) among pregnant women attending selected Primary Health Care facilities in Kenya.

Methods

Using a multi-design approach, we analyzed ANC medical records from 577 pregnant women attending eight facilities across four different counties. Blood from the women fingerpick was tested for HIV, Syphilis Hepatitis B Virus and Malaria using the four-tests panel and the results compared to those in the medical records.

Results

Out of 577 ANC women, only 8.3% had test results for all four infections available. The majority of the mothers had been tested for syphilis (93.7%), HIV (78.5%), and malaria (62.6%), only 19.5% had been tested for HBV. Testing the women using the 4-tests panel yielded positivity rates of 6.9% for HIV, 0.9% for syphilis, 1.9% for malaria, and 1.1% for HBV. Among those without previous test results, the positivity rate was 2.8% for syphilis, 13.8% for HIV (with 10.6% testing positive for recent p24 infections, F = 24.876, p < 0.001), 2.3% for malaria, and 4.5% for HBV, with 83.3% of these individuals having no prior test results. The mean positivity rate of those tested using the 4-tests panel compared to segmented single tests was significantly different. The panel was cost-effective and user-friendly for healthcare workers, and in facilities facing staff shortages, it reduced turnaround time and workloads by half. The use of the panel also improved the profiling of ANC mothers and enhanced data management for the four infections by 91.7%.

Conclusion

Adopting the 4-tests panel has the potential to improve test result outputs, enhance the quality-of-service delivery, and contribute significantly to the achievement of triple elimination goals.
The practice, nature, and impact of nurse-led type 2 diabetic foot prevention services and educational programs in Sub-Saharan Africa: a scoping review
Authors: Sajith Rincy , Ackers Louise , Ackers-Johnson Simona , Parker Daniel J. , Stephens Melanie
Published: November 2024

Objective

The objective of this study is to assess the scope of existing practice, nature, and impact of nurse-led type 2 diabetic foot prevention services and educational programmes in Sub-Saharan Africa (SSA).

Introduction

Type 2 diabetes mellitus (T2DM) in SSA imposes a heavy burden on current healthcare services. Complications such as foot ulcers can have a significant impact on patient care and healthcare resources. It is imperative to identify patients at risk of developing diabetic foot complications and empower them with diabetes self-management education and support from specialised foot clinics is crucial. However, the availability of such programmes and services in SSA is limited.

Inclusion criteria

Studies of nurse-led diabetic foot prevention services and/or educational programmes in low- or middle-income countries in SSA for adults with T2DM, written in English, between August 2013 and March 2024 were considered.

Methods

Following the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting and reporting scoping reviews, searches were conducted on four electronic databases (CINAHL, ProQuest, MEDLINE, and Scopus) and Google Scholar. The titles and abstracts were scrutinised. All eligible papers were retrieved and screened for full text.

Results

The review included ten studies (across 14 papers), all of which focused on nurse-led diabetes self-management education (DSME) programmes in SSA. There are no specific educational programmes or services led by nurses that focus exclusively on diabetic foot prevention. The analysis highlighted the components of successful nurse-led DSMEs that led to positive glycaemic control and self-care behaviors, including the focus on behavior change and the DSME should be co-produced with service users. The theoretical aspects of the DSME include evidence-based, structured, interactive, culturally and linguistically appropriate group-based activities. The DSME should be delivered over a period of several weeks, and sessions should last between 1.5 and 2 h. Barriers to delivery and participation include the rainy season, stockouts, time and resources needed, and a DSME that meets diverse levels of literacy and education.

Conclusion

There is a heightened need for nurse-led, co-produced, culturally congruent, frugal, and sustainable education interventions or programmes. There is also a need for diabetic foot screening and foot ulcer prevention services that can operate sustainably alongside these educational interventions through task-shifted, simple, and frugal initiatives.
Knowledge, attitude, and practice toward family-based treatment among parents of children with leukemia
Authors: Yang Xue , Long Shihua , Lu Feng , Ma Zhigui
Published: November 2024

Background

To investigate the KAP toward family-based treatment among parents of children with leukemia.

Methods

This cross-sectional study was conducted between December, 2022 and July, 2023 in the Pediatric hematologic oncology department of West China Second University Hospital, Sichuan University. The study population consisted of parents of children diagnosed with leukemia. Their demographic characteristics and KAP toward family-based treatment for leukemia were collected by self-administered questionnaires.

Results

A total of 482 parents participated, including 379 (78.63%) females, with an average age of 35.83 ± 6.40 years. The mean scores for KAP were 7.28 ± 1.13 (possible range: 0–10), 37.82 ± 4.38 (possible range: 9–45), and 40.09 ± 4.17 (possible range: 9–45), respectively. Multivariate logistic regression analysis indicated that the knowledge score (OR = 1.48, 95% CI: [1.08–2.05], P = 0.016), attitude score (OR = 1.31, 95% CI: [1.18–1.46], P < 0.001), education of junior college and above (OR = 11.28, 95% CI: [1.94–65.65], P = 0.007), and monthly income of 5,000–10,000 Yuan (OR = 10.88, 95% CI: [1.15–102.98], P = 0.037) were independently associated with a proactive practice. Structural equation modeling (SEM) results highlighted the significant direct impact of knowledge on attitude (β = 0.72, P = 0.002), attitude on practice (β = 0.57, P < 0.001), and knowledge on practice (β = 0.81, P < 0.001).

Conclusion

Parents of children with leukemia demonstrated inadequate knowledge, but positive attitudes and proactive practices toward family-based treatment for leukemia. Future interventions should not only prioritize augmenting parental knowledge through educational initiatives but also focus on fostering positive attitudes and providing support for both knowledge and practical parenting skills to facilitate proactive involvement.
Early childhood psychopathology and parental mental health during the COVID-19 pandemic: the effects of pandemic restrictions on 0- to 3-year-olds
Authors: Keller K. , Taubner S. , Georg A. K.
Published: November 2024

Introduction

The COVID-19 pandemic placed many restrictions on families and affected the mental health of parents and children. The present study examines how the restrictions imposed during the pandemic and parental mental health affect early childhood psychopathology.

Method

From September 2019 to December 2021, the Outpatient Department of Family Therapy at the Institute for Psychosocial Prevention, Heidelberg surveyed a clinical sample of 249 families who sought consultation for early childhood psychopathology. Early childhood psychopathology in children aged 0–3 years was assessed using the German Questionnaire for Crying, Feeding and Sleeping and the German version of the Child Behavior Checklist 1½–5. The Patient Health Questionnaire provided information on parental depressiveness and generalized anxiety. At the same time, the Stringency Index as part of the Oxford Coronavirus Government Response Tracker indicated the severity of COVID restrictions in Germany.

Results

Dependent comparisons did not reveal significant differences in the infants' regulatory problems (n = 165, mean age = 8 months) during the lockdown compared to reopening phases. However, older children (n = 84, mean age = 25 months) exhibited more behavioral problems during lockdowns compared to reopening phases (Cohen's d = 0.32, p = .04). Subsequent regression analyses confirmed a slight increase in behavioral problems only among children aged 1.5–3 years (p = .047, R2 = .08), but did not indicate any increase in parental mental health problems when more restrictions were in place. However, parental depressiveness had a strong independent effect on early childhood psychopathology. A hierarchical regression analysis indicated that psychopathology in children aged 1.5–3 years is best explained by female child gender, high parental depressiveness, and more severe restrictions during the COVID-19 pandemic (p < .001, R2 = .17) whereas early childhood psychopathology in infants aged 0-1.5 years is more prevalent in younger and male children with parents experiencing higher levels of depressiveness (p < .001, R2 = .26).

Discussion

The study found no increase in infant regulatory disorders or parental depressiveness and generalized anxiety during the pandemic. However, older children exhibited more behavioral problems during more severe pandemic restrictions. The study supports the provision of parent-child support during crises and beyond, as early childhood psychopathology was strongly associated with parental depressiveness.
The role of optometry in healthcare for visually impaired older adult populations: a Swiss case study
Authors: Seifert Alexander , Nosch Daniela S.
Published: November 2024

Background

Visual impairment (VI) is common among older adults aged 70 years and older, and its prevalence increases with advancing age. The optometry profession may play an important role in a patient-centred health system that incorporates medical and psychosocial aspects by working closely with low vision counselling services (LVCS). This paper investigates the current level of cooperation between optometry and LVCS by analysing the referral practice of optometrists to LVCS for the older population with VI, based on the PROVIAGE study.

Methods

A national, telephone-based survey of individuals aged ≥70 years and an online survey of professionals in ophthalmology, optometry and LVCS was conducted in 2022 across Switzerland.

Results

The responses of 154 individuals with VI and 272 professionals (123 ophthalmologists, 126 optometrists and 23 staff of low vision rehabilitation consulting centres) were analysed. Among the respondents with age-related VI, 33.1% stated that they were aware of LVCS. Of these, however, only 11.7% reported that they had visited such centres during the last five years. Sixty-eight percent of respondents attended the ophthalmologist, but only 1.3% went to the optometrist for vision-related problems. Among ophthalmologists, 95.9% indicated that they had referred patients to LVCS, whereas only 58.8% of optometrists had done so.

Conclusions

The results of this study highlighted the relationship between the different clinician referrals, patient needs, and potential barriers preventing referrals towards older adults in Switzerland. A stronger cooperation between professions in the care network will enhance vision care for the ageing population without the need for additional infrastructure.
Psychological and sociodemographic factors associated with hypoactive sexual desire in Ecuadorian women
Authors: Pérez-Vega Doris , Subía-Arellano Andrés , Buele Jorge
Published: November 2024

Introduction

Human sexuality is a multifaceted process, and sexual desire plays a central role in the triphasic model of the sexual response cycle, as proposed by Helen Singer Kaplan.

Methods

In this cross-sectional correlational study, we examined the relationship between various sociodemographic factors, such as age and motherhood, and sexual variables, including erotophobia, erotophilia, homophobia, and unconventional sex, with hypoactive sexual desire in women from Quito, Ecuador. The study sample comprised 421 women between the ages of 18 and 50, who were administered the Revised Sexual Opinion Survey and the Inhibited Sexual Desire Scale to assess their sexual attitudes and levels of desire.

Results

The findings revealed that age (F = 7.13, p < 0.001) and motherhood (F = 13.72, p < 0.001) had a significant impact on inhibited sexual desire. Furthermore, significant correlations were observed between inhibited sexual desire and age (r = 0.16, p < 0.001), motherhood (r = 0.18, p < 0.001), erotophobia (r = 0.19, p < 0.001), erotophilia (r = −0.21, p < 0.001), and homophobia (r = −0.18, p < 0.001).

Discussion

These results suggest that women who are older, mothers, or have higher levels of erotophobia are more likely to experience hypoactive sexual desire. In contrast, higher levels of erotophilia and homophobia were inversely related to hypoactive sexual desire. This contributes to a deeper understanding of how different personal and sexual attitudes influence sexual desire in Ecuadorian women.
An Investigation of the Ventilation Systems of Whole-Indoor Urban Substations
Authors: Xu Dakun , Zhang Lei , Wang Hao , Wang Kangyue , Zhang Wenke
Published: November 2024

The electricity load increases significantly with the development of the economy, which raises the issue of scarce land resources; therefore, the application of whole-indoor urban substations has become more and more extensive. However, both the closed environment of indoor substations and their unreasonable ventilation systems mean that the heat dissipation of the equipment cannot be discharged in time. In this study, a combination of natural and mechanical ventilation systems is developed to solve the problem of high indoor temperatures, and corresponding studies are conducted via both numerical simulation and experimental research. Firstly, the ventilation and heat dissipation problem of the whole-indoor urban substation was investigated using numerical simulation technology, and then the feasibility of the ventilation system was determined. Secondly, the experimental platform (including the heat dissipation equipment and ventilation system) was set up, the heat dissipation of the reactor room was analyzed, and the system was tested experimentally. Afterward, the noise generated by the experimental platform was measured and predicted. Finally, via the numerical simulation analysis, it was found that the ventilation effect would be improved regardless of the heat dissipation and that reducing the outdoor temperature or increasing the ventilation volume would reduce the indoor temperature, which could be controlled within 40 °C. The results of this study provide a reference basis and technical guidance for the engineering projects of ventilation systems for indoor substations, which can effectively solve the problem of excessive indoor temperature caused by heat dissipation from substation equipment while providing a favorable guarantee for sustainable operation of the substation.
Knowledge Sharing as a Safety Catalyst: The Dimensions of Safety Attitudes in Enhancing Sports Stadium Construction Workers’ Emergency Response
Authors: Hou Yuyang , Mi Chengze , Huang Qian
Published: November 2024

As the scale and complexity of sports stadium construction projects around the world continue to grow, the safety risks faced by workers are becoming increasingly severe. In particular, the emergency response capabilities of workers have become a key factor affecting construction safety when dealing with unexpected accidents. However, there is still a relative lack of systematic exploration of the factors affecting the emergency response capabilities of sports stadium construction workers in existing research, especially the complex impact of multidimensional safety attitudes and knowledge sharing on this ability. This study focuses on the intersection of safety management and organizational behavior, analyzing how the safety awareness, safety behavior, safety culture, and safety responsibility of stadium construction workers affect their emergency response capabilities. It further explores the mediating role of knowledge sharing in this process. Through structural equation model (SEM) analysis of survey data, this study found that although safety culture did not directly affect emergency response capabilities, it had a significant indirect effect through knowledge sharing. Safety awareness did not significantly improve emergency response capabilities through knowledge sharing. In contrast, safety behavior and safety responsibility both had a significant direct and indirect impact on workers’ emergency response capabilities. This study not only provides a new theoretical framework for improving the emergency response capabilities of construction workers, but also reveals the potential value of knowledge sharing as a safety management tool. The research results have certain guiding significance for the future safety management policy design of large and complex construction projects such as sports stadiums. It emphasizes the synergistic effect of promoting knowledge sharing and comprehensively improving safety attitudes in emergency response, which will provide a scientific basis for more efficient construction safety management.
Adjuvant Radiation Therapy in Macroscopic Regional Nodal Melanoma
Authors: Fogarty Gerald B.
Published: November 2024

Adjuvant radiation therapy (ART) for macroscopic regional nodal cutaneous melanoma has evolved. A significant step was the discovery of targeted therapies, particularly towards V600E-mutated melanoma, and immunotherapy under its different kinds. Prior to this, the defining trial was the Australia and New Zealand Melanoma Trials Group (ANZMTG) 01.02/Trans-Tasman Radiation Oncology Group (TROG) 02.01 phase III trial that showed that ART using three-dimensional conformal radiotherapy (3DCRT) decreased in-field recurrence by 50% (48 Gray (Gy) in 20 fractions). After the advent of systemic therapies, a trial of the combination targeted therapy of dabrafenib plus trametinib toward BRAF V600-mutant nodal cutaneous melanoma showed that all 35 patients achieved a pathological response. Radiotherapy (RT) was found to be safe to give with concurrent combination therapy. A retrospective immunotherapy study found that in 71 patients that received ART after a first recurrence, further in-field recurrence significantly decreased (p = 0.01). For those tumours that do recur in-field, there are now competing therapies like Talimogene laherparepvec or T-VEC. Generally, ART is now used at the first recurrence. The challenge now is to find which melanomas are truly radiosensitive if ART is to have any future role in this scenario.
Study on the Resonance Characteristics and Active Damping Suppression Strategies of Multi-Inverter Grid-Connected Systems Under Weak Grid Conditions
Authors: Hou Tianhao , Jiang Yunhao , Cai Zishuo
Published: November 2024

When a multi-inverter grid-connected system is influenced by the parasitic parameters of LCL-type inverters and the impedance of the connected system’s lines, its resonance characteristics become more complex and difficult to predict. For LCL-type multi-inverter grid-connected systems, a mathematical model that considers the effects of parasitic parameters and line impedance has been established, leading to the derivation of the system’s Norton equivalent circuit and a general expression for the inverter output current. The resonance characteristics of multi-inverter grid-connected systems composed of inverters with the same and different parameters were analyzed under the influence of parasitic parameters and line impedance. To suppress the resonance in multi-inverter grid-connected systems and address the issue of traditional PI control not meeting grid requirements for LCL-type grid-connected inverters, a strategy combining superhelical sliding mode control with active damping was adopted. To verify the practical performance of the adopted resonance suppression strategy in complex environments, a grid-connected system model containing two LCL-type inverters was constructed using the MATLAB/Simulink software platform, followed by simulation analysis. The simulation results strongly confirm the feasibility and effectiveness of the adopted resonance suppression strategy, considering the effects of parasitic parameters and line impedance. This strategy demonstrates significant suppression effects in addressing resonance issues caused by parasitic parameters and line impedance, effectively enhancing the quality of grid-connected electrical energy.
Prognostic Significance of DSCC1, a Biomarker Associated with Aggressive Features of Breast Cancer
Authors: Aljohani Abrar I.
Published: November 2024

Background and Objectives: Invasive breast cancer (BC) was traditionally investigated visually, and no technique could identify the key molecular drivers of patient survival. However, essential molecular drivers of invasive BC have now been discovered using innovative genomic, transcriptomic, and proteomic methodologies. Nevertheless, few evaluations of the prognostic factors of BC in Saudi Arabia have been performed. Evaluating the biomarkers associated with the development of early-stage BC could help determine the risk of metastasis and guide treatment decisions. In a previous study, using large BC cohorts and artificial neural network techniques, DNA replication and sister chromatid cohesion 1 (DSCC1) was found to be one of the principal genes in invasive BC samples. To date, no studies have addressed the prognostic significance of DSCC1 in invasive BC and its association with aggressive tumor behavior. This research aimed to address this gap. Materials and Methods: The association of clinicopathological features and patient outcomes with DSCC1 expression at the mRNA level was assessed using the Molecular Taxonomy Breast Cancer International Consortium (METABRIC; n = 1980) and The Cancer Genome Atlas (TCGA; n = 854) cohorts. DSCC1 was also evaluated at the protein level using immunohistochemistry on samples from invasive BC patients (n = 100) presenting to King Abdul Aziz Specialist Hospital in Saudi Arabia. The association of clinicopathological parameters (including patient age, tumor grade, tumor size, and patient outcome) with protein level was also evaluated. Results: In both METABRIC and TCGA cohorts, high expression of DSCC1 was significantly associated with high histological grade, large tumor size, lymphovascular invasion positivity, and hormone receptor negativity (all p < 0.001). A high DSCC1 mRNA level was associated with poor outcomes (p < 0.001 for METABRIC, p = 0.23 for TCGA). At the protein level, high DSCC1 expression was associated with high histological grade (p = 0.001), lymph node presence (p = 0.008), hormone receptor negativity (p = 0.005), high Ki67 expression (p = 0.036), and shorter survival (p = 0.008). Conclusions: This study confirmed the prognostic significance of DSCC1 in invasive BC patients. DSCC1 could be a therapeutic target in BC cases with poor outcomes.
The Growing Phenomenon of ‘Frozen’ Virus Genome Sequences and Their Likely Origin in Research Facility Escapes
Authors: Massey Steven E.
Published: November 2024

‘Frozen’ virus genome sequences are sampled from outbreaks and have unusually low sequence divergence when compared to genome sequences from historical strains. A growing number of ‘frozen’ virus genome sequences are being reported as virus genome sequencing becomes more common. Examples of ‘frozen’ sequences include the 1977 H1N1 ‘Russian’ flu; Venezuelan Equine Encephalitis Virus from Venezuela and Colombia in 1995; E71 sequences from a Hand, Foot and Mouth outbreak in 2007–2009 in China; and a polio strain isolated in 2014 from Anhui, China. The origin of these ‘frozen’ sequences has been attributed to escapes from research facilities and often appears to be associated with vaccine work. Consequently, a new paradigm for pathogen emergence appears in operation, that involves laboratory research or vaccine production which utilizes ‘live’ virus isolates of historical strains. The accidental release and re-emergence of such strains are straightforward to detect from their genome sequences and should spur the routine sequencing and publication of all known pathogenic viral strains undergoing experimentation, or being used for vaccine manufacture, in order to facilitate tracing. However, it is noted that novel pathogenic viruses accidentally released into the population from research facilities are harder to detect if their sequence has first not been made public, which should prompt the routine sequencing and reporting of all novel pathogenic viruses before experimentation.
The Role of Exogenous Ketones in Road Cycling: Evidence, Mechanisms, and Performance Claims
Authors: Sitko Sebastian
Published: November 2024

Background: Ketone body supplementation has emerged as a potential ergogenic aid in cycling. Exogenous ketones, primarily in the form of beta-hydroxybutyrate, offer an alternative fuel source, bypassing the need for strict ketogenic diets. However, the science surrounding their efficacy remains complex, with mixed field findings and unexplored mechanisms. Methods: A narrative review of the current literature was conducted, synthesizing studies on the metabolic and cognitive effects of ketone bodies in cycling. The review included an examination of human and mechanistic studies, along with emerging hypotheses on ketone bodies and their role in modulating red blood cell production and recovery processes. Results: Ketone body supplementation can theoretically spare glycogen, reduce muscle protein breakdown, enhance fat oxidation, and improve recovery by mitigating oxidative stress and inflammation. Additionally, ketone bodies may support cognitive function, reducing perceived mental fatigue. Preliminary evidence also suggests a potential role in modulating erythropoietin levels through histone acetylation, though further research is needed to establish its impact on oxygen delivery. Despite the theoretical potential, the practical assessment of field studies shows disappointing effects on performance from ketone body supplementation. Conclusions: While ketone bodies offer several potential benefits for cyclists, the variability in individual responses, lack of long-term data, and inconsistent findings in performance studies highlight the need for further research. Optimizing dosage, timing, and understanding the broader implications of ketone body supplementation will be crucial for their practical application in cycling.
The Lived Experience of Divorcing Evangelicals and How Integrated, Empathetic, and Restorative Practice Can Disclose God to Them
Authors: Hornby Robert
Published: November 2024

Approximately seven in twenty marriages end in divorce in the UK, causing anxiety, depression, and a lasting impact on children. British evangelicals may fare better than average but are not immune from divorce. Despite a rich body of theological literature offering perspectives on divorce contributed by British evangelical scholars, there have been no related empirical studies to examine the lived experience of divorced evangelicals or the pastoral practitioners who support them. My study captures this missing empirical data, finding that evangelical divorce is a life-changing trauma that church practices sometimes compound. In contrast, those who reported integrated, empathetic, and restorative practices in their church or on the Restored Lives course say they were better able to cope, heal, and find hope. Irrespective of the pastoral environment, God was reported to act with compassion. The study employed mixed qualitative methods to capture the empirical data, which were analyzed and brought into dialog with relevant evangelical academic theology and documented practice. I concluded that in the context of complex connections and disconnections between the evangelical domains of theory and practice, integrated, empathetic, and restorative approaches toward the divorced are possible, effective, and disclose a God of grace.
Investigating the Impact of Innovation Policies and Innovation Environment on Regional Innovation Capacity in China
Authors: Li Chengzhao , Wang Zongjun
Published: November 2024

Regional technological innovation serves as a key pillar for achieving high-level self-reliance and self-strengthening, a fundamental requirement for promoting balanced regional development, and a vital aspect of implementing the innovation-driven development strategy. We examine the impact of innovation policies on corporate innovation activities and the importance of the innovation environment in enhancing innovation capacity. By analyzing the implementation of innovation policies in three provinces in Central China from 2018 to 2022, this study introduces two indicators—policy intensity and policy volume—to assess the level of government policy support. The findings are as follows: First, local government innovation policies exert a significant positive impact on corporate innovation activities, with particularly strong effects observed in the implementation of R&D subsidies. Second, the implementation of regional innovation policies enhances regional innovation capacity by promoting increased R&D investment by firms. Third, the innovation environment moderates the influence of regional innovation policies on corporate R&D investment, amplifying the effect of R&D investment on regional innovation capacity. In summary, when formulating innovation policies, governments should consider the unique needs of different industries, regions, and enterprises, adopting flexible and diverse policy measures to optimize the innovation environment and accelerate the nation’s technological innovation development.
Unlocking Market Transformation Through Circular Procurement: The Amsterdam Metropolitan Area Experience
Authors: Cramer Jacqueline
Published: November 2024

This paper hypothesizes that knowledge sharing and collaboration among procurers can positively impact markets for circular products and services. To test this hypothesis, this paper evaluates an urban-scale experiment conducted in the Amsterdam Metropolitan Area (AMA) from 2015 to 2024, involving 48 organizations. The circular procurement experiment was analyzed as a transition process facilitated by intermediaries. Detailed documentation was collected, including meeting minutes and individual interviews. No previous empirical studies cover a nine-year period and address all three levels: the micro-level of individual organizations, the meso-level (supply chain), and the macro-level (national), while also describing the transition process in detail. The qualitative analysis reveals the limitations of achieving significant impact by individual procurers, as well as the potential to fundamentally transform product chains at the meso-level (supply chain) and the macro-level (national) through a collective approach. The findings include a systematic overview of the scope of circular procurement, as well as the preconditions and enablers at the micro-, meso-, and macro-levels necessary to foster innovation and markets for circular products and services. Only a limited number of barriers are key to accelerating circular procurement. Based on the findings, a structured, practical guide for implementing circular procurement is provided.
Rainfall-Induced Landslides: Influencing, Modelling and Hazard Assessment
Authors: Zhang Qingzhao , Shen Danyi
Published: November 2024

Landslide hazards pose a great threat to people’s lives and the safety of their property all over the world, especially in mountainous areas [...]
The effectiveness of non-drug correction of chronic periodontitis in patients who have undergone a new coronavirus infection on the severity of oxidative stress
Authors:   Federal State Budgetary Institution of Additional Professional Education «Central State Medical Academy» of the Office of the President of the Russian Federation, Romashchenko A.S.
Published: November 2024

Purpose of the study. To evaluate the effect of the use of non-drug correction of chronic periodontitis in patients who have undergone a new coronavirus infection on the severity of oxidative stress.
Material and methods. A total of 156 patients with CP aged 26 to 63 years participated in the study (the average age was 44.7±6.15 years).
When dividing patients by gender, the majority were men — 86 patients (55.1 %). 126 patients out of 156 examined had a history of COVID-19 with a prescription of 1 to 6 months. At the first stage, by stratified randomization, all patients (156 patients), depending on the presence of a history of NCI, were divided into two unequal groups: 126 patients with CP who underwent COVID-19, and 30 patients with CP who did not have
NCI. At the second stage, 126 patients with CP who underwent COVID-19 were divided into 4 groups using simple fixed randomization: a control
group, two comparison groups and a main one. The control group received standard periodontal therapy (SPT), regulated by clinical guidelines.
In comparison groups 1 and 2, SPT was supplemented, respectively, with applications of liposomal gel with DHA and NILI. In the main group, a
complex of liposomal gel and NILI was used as an adjunct to SPT.
Results. The SPT included professional oral hygiene with ultrasonic scalers and curettes of the Piezon Master 700 device (EMS, Switzerland).
The removal of dental deposits was carried out using air-abrasive technology Aig-Flow (EMS, Switzerland). Individual oral hygiene was trained
and monitored.
Conclusion. The factors contributing to the development of inflammatory periodontal diseases, namely carious cavities, wedge-shaped defects, overhanging edges of fillings, were also eliminated.
Motor profile dynamics using biofeedback virtual reality technologies for children with autism spectrum disorders
Authors:   Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation, Samara, Russia, Yashkov A.V. , Shishkina A.A. ,   Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation, Samara, Russia, Martynova A.V. ,   Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation, Samara, Russia
Published: November 2024

Purpose of the study. The WHO estimates that autism spectrum disorder (ASD) affects one in 160 children. in Russia, the ratio of the number of children with ASD to the total child population (0–18 years) is 1:961, which reflects the high social significance of the disease [1]. To study the impact of biofeedback virtual reality rehabilitation technology on ReviMotion on motor
profile dynamics in children with ASD.
Materials and methods. The study included 11 children aged 4–7 years with diagnoses: autism, autistic behavior, delayed psychospeech development. To determine the severity of the symptoms of the disease, the Wexler test was used [2]. All children, before and after the course of classes, were tested according to the method of assessing the overall motor functionality of children with autism
spectrum disorder [3]. The rehabilitation complex included classes using a virtual reality simulator with biofeedback «ReviMotion.»
Results. The impact of biofeedback virtual reality technologies on the ReviMotion apparatus on the dynamics of the motor profile in children with ASD was studied. The study showed that this technique increases the level of adaptive functioning in children with
ASD and can be used in clinical practice. Analysis of the results of motor function testing after a course of classes revealed positive dynamics in 82 % of patients, expressed in improved coordination of movements, reduced anxiety, increased concentration and motivation for classes. Positive changes can be associated with the beneficial influence of the developed methodology, which
contributes to increasing the interest of children in exercise, simplifying the communication algorithm and adequate selection of exercise.
Conclusion. Thus, the proposed rehabilitation technique using virtual reality and biofeedback can be considered for use in clinical practice.
State of physiotherapeutic service in Irkutsk region: problems and prospects
Authors:   IGMAPO-branch of the Federal State Budgetary Educational Institution of Further Professional Education RMANPO of the Ministry of Health of Russia, Irkutsk, Russia, Abramovich S.G.
Published: November 2024

Purpose of the study. Introduction. Despite the active introduction of physical and rehabilitation medicine into practical healthcare, the specialty «Physiotherapy» has not lost its importance. Along with this, there are problems that complicate the development of the specialty: the absence and non-compliance with modern requirements of the regulatory framework, the unreasonably small representation
of physiotherapy in modern clinical guidelines. Resolving these issues is impossible without analyzing the current situation in the departments of the physiotherapeutic network, which will ensure the proper quality of medical care with a high level of safety and satisfaction of the consumer
of this medical service and expand the list of physiotherapy technologies in modern clinical recommendations. The purpose of the study is to study the performance indicators of physiotherapeutic units of medical and preventive organizations in the Irkutsk region to assess the
dynamics of their development and future prospects.
Material and methods. An analysis of data from state statistical annual reporting on the work of physiotherapeutic departments (PTD) and physiotherapeutic offices (FTK) of the Ministry of Health of the Irkutsk region, on the provision of physiotherapeutic medical care in
treatment and preventive organizations of the Irkutsk region in the period from 2017 to 2023 was carried out.
Results. The quantitative indicators of the work of FTO (FTC) employees were studied, the qualitative components of their activities were assessed, problems in the implementation of physiotherapeutic treatment were identified and ways to eliminate them were determined.
It has been shown that negative trends in the development of physical therapy continue: the material and technical base is deteriorating, the staff of doctors and nurses is being reduced, the level of qualifications of specialists is decreasing, and the coverage of patients with physical therapy methods is decreasing.
Conclusion. Despite the slight improvement in the quantitative parameters of the activities of physical therapy (FTK), the period of
stagnation in physical therapy continues. It is necessary to formulate a regulatory framework for the specialty and expand the role of physiotherapy in modern clinical guidelines. This is the basis for motivating employees of the physiotherapy service and the influx of young personnel.
Влияние силосов из злаково-бобовых культур на молочную продуктивность коров в начале лактации
Authors: Б.Г. ШАРИФЯНОВ , И.Ф. ЮМАГУЗИН , Ф.М. ШАГАЛИЕВ , А.А. БАШАРОВ , Х.Х. ТАГИРОВ , Э.М. АНДРИЯНОВА
Published: November 2024

Представлены результаты научно-хозяйственных опытов по оценке кормовой и продуктивной ценности силосов, заготовленных из злаково-бобовых смесей, при кормлении голштинизированных коров черно-пестрой породы. Как показали проведенные лабораторные исследования, силос из смеси козлятника восточного и костреца безостого имел преимущество над силосом из смеси люцерны и костреца безостого, превосходя его по содержанию обменной энергии на 1,03 МДж, или на 11,9%, по количеству сырого протеина — на 25 г/кг (или на 20,8%), сырого жира — на 10,7 г (или на 16,3%), сахара — на 6,9 г/кг (или на 39,2%),а концентрация сырой клетчатки в нем была ниже на 43 г/кг (или на 14,5%), в пересчете на сухое вещество корма. Использование в рационе дойных коров силоса из смеси нетрадиционной бобовой культуры — козлятника восточного с кострецом безостым взамен силоса из смеси люцерны с кострецом безостым позволяет увеличить молочную продуктивность животных и повысить содержание молочного белка и сахара на 9,9 и 5,3%, соответственно, за счет сбалансированного соотношения энергии, протеина и фракций структурных углеводов.

The paper presents the results of scientific and economic experiments aimed at assessing feed energy and nutritional value of silage. The analyzed fodder was made from grass-legume mixtures to feed black-and-white Holstein cows. The conducted laboratory studies showed the advantage of silage from a mixture of fodder galega and awnless brome over silage from a mixture of alfalfa and awnless brome. On a dry-matter basis the first fodder outran the second one in metabolizable energy by 1.03 MJ, or 11.9%, the content of crude protein by 25 g/kg (or 20.8%), crude fat by 10.7 g (or 16.3%), sugar by 6.9 g/kg (or 39.2%), the concentration of crude fiber in it was lower by 43 g/kg (or 14.5%). Using silage made from a mixture of non—traditional legume crops as fodder galega and awnless brome instead of silage from a mixture of alfalfa and awnless brome provides higher milk productivity of animals and more milk protein and sugar by 9.9 and 5.3%, respectively, due to a balanced ratio of energy, protein and fractions of structural carbohydrates.
ЭФФЕКТИВНОСТЬ ВКЛЮЧЕНИЯ ВИНАССЫ В РАЦИОН ВЫСОКОУДОЙНЫХ КОРОВ
Authors: З.К. МИЮЦ , А.С. АБРАМЯН
Published: November 2024

В связи с актуальностью снижения уровня концентратов в рационах коров и их замены эффективными дешевыми добавками, нами изучено использование винассы — побочного продукта производства дрожжей — в рационах лактирующих коров голштинской породы. Опыт проведен на 2 группах животных, по 25 голов в каждой, в течение 90 суток. При замене винассой по энергетической питательности 10% концентрированного корма в суточном рационе высокопродуктивных коров в конце раздоя — начале стабилизации лактации среднесуточный удой особей из опытной группы был выше на 7,17% по сравнению с контролем. При этом стоимость рациона оказалась ниже на 7,33%, а стоимость кормов, израсходованных на 1 кг молока, — ниже на 15,59%, что является основанием для включения винассы в рацион высокоудойных коров.

We conducted a study on the use of vinasse, a by-product of yeast production, in the diets of lactating Holstein cows. The experiment involved two groups of 25 cows each and lasted for 90 days. The results showed that replacing 10% of concentrated feed with vinasse in the daily ration of highly productive cows during the end of milking and the beginning of lactation stabilization phase led to a 7.17% increase in average daily milk yield compared to the control group. Additionally, the cost of the ration was 7.33% lower, and the cost of feed consumed per 1 kg of milk was 15.59% lower. These findings indicate the potential for the use of vinasse as a cost-effective feed additive for lactating cows.
Internacionalización: Estrategia competitiva para las PYMES de alimentos y bebidas en el mercado global
Authors: Mendoza-Yépez Yolanda-Alexandra
Published: November 2024

La internacionalización es una estrategia crucial para las pymes. El estudio en Ecuador analizó la internacionalización como estrategia competitiva para 400 MIPYMES de alimentos y bebidas en el mercado global, de las cuales 200 se dedican a la producción de alimentos y 120 a bebidas. La investigación, realizada bajo un enfoque cuantitativo descriptivo, incluyó encuestas con preguntas cualitativas y cuantitativas aplicadas a una muestra representativa seleccionada mediante muestreo aleatorio estratificado. Los datos recopilados fueron analizados utilizando técnicas estadísticas descriptivas, permitiendo obtener medidas de tendencia central, dispersión y correlaciones entre variables. El análisis destaca la importancia de la internacionalización para el desarrollo de las exportaciones, la sostenibilidad y el crecimiento a largo plazo de las MIPYMES, contribuyendo a su desarrollo y creación de empleo. Se concluye que es fundamental establecer un marco regulatorio que facilite la inserción de estas empresas en los mercados internacionales.
Gravedad de las lesiones e incapacidades en sobrevivientes de siniestros viales: un estudio retrospectivo
Authors: Flores-Sandí Grettchen
Published: November 2024

Las consecuencias clínicas a largo plazo en sobrevivientes de siniestros viales han sido poco investigadas; además, existen diferentes modelos, factores y normas en cada país para definir y evaluar la discapacidad resultante. Objetivo: Determinar la gravedad de las lesiones en sobrevivientes de siniestros viales, considerando las regiones corporales lesionadas, los niveles de gravedad de las lesiones inmediatas y los criterios de incapacidad temporal y permanente. Materiales y Métodos: Estudio retrospectivo, observacional y transversal de enfoque cuantitativo, basado en una muestra de 240 dictámenes medico legales de personas valoradas en la Clínica Médico Forense de Costa Rica durante 2019-2021. La muestra fue seleccionada con un margen de error del 5% y un nivel de confianza del 90%. Las variables se analizaron mediante estadística descriptiva, pruebas de independencia estadística y análisis de varianza. Resultados: El 70% de las víctimas fueron hombres, el 47% de las lesiones se produjeron en las extremidades, especialmente las inferiores. El 65,8% de las lesiones fueron de gravedad clínica menor según la escala abreviada de lesiones, y el 58,3% de las personas presentaron secuelas. De las lesiones que provocaron incapacidad permanente, el 75% ocurrieron en hombres, y en el 64,29% de los casos, el vehículo implicado fue una motocicleta. Se obtuvieron relaciones significativas entre la incapacidad permanente, el mecanismo del trauma y el tipo de secuelas. Los días de incapacidad temporal y la incapacidad permanente mostraron una correlación positiva y alta. Conclusiones: La mayoría de las lesiones fueron de gravedad clínica menor; sin embargo, un porcentaje significativo de personas presentó incapacidad permanente, alcanzando la categoría legal de lesiones gravísimas.
Estudio del Burnout y la satisfacción laboral en profesionales de la salud en un hospital en Ecuador
Authors: Martinez Jines Sulay Maricela , Chantong Cabrera Kevin Leonel , Naranjo Rios Edwin Leonidas , Parra Martinez Jazmin Corina
Published: November 2024

El estudio del burnout y la satisfacción laboral en profesionales de la salud es un tema de creciente relevancia, dado que ambos factores impactan en la calidad del servicio y el bienestar del personal. El objetivo es analizar el síndrome de Burnout y su efecto en la satisfacción laboral en los trabajadores de un Hospital en Ecuador. A través de Question Pro, se aplicó un cuestionario que aplicado a una muestra de 57 profesionales de la salud operativos. Los instrumentos de medición utilizados fueron el Burnout assessment tool (BAT 23) y la escala de satisfacción laboral es S20/23. Los resultados revelan que el 86,0% muestra niveles bajos de burnout, el 7,0% nivel medio y otro 7,0% nivel alto. En cambio, respecto a la satisfacción laboral, el 32,3% de los trabajadores se sienten insatisfechos con el ambiente físico del hospital. Sin embargo, en cuanto a la participación, un 34,4% se siente neutral, y en la supervisión, un 40,8%