bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 infection prevention and control for hospital workers in Indonesia
Authors: Modjo Robiana , Lestari Fatma , Tanjung Hendra , Kadir Abdul , Putra Riskiyana Sukandhi , Rahmadani Meilisa , Chaeruman Ali Syahrul , Lestari Fetrina , Sutanto Juliana
Published: January 2024

Introduction

The outbreak of SARS-CoV-2 in 2019 led to a global pandemic, posing unprecedented challenges to healthcare systems, particularly in hospitals.

Purpose

This study explores the intricacies of strategies employed for preventing and controlling COVID-19 in Indonesian hospitals, with a particular focus on the protocols, challenges, and solutions faced by healthcare professionals.

Methods

Using a cross-sectional analysis, we examined 27 hospitals and uncovered disparities in their preparedness levels. During our investigation, we observed the robust implementation of infection prevention measures, which encompassed stringent protocols, adequate ventilation, and proper use of personal protective equipment. However, shortcomings were identified in areas such as surveillance, mental health support, and patient management.

Discussion

This study underscores the importance of addressing these gaps, suggesting tailored interventions, and continuous training for healthcare staff. Effective leadership, positive team dynamics, and adherence to comprehensive policies emerge as pivotal factors. Hospitals should strengthen weak areas, ensure the ethical execution of emergency protocols, and integrate technology for tracking and improving standard operating procedures. By enhancing the knowledge and skills of healthcare workers and maintaining strong management practices, hospitals can optimize their efforts in COVID-19 prevention and control, thereby safeguarding the wellbeing of professionals, patients, and communities.
Access to eye care and support services among adults from minority ethnic communities living with visual impairment in the United Kingdom
Authors: Heinze Nikki , Jones Lee
Published: January 2024

Background

Despite an increased risk of certain eye conditions which can lead to visual impairment (V.I.), there is evidence of a greater delay to treatment-seeking among adults from minority ethnic communities (MEC). MEC adults may also be underrepresented on V.I. registers, within early intervention services, and among the beneficiaries of national V.I. charities. However, much of this evidence is outdated or anecdotal.

Methods

This secondary analysis of V.I. Lives survey data explored use of eye health and support services and mobility aids among a matched control sample of 77 MEC and 77 adults aged 18 and over from white communities (WC). Participants were matched on age, gender, UK region and urban/rural setting. Additional subgroup analysis was conducted for Asian (n = 46) and black participants (n = 22).

Results

There were no significant group differences in areas such as eye health service use, registration status, contact with charities, and level of practical support received. But MEC participants were significantly more likely than WC participants to have received direct payments from social services to cover their care needs, Χ2 (1, 154) = 8.27, p = 0.004, and to use apps on their mobile for mobility, Χ2 (1, 154) = 5.75, p = 0.017. In contrast, WC participants were significantly more likely to agree that they were getting the level of emotional support to get on with their life, U = 3,638, p = 0.010, to feel confident to ask their friends for support, U = 2,416, p = 0.040, and to have a guide dog for mobility, Χ2 (1, 154) = 3.62, p = 0.057, although the latter did not reach statistical significance. Within the MEC group, Asian participants were significantly more likely than black participants to use a long cane, Χ2 (1, 68) = 7.24, p = 0.007, but they were significantly less likely to agree that they had received the right level of support when they started to experience V.I., U = 236.5, p = 0.040.

Conclusion

The preliminary findings suggests that there is scope to increase support provided by V.I. charities and the V.I. register, although, contrary to existing evidence, there were no statistically significant differences in eye health service use, registration status and use of wider support services. Further research is required to confirm these findings and explore reasons for differences.
Evolution of in-hospital patient characteristics and predictors of death in the COVID-19 pandemic across four waves: are they moving targets with implications for patient care?
Authors: Trecarichi Enrico Maria , Olivadese Vincenzo , Davoli Chiara , Rotundo Salvatore , Serapide Francesca , Lionello Rosaria , Tassone Bruno , La Gamba Valentina , Fusco Paolo , Russo Alessandro , Borelli Massimo , Torti Carlo ,   the IDTM UMG COVID-19 Group
Published: January 2024

Objectives

The aim of this work was to study characteristics, outcomes and predictors of all-cause death in inpatients with SARS-CoV-2 infection across the pandemic waves in one large teaching hospital in Italy to optimize disease management.

Methods

All patients with SARS-CoV-2 infection admitted to our center from March 2020 to June 2022 were included in this retrospective observational cohort study. Both descriptive and regression tree analyses were applied to identify factors influencing all-cause mortality.

Results

527 patients were included in the study (65.3% with moderate and 34.7% with severe COVID-19). Significant evolutions of patient characteristics were found, and mortality increased in the last wave with respect to the third wave notwithstanding vaccination. Regression tree analysis showed that in-patients with severe COVID-19 had the greatest mortality across all waves, especially the older adults, while prognosis depended on the pandemic waves in patients with moderate COVID-19: during the first wave, dyspnea was the main predictor, while chronic kidney disease emerged as determinant factor afterwards.

Conclusion

Patients with severe COVID-19, especially the older adults during all waves, as well as those with moderate COVID-19 and concomitant chronic kidney disease during the most recent waves require more attention for monitoring and care. Therefore, our study drives attention towards the importance of co-morbidities and their clinical impact in patients with COVID-19 admitted to hospital, indicating that the healthcare system should adapt to the evolving features of the epidemic.
Reasons for non-participation of children and adolescents in a large-scale school-based mental health project
Authors: Baldofski Sabrina , Klemm Sarah-Lena , Kohls Elisabeth , Mueller Sophia M. E. , Bauer Stephanie , Becker Katja , Diestelkamp Silke , Eschenbeck Heike , Hiery Alisa , Kaess Michael , Koenig Julian , Lehner Laya , Moessner Markus , Thomasius Rainer , Rummel-Kluge Christine
Published: January 2024

Background

Non-participation in mental health studies is an under-explored but very important topic. Investigating reasons for non-participation holds promise for the planning of future study designs and recruitment strategies. This study aimed at investigating reasons for children and adolescents (C&A) not participating in a school-based mental health research project.

Methods

Data collection took place within the school-based recruitment of a large-scale multi-site project (“ProHEAD—Promoting Help-seeking using E-technology for Adolescents”) in Germany. Participants were N = 534 C&A aged ≥ 12 years attending secondary schools. The present cross-sectional study analyzed anonymous survey data of C&A who themselves or whose parents, respectively, did not provide written consent to participate in the mental health research project. The questionnaire consisted of 14 items covering potential reasons for non-participation, and four free text fields. Besides descriptive statistics, free text field answers were analyzed using qualitative content analysis.

Results

Students indicated an average of M = 2.94 (SD = 1.75) reasons for their non-participation in the project. In the descriptive analysis of indicated items, the three most frequently reported reasons for non-participation included students reporting to not be concerned by the topic “mental health” (n = 290, 54.3%), not having returned the consent form to the teacher (n = 175, 32.8%), and not having time for participation (n = 149, 27.9%). In the qualitative content analysis, the most frequently assigned categories were organizational reasons (n = 216, 57.1%), general disinterest in study participation (n = 139, 36.8%), and personal attitudes toward the topic “mental health” (n = 84, 22.2%), such as not being concerned with the topic “mental health” (n = 23, 6.1%) or being too concerned with the topic “mental health” (n = 16, 4.2%).

Conclusion

The study provides unique insights into reasons for C&A and their caregivers not participating in a large federally funded mental health research project. The results suggest that in order to increase participation rates, stigma should be reduced, parents as well as teachers should be involved where possible, and the use of incentives might be helpful. The study highlights the importance of assessing reasons for non-participation, especially in online intervention studies on mental health.
The effects of different types of Tai Chi exercise on anxiety and depression in older adults: a systematic review and network meta-analysis
Authors: Kuang Xiaoqin , Dong Yangjian , Song Long , Dong Lili , Chao Guodong , Zhang Xinxin , Yang Jiefu
Published: January 2024

Background

The body of evidence supporting the beneficial effects of Tai Chi in reducing anxiety and depressive symptoms in older adults is steadily increasing. Nonetheless, there remains a scarcity of studies directly comparing the clinical effectiveness of various Tai Chi exercises in addressing anxiety and depressive symptoms in older adults. Thus, this study aimed to systematically review and analyze the therapeutic efficacy of four types of Tai Chi interventions in enhancing anxiety and depressive symptoms in older adults.

Methods

During the period up to July 26, 2023, searches were conducted in the Web of Science, PubMed, the Cochrane Library, CNKI, and the Chinese Scientific Journal Database (VIP). The language scope encompassed both English and Chinese. Two independent reviewers conducted the literature review and data extraction. Review Manager 5.4 was employed for traditional meta-analysis and risk assessment, while version 15 of STATA software was used for generating evidence and funnel plots for network meta-analysis. This study was registered in PROSPERO number CRD 42023442270.

Result

In this analysis, a total of 20 studies were included, involving 1798 participants. The findings of the pairwise meta-analysis revealed that Tai Chi intervention was more effective than the control group in reducing anxiety (SMD: −1.19, 95% CI: −2.04, −0.34, p < 0.05) and depression (SMD: −0.65, 95% CI: −0.95, −0.65, p < 0.05) symptoms among older adults. The network meta-analysis specifically focused on anxiety symptoms and found that Yang-style Tai Chi (69.9%) had the most favorable outcome, followed by the 24-form Simplified Tai Chi (66.8%). In terms of depression symptoms, the Tai Chi Exercise Program (92.6%) had the highest performance, followed by Yang-style Tai Chi (77.9%).

Conclusion

The findings of this study imply that Tai Chi can have beneficial outcomes in the reduction of anxiety and depressive symptoms among older individuals. Specifically, when examining various forms of Tai Chi interventions, it was observed that Yang-style Tai Chi exhibited a greater efficacy in alleviating anxiety symptoms, whereas Tai Chi exercise programs demonstrated a higher effectiveness in improving depressive symptoms. Nonetheless, it is strongly advised that older adults select an exercise program that aligns with their interests and preferences, as this can enhance social integration and overall well-being.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023442270, identifier [CRD42023442270].
Inequalities in health outcomes of SARS-CoV-2 infection by migration status in Barcelona, Spain
Authors: Pérez-Muto Valeria , Bertran Maria Jesús , Barón-Miras Lourdes , Torá-Rocamora Isabel , Gualda-Gea Juan José , Vilella Anna
Published: January 2024

Background

Migrants are a vulnerable population at risk of worse health outcomes due to legal status, language barriers, and socioeconomic and cultural factors. Considering the conflicting literature on the subject, it is important to further explore the extent and nature of these inequalities.

Objective

The aim of this study is to compare health outcomes associated with SARS-CoV-2 infection between Spanish native and migrant population living in Barcelona.

Methods

Observational retrospective cohort study including all adult cases of SARS-CoV-2 infection who visited a tertiary hospital in Barcelona between the 1st March 2020 and the 31st March 2022. We established the following five health outcomes: the presence of symptomatology, hospitalisation, intensive care unit admission, use of mechanical ventilation, and in-hospital 30-day mortality (IHM). Using Spanish natives as a reference, Odds Ratios (OR) with 95% confidence interval (95%CI) were calculated for migrants by multivariate logistic regression and adjusted by sociodemographic and clinical factors.

Results

Of 11,589 patients (46.8% females), 3,914 were born outside of Spain, although 34.8% of them had legal citizenship. Most migrants were born in the Americas Region (20.3%), followed by other countries in Europe (17.2%). Migrants were younger than natives (median 43 [IQR 33–55] years vs. 65 [49–78] years) and had a higher socioeconomic privation index, less comorbidities, and fewer vaccine doses. Adjusted models showed migrants were more likely to report SARS-CoV-2 symptomatology with an adjusted OR of 1.36 (95%CI 1.20–1.54), and more likely to be hospitalised (OR 1.11 [IC95% 1.00–1.23], p < 0.05), but less likely to experience IHM (OR 0.67 [IC95% 0.47–0.93], p < 0.05).

Conclusion

Characteristics of migrant and native population differ greatly, which could be translated into different needs and health priorities. Native population had higher odds of IHM, but migrants were more likely to present to care symptomatic and to be hospitalised. This could suggest disparities in healthcare access for migrant population. More research on health disparities beyond SARS-CoV-2 in migrant populations is necessary to identify gaps in healthcare access and health literacy.
Association between multidrug-resistant bacteria and outcomes in intensive care unit patients: a non-interventional study
Authors: Martins Alessandro Pacheco Silveira , da Mata Camila Pacheco Silveira Martins , dos Santos Uener Ribeiro , de Araújo César Augusto , Leite Edna Marilea Meireiles , de Carvalho Luciana Debortoli , Vidigal Pedro Guatimosim , Vieira Cristina Dutra , dos Santos-Key Simone Gonçalves
Published: January 2024

Background

In intensive care units (ICUs), infections by multidrug-resistant (MDR) microorganisms should be monitored to prevent healthcare-associated infections (HAIs).

Methods

From 2018 to 2020, we investigated all medical records of patients admitted to the ICU of a public university hospital. All patients colonized/infected by MDR microorganisms and submitted to active surveillance cultures (ASCs) were included.

Results and discussion

Male patients prevailed, and 9.5% were positive for MDR bacteria. In-hospital deaths were statistically significant (p < 0.05) for older patients, patients with orotracheal tube use during previous and current hospitalization, and patients with high blood pressure, cardiac and pulmonary diseases, and chronic kidney disease. Carbapenem resistant Enterobacteriaceae was the most frequently resistance profile, followed by extended-spectrum beta-lactamase. The diagnosis or evolution of HAIs was statistically significant (p < 0.0001) for patients treated with meropenem and vancomycin, and in-hospital deaths occurred in 29.5% of patients using polypeptides while the use of macrolides reduced the odds for mortality. The BRADEN Scale demonstrated that 50% of the patients were at high risk of dying.

Conclusion

Patients hospitalized in the ICU, colonized or infected by MDR bacteria, using invasive medical devices, and with underlying medical conditions presented increased mortality rates. The prescription of meropenem and vancomycin should be carefully monitored once patients using these antimicrobials already have or develop an HAI.
Socioecological influencers of health-promoting lifestyles in Chinese: a preliminary survey using convenient samples
Authors: Huang Li , Li Hansen , Liu Haowei , Tian Haodong , Luo Haoyue , Wu Jinlong , Luo Yue , Peng Li , Guo Liya
Published: January 2024

Background

Healthy lifestyles are considered important means to reduce the burden of diseases. This cross-sectional study was conducted based on the Ecological Model of Health Behavior (EMHB) to analyze the factors associated with the health-promoting lifestyles of Chinese residents.

Methods

We carried out a cross-sectional investigation in July 2023. Our investigated factors included social-demographic characteristics (including sex, age, education level, employment status, marital status, personal monthly income, and daily behavioral habits [which were measured by a questionnaire)], health literacy [which was measured by the Chinese version of the Health Literacy Scale Short-Form scale (HLS-SF12)], and family health [which was measured by the Chinese version of the Short-Form of the Family Health Scale (FHS-SF)]. Our outcome was health promoting lifestyle, which was measured by a revised version of Health Promoting Lifestyle Profile-II (HPLP-IIR). Data were analyzed using stepwise regression.

Results

A total of 1,402 participants were enrolled. Higher scores of HLS-SF12 (β = 0.467), having regular exercise (β = 0.212), and regular physical examination (β = 0.088) were associated with better health-prompting lifestyles. However, older age (≥60 years) (β = −0.046), drinking (β = −0.066), and sleeping time (5–6 h/day) (β = −0.048) were associated lower levels of health-prompting lifestyles. Living with family (β = 0.077), FHS-SF (β = 0.104), and married (β = −0.077) were significant influencers. Unemployed (β = −0.048), receiving retirement pay (β = −0.053), and economic support provided by parents (β = 0.094) were associated with better health-prompting lifestyles. There were multiple influencing factors of the six dimensions of the HPLP-IIR. Our findings indicate that community residents with higher health literacy, better family health, and health-related behaviors tend to have better health-promoting lifestyles.

Conclusion

Our findings have confirmed the complex impacts of social-ecological factors on health-promoting lifestyles, which may help policy makers with health-promotion strategies making and also help researchers to control for confounding in study design.
Environmental pressures, tumor characteristics, and death rate in a female breast cancer cohort: a seven-years Bayesian survival analysis using cancer registry data from a contaminated area in Italy
Authors: Giannico Orazio Valerio , Carone Simona , Tanzarella Margherita , Galluzzo Claudia , Bruni Antonella , Lagravinese Giovanna Maria , Rashid Ivan , Bisceglia Lucia , Sardone Rodolfo , Addabbo Francesco , Minerba Sante , Mincuzzi Antonia
Published: January 2024

Introduction

In Taranto, Southern Italy, adverse impacts on the environment and human health due to industrial installations have been studied. In the literature, few associations have been reported between environmental factors and breast cancer mortality in women. The aim of this study was to investigate the relationships between residence in areas with high environmental pressures, female breast cancer characteristics, and death rate.

Methods

Data from the Taranto Cancer Registry were used, including all women with invasive breast cancer diagnosed between 01 January 2015 and 31 December 2020 and with follow-up to 31 December 2021. Bayesian mixed effects logistic and Cox regression models were fitted with the approach of integrated nested Laplace approximation, adjusting for patients and disease characteristics.

Results

A total of 10,445 person-years were observed. Variables associated with higher death rate were residence in the contaminated site of national interest (SIN) (HR 1.22, 95% CrI 1.01–1.48), pathological/clinical stage III (HR 2.77, 95% CrI 1.93–3.97) and IV (HR 17.05, 95% CrI 11.94–24.34), histological grade 3 (HR 2.50, 95% CrI 1.20–5.23), Ki-67 proliferation index of 21–50% (HR 1.42, 95% CrI 1.10–1.83) and > 50% (HR 1.81, 95% CrI 1.29–2.55), and bilateral localization (HR 1.65, 95% CrI 1.01–2.68). Variables associated with lower death rate were estrogen and/or progesterone receptor positivity (HR 0.61, 95% CrI 0.45–0.81) and HER2/neu oncogene positivity (HR 0.59, 95% CrI 0.44–0.79).

Discussion

The findings confirmed the independent prognostic values of different female breast cancer characteristics. Even after adjusting for patients and disease characteristics, residence in the SIN of Taranto appeared to be associated with an increased death rate.
Effect of the number of coronavirus disease 2019 (COVID-19) vaccination shots on the occurrence of pneumonia, severe pneumonia, and death in SARS-CoV-2-infected patients
Authors: Xin Shijun , Chen Wei , Yu Qilin , Gao Li , Lu Genjie
Published: January 2024

Background

Coronavirus disease (COVID-19) has posed a significant threat to the lives and health of people worldwide since its onset in 2019. However, the relationship between the number of vaccination shots and the severity of SARS-CoV-2 infection in Chinese patients remains unclear.

Methods

We retrospectively collected information from 829 patients infected with SARS-CoV-2 in Ningbo Medical Center Lihuili Hospital from December 05, 2022 to March 31, 2023, then divided them into four groups based on the severity of pneumonia. Last, we compared the difference in the number of shots of COVID-19 vaccine between the four groups, considering potential confounding factors using univariate and multivariate logistic regression.

Results

Vaccination with two and three doses was positively associated with low prevalence of pneumonia and severe pneumonia both in crude and optimal models, while only three doses of the vaccine was correlated with low prevalence of death in SARS-CoV-2-infected patients. In optimal models, male SARS-CoV-2-infected individuals with advanced age were positively associated with high prevalence of pneumonia, severe pneumonia, and death; comorbidity with hypertension (OR = 2.532, p < 0.001) was positively associated with high prevalence of pneumonia (OR = 2.532, p < 0.001); and comorbidity with diabetes was positively associated with high prevalence of death (OR = 1.856, p = 0.011). However, this is a cross-sectional study and the causal relationships need to be further studied.

Conclusion

One dose of vaccine may not have a protective effect against pneumonia, severe pneumonia, and death; more than one dose of vaccine is an independent protective factor for pneumonia and severe pneumonia; and three doses of vaccine is an independent protective factor for death.
Implementing a provisional overarching intervention for COVID-19 monitoring and control in the Brazil-Colombia-Peru frontier
Authors: Contreras Matilde , Gomes Naveca Felipe , Carvajal-Cortes Jose Joaquin , Faviero Guilherme F. , Saavedra Jorge , Ruback dos Santos Eduardo , Alves do Nascimento Valdinete , Costa de Souza Victor , Oliveira do Nascimento Fernanda , Silva e Silva Dejanane , Luz Sérgio Luiz Bessa , Romero Vesga Kelly Natalia , Grisales Nieto Juan Camilo , Avelino-Silva Vivian I. , Benzaken Adele Schwartz
Published: January 2024

Introduction

he challenge was to provide comprehensive health resources to a remote and underserved population living in the Brazil-Colombia-Peru border, amid the most disruptive global crisis of the century.

Methods

In August 2021, Fundação Oswaldo Cruz Amazonia (FIOCRUZ Amazônia) and partner collaborators implemented an overarching provisional program for SARS-CoV-2 detection and lineages characterization, training of laboratory personnel and healthcare providers, donation of diagnostic supplies and personal protective equipment, and COVID-19 vaccination. The expedition was conducted at the Port of Tabatinga, a busy terminal with an intense flux of people arriving and departing in boats of all sizes, located in the Amazon River basin. Local government, non-profit organizations, private companies, and other stakeholders supported the intervention.

Results

The expedition was accomplished in a convergence point, where migrant workers, traders, army personnel, people living in urban areas, and people from small villages living in riversides and indigenous territories are in close and frequent contact, with widespread cross-border movement. Using a boat as a provisional lab and storage facility, the intervention provided clinical and laboratory monitoring for 891 participants; vaccination for 536 individuals; personal protective equipment for 200 healthcare providers; diagnostic supplies for 1,000 COVID-19 rapid tests; training for 42 community health agents on personal protection, rapid test execution, and pulse oximeter management; and hands-on training for four lab technicians on molecular diagnosis.

Discussion

Our experience demonstrates that multilateral initiatives can counterweigh the scarcity of health resources in underserved regions. Moreover, provisional programs can have a long-lasting effect if investments are also provided for local capacity building.
Application of hybrid fuzzy interval-based machine learning models on financial time series — A case study of Taiwan biotech index during the epidemic period
Authors: Lin Hsio-Yi , Hsu Bin-Wei
Published: January 2024

In recent years, the use of machine learning to predict stock market indices has emerged as a vital concern in the FinTech domain. However, the inherent nature of point estimation in traditional supervised machine learning models leads to an almost negligible probability of achieving perfect predictions, significantly constraining the applicability of machine learning prediction models. This study employs 4 machine learning models, namely BPN, LSTM, RF, and ELM, to establish predictive models for the Taiwan biotech index during the COVID-19 period. Additionally, it integrates the Gaussian membership function MF from fuzzy theory to develop 4 hybrid fuzzy interval-based machine learning models, evaluating their predictive accuracy through empirical analysis and comparing them with conventional point estimation models. The empirical data is sourced from the financial time series of the “M1722 Listed Biotechnology and Medical Care Index” compiled by the Taiwan Economic Journal during the outbreak of the COVID-19 pandemic, aiming to understand the effectiveness of machine learning models in the face of significant disruptive factors like the pandemic. The findings demonstrate that despite the influence of COVID-19, machine learning remains effective. LSTM performs the best among the models, both in traditional mode and after fuzzy interval enhancement, followed by the ELM and RF models. The predictive results of these three models reach a certain level of accuracy and all outperform the BPN model. Fuzzy-LSTM effectively predicts at a 68% confidence level, while Fuzzy-ELM and Fuzzy-RF yield better results at a 95% confidence level. Fuzzy-BPN exhibits the lowest predictive accuracy. Overall, the fuzzy interval-based LSTM excels in time series prediction, suggesting its potential application in forecasting time series data in financial markets to enhance the efficacy of investment analysis for investors.
Adaptive outdoor physical activities for adults with mobility disability: a scoping review
Authors: Derakhshan Pegah , Miller William C. , Bundon Andrea , Labbé Delphine , Bolt Tanelle , Mortenson W. Ben
Published: January 2024

Introduction

Outdoor physical activity (PA) contributes to the physical and mental health and well-being of individuals with a mobility impairment. However, individuals are commonly excluded from outdoor PA because of accessibility challenges. No reviews summarizing evidence on factors that facilitate/hinder participation and inclusion of individuals with mobility disabilities in adaptive outdoor PA were identified.. This makes it challenging to establish the key components for implementing inclusive outdoor PA interventions. A scoping review was conducted to identify barriers and facilitators to participation in adaptive outdoor PA and identify suggestions for adaptive outdoor PA design.

Methods

A scoping review of qualitative and quantitative studies was conducted based on the methodological framework of Arksey and O'Malley with modifications by Levac. Barriers and facilitators were categorized into four levels based on a Social Ecological Model (SEM). Suggestions for interventions designed to overcome accessibility issues of outdoor PA were classified based on Universal Design (UD).

Results

Thirty-seven factors regarding barriers and facilitators of outdoor adaptive PA were extracted from 19 studies published between 2002 and 2023. Barriers and facilitators were identified primarily in four levels of the SEM, including intrapersonal, social-environmental, physical-environmental, and policy-related. Eleven design suggestions were identified and categorized according to the seven principles of UD. This study identified gaps in the presented barriers and facilitators and the design suggestions of the included studies, mainly at the social and environmental level, such as a lack of innovation in program delivery and logistics.

Conclusion

This study identified gaps in knowledge about facilitators and barriers to outdoor adaptive PA and in the design of interventions addressing them. Future research should focus on the strategies addressing these gaps by involving individuals with mobility disability in designing interventions to gain a better insight into their needs.
Psychometric properties of the TACT framework—Determining rigor in qualitative research
Authors: Daniel Ben Kei , Asil Mustafa , Carr Sarah
Published: January 2024

Introduction

The credibility of qualitative research has long been debated, with critics emphasizing the lack of rigor and the challenges of demonstrating it. In qualitative research, rigor encompasses explicit, detailed descriptions of various research stages, including problem framing, study design, data collection, analysis, and reporting. The diversity inherent in qualitative research, originating from various beliefs and paradigms, challenges establishing universal guidelines for determining its rigor. Additionally, researchers' often unrecorded thought processes in qualitative studies further complicate the assessment of research quality.

Methods

To address these concerns, this article builds on the TACT framework, which was developed to teach postgraduate students and those new to qualitative research to identify and apply rigorous principles and indicators in qualitative research. The research reported in this article focuses on creating a scale designed to evaluate the psychometric properties of the TACT framework. This involves analyzing the stability of its dimensions and understanding its effectiveness as a tool for teaching and research.

Results

The study's findings indicate that the TACT framework, when assessed through the newly developed scale, exhibits stable dimensions consistent with rigorous qualitative research principles. The framework effectively guides postgraduate students and new researchers in assessing the rigor of qualitative research processes and outcomes.

Discussion

The application of the TACT framework and its evaluation scale reveals several insights. Firstly, it demonstrates the framework's utility in bridging the gap in pedagogical tools for teaching rigor in qualitative research methods. Secondly, it highlights the framework's potential in providing a structured approach to undertaking qualitative research, which is essential given this field's diverse methodologies and paradigms. However, the TACT framework remains a guide to enhancing rigor in qualitative research throughout all the various phases but by no means a measure of rigor.

Conclusion

In conclusion, the TACT framework and its accompanying evaluative scale represent significant steps toward standardizing and enhancing the rigor of qualitative research, particularly for postgraduate students and early career researchers. While it does not solve all challenges associated with obtaining and demonstrating rigor in qualitative research, it provides a valuable tool for assessing and ensuring research quality, thereby addressing some of the longstanding criticisms of the quality of research obtained through qualitative methods.
The effect of daily oral PrEP use during pregnancy on bone mineral density among adolescent girls and young women in Uganda
Authors: Zewdie Kidist , Kiweewa Flavia M. , Ssebuliba Timothy , Morrison Susan A. , Muwonge Timothy R. , Boyer Jade , Bambia Felix , Badaru Josephine , Stein Gabrielle , Mugwanya Kenneth K. , Wyatt Christina , Yin Michael T. , Mujugira Andrew , Heffron Renee
Published: January 2024

Introduction

Oral pre-exposure prophylaxis (PrEP) is recommended during pregnancy for at-risk cisgender women. Pregnancy is known to impede bone growth and tenofovir-based PrEP may also yield detrimental changes to bone health. Thus, we evaluated the effect of PrEP use during pregnancy on bone mineral density (BMD).

Methods

We used data from a cohort of women who were sexually active, HIV-negative, ages 16–25 years, initiating DMPA or choosing condoms for contraception and enrolled in the Kampala Women's Bone Study. Women were followed quarterly with rapid testing for HIV and pregnancy, PrEP dispensation, and adherence counseling. Those who became pregnant were counseled on PrEP use during pregnancy per national guidelines. BMD of the neck of the hip, total hip, and lumbar spine was measured using dual-energy x-ray absorptiometry at baseline and annually. We compared the mean percent change in BMD from baseline to month 24.

Results

Among 499 women enrolled in the study, 105 pregnancies occurred in 90 women. At enrollment, the median age was 20 years (IQR: 19–21) and 89% initiated PrEP. During pregnancy, 67% of women continued using PrEP and PrEP was dispensed in 64% of visits. BMD declined significantly in women using PrEP during pregnancy compared to women who were not pregnant nor used PrEP: relative BMD change was −2.26% (95% CI: −4.63 to 0.11, p = 0.06) in the femoral neck, −2.57% (95% CI: −4.48 to −0.66, p = 0.01) in total hip, −3.06% (95% CI: −5.49 to −0.63, p = 0.001) lumbar spine. There was no significant difference in BMD loss when comparing PrEP-exposed pregnant women to pregnant women who never used PrEP. Women who became pregnant were less likely to continue PrEP at subsequent study visits than women who did not become pregnant (adjOR: 0.25, 95% CI: 0.16–0.37, p < 0.001). Based on pill counts, there was a 62% reduction in the odds of high PrEP adherence during pregnancy (adjOR = 0.38, 95% CI: 0.27–0.58, p < 0.001).

Conclusion

Women who used PrEP during pregnancy experienced a similar reduction in BMD as pregnant women with no PrEP exposure, indicating that BMD loss in PrEP-using pregnant women is largely driven by pregnancy and not PrEP.
Cataloging variation in 16S rRNA gene sequences of female urobiome bacteria
Authors: Baddoo Genevieve , Ene Adriana , Merchant Zubia , Banerjee Swarnali , Wolfe Alan J. , Putonti Catherine
Published: January 2024

Continued efforts to isolate and sequence bacteria of the urinary tract has increased representation of these species in publicly available databases. This in turn has improved taxonomic classifications of the urinary microbiome (urobiome). Short-read sequencing targeting a variable region(s) of the 16S rRNA gene sequence has been fundamental in characterizing the urobiomes of males and females with and without lower urinary tract symptoms, as well as cancers of the urinary tract. Here, we have compiled a data set of full-length or near-full-length 16S rRNA gene sequences for the urobiome. To generate this data set, we first plated 203 isolates from the bladder on differential media and sequenced their full-length 16S rRNA gene sequence. We combined this data set with publicly available genomes from primarily the female urinary tract. The final data set includes 399 sequences representative of 160 different species from 73 genera. We assessed the ability of publicly available databases to correctly predict these sequences based on the V1-V3, V4, and V4-V6 variable regions. As expected, species designations based upon these variable regions is often not possible or incorrect. We also detected incorrect genus-level classifications. This data set can be used to supplement existing databases, by increasing urobiome species variation, and thus improve future studies characterizing urobiomes.
Precipitation fuels dissolved greenhouse gas (CO2, CH4, N2O) dynamics in a peatland-dominated headwater stream: results from a continuous monitoring setup
Authors: Piatka David R. , Nánási Raphaela L. , Mwanake Ricky M. , Engelsberger Florian , Willibald Georg , Neidl Frank , Kiese Ralf
Published: January 2024

Stream ecosystems are actively involved in the biogeochemical cycling of carbon (C) and nitrogen (N) from terrestrial and aquatic sources. Streams hydrologically connected to peatland soils are suggested to receive significant quantities of particulate, dissolved, and gaseous C and N species, which directly enhance losses of greenhouse gases (GHGs), i.e., carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O), and fuel in-stream GHG production. However, riverine GHG concentrations and emissions are highly dynamic due to temporally and spatially variable hydrological, meteorological, and biogeochemical conditions. In this study, we present a complete GHG monitoring system in a peatland stream, which can continuously measure dissolved GHG concentrations and allows to infer gaseous fluxes between the stream and the atmosphere and discuss the results from March 31 to August 25 at variable hydrological conditions during a cool spring and warm summer period. Stream water was continuously pumped into a water-air equilibration chamber, with the equilibrated and actively dried gas phase being measured with two GHG analyzers for CO2 and N2O and CH4 based on Off-Axis Integrated Cavity Output Spectroscopy (OA-ICOS) and Non-Dispersive Infra-Red (NDIR) spectroscopy, respectively. GHG measurements were performed continuously with only shorter measurement interruptions, mostly following a regular maintenance program. The results showed strong dynamics of GHGs with hourly mean concentrations up to 9959.1, 1478.6, and 9.9 parts per million (ppm) and emissions up to 313.89, 1.17, and 0.40 mg C or N m−2h−1 for CO2, CH4, and N2O, respectively. Significantly higher GHG concentrations and emissions were observed shortly after intense precipitation events at increasing stream water levels, contributing 59% to the total GHG budget of 762.2 g m−2 CO2-equivalents (CO2-eq). The GHG data indicated a constantly strong terrestrial signal from peatland pore waters, with high concentrations of dissolved GHGs being flushed into the stream water after precipitation. During drier periods, CO2 and CH4 dynamics were strongly influenced by in-stream metabolism. Continuous and high-frequency GHG data are needed to assess short- and long-term dynamics in stream ecosystems and for improved source partitioning between in-situ and ex-situ production.
Rating curve development and uncertainty analysis in mountainous watersheds for informed hydrology and resource management
Authors: Kumar Vikram , Sen Sumit
Published: January 2024

Accurate measurement of continuous stream discharge poses both excitement and challenges for hydrologists and water resource planners, particularly in mountainous watersheds. This study centers on the development of rating curves utilizing the power law at three headwaters of the lesser Himalayas—Aglar, Paligaad, and Balganga—through the installation of water level recorders for stage measurement and salt dilution for discharge measurement from 2014 to 2016. The stream stage–discharge relationship, crucially known as the rating curve, is susceptible to numerous factors in mountainous watersheds that are often challenging to comprehend or quantify. Despite significant errors introduced during the rating curve development, such as stemming from observations, modeling, and parameterization, they are frequently overlooked. In this study, acknowledging the inherent uncertainty, we employ the maximum-likelihood method to assess uncertainty in the developed rating curve. Our findings reveal substantial inconsistency in the stage–discharge relationship, particularly during high flows. A novel contribution of this study is introducing a weighing factor concept that correlates uncertainty with the morphological parameters of the watershed. The higher value of the weighting factor in Paligaad (0.37) as compared to Balganga (0.35) and less in the case of Aglar (0.27) will have more uncertainty. The authors contend that precise rating curves and comprehensive uncertainty analyses can mitigate construction costs, foster robust decision-making, and enhance the perceived credibility of decisions in hydrology and water resource management.
Bacterial Coaggregation: A Way Different Bacteria Come Together
Authors: Rickard Alexander H. , Hayashi Michael A. L. , Redissi Aneesa F. , Fenno J. Christopher , Jakubovics Nicholas S.
Published: January 2024

Bacteria are the smallest living organisms on this planet. While bacteria can live as free-floating single cells, many can specifically recognize other kinds of bacteria and stick to them. This ability is called coaggregation. Over 50 years ago, microbiologists first observed coaggregation between bacteria that grow in human mouths. However, it is becoming clear that coaggregation happens in many environments and may be an important and widespread phenomenon for bacterial survival. This article will help you understand bacterial coaggregation and hopefully inspire you to learn more about the microscopic behavior of bacteria.
Intestinal parasites infecting captive non-human primates in Italy
Authors: Rondón Silvia , Cavallero Serena , Montalbano Di Filippo Margherita , De Liberato Claudio , Berrilli Federica , Capitani Nazareno , D’Amelio Stefano
Published: January 2024

Non-human primates (NHPs) living in captive conditions are susceptible to intestinal parasites that can contribute to mortality and morbidity, and cause zoonotic infections. Thus, parasite surveys on NHP populations under human care are relevant as part of the evaluation of NHPs welfare and in the zoonotic disease risk assessment, as well as in the exploration of parasite transmission pathways, according to the One-Health concept. This study aimed to identify intestinal parasites infecting NHPs living in two wildlife recovery centers and in a zoological garden, in Italy. Ninety-three fecal samples from Macaca tonkeana, Macaca fascicularis, Sapajus apella, Chlorocebus aethiops, Macaca fuscata, Macaca sylvanus, and Cebus capucinus were collected at Piano dell’Abatino Park (Lazio), and fecal smears and flotation were performed in order to identify parasites according to morphological keys. Additionally, one carcass of M. fuscata from the Bioparco Zoological Garden of Rome (Lazio) and one of M. fascicularis from the Center for the Recovery of Exotic and Maremma Wild Animals (Tuscany) were necropsied and intestinal adult nematodes were collected and characterized at morphological and molecular level, using the mitochondrial cox1 and rrnL markers. Protozoans (Entamoeba coli, Iodamoeba bütschlii, Dientamoeba fragilis-like, Giardia sp.), chromists (Balantidium/Buxtonella sp.) and nematodes (Capillaria sp., Trichuris sp., strongyliform larvae and Oesophagostomum sp.) were found through fecal smears and flotation. The collected adult nematodes from dead NHPs were morphologically identified as whipworms (genus Trichuris). Phylogenetic analyses grouped Trichuris specimens into the Trichuris trichiura complex of species, with specimens from M. fuscata clustering into a host-specific branch, and whipworms from M. fascicularis clustering within a clade formed by Trichuris infecting several primate species, including humans. The results here collected revealed the presence of potentially zoonotic parasites circulating in captive primates in Italy, providing useful information for the formulation of management and care plans for captive NHPs, and for the elaboration of safety measures for visitors and animal keepers.
Long-acting reversible contraception with etonogestrel implants in female macaques (Macaca mulatta and Macaca fascicularis)
Authors: Maaskant Annemiek , Scarsi Kimberly K. , Meijer Lisette , Roubos Sandra , Louwerse Annet L. , Remarque Edmond J. , Langermans Jan A. M. , Stammes Marieke A. , Bakker Jaco
Published: January 2024

Introduction

Contraception is often required for management and population control purposes in group-housed and free-roaming non-human primates. Long-acting reversible contraceptives, including subdermal progestin-releasing implants, are preferred as they eliminate challenges associated with frequent administration. Etonogestrel (ENG)-releasing subdermal implants are reversible and long-acting for a minimum of 3 years, and are commercially available for human use as Implanon® or Nexplanon®.

Methods

A retrospective analysis was performed detailing the contraceptive effectiveness and reversibility of subdermal placement of one-fourth or one-third of an ENG implant (68 mg/implant) in 129 female rhesus macaques (Macaca mulatta) and 67 cynomolgus macaques (Macaca fascicularis) at the Biomedical Primate Research Centre (Rijswijk, Netherlands). Furthermore, single cross-sectional ENG serum concentrations were measured for 16 rhesus and 10 cynomolgus macaques, and hemoglobin and blood chemistry pre-ENG and at timepoints >0.5, >1.5, and > 2.5 years post-ENG insertion were evaluated for 24 rhesus macaques. Finally, data were obtained using trans-abdominal ultrasound regarding the influence of ENG on uterine volume and endometrial thickness in 14 rhesus and 11 cynomolgus macaques.

Results

As a contraceptive ENG was in 99.80% (CI 93.50–99.99) and 99.95% (CI 99.95–100) effective in rhesus and cynomolgus macaques, respectively. Prolonged ENG durations of implant use in 14 rhesus macaques (range 3.1–5.0 years) and eight cynomolgus macaques (range 3.2–4.0 years) resulted in no unintended pregnancies. A total of 17 female macaques were allowed to breed after ENG removal, and among them, 14 female macaques (82%) had an uneventful delivery. Serum ENG concentrations with a median ENG duration of 1.2 years (range 0.1–6.0 years) and 1.9 years (range 0.6–4.7 years) resulted in median concentrations of 112 pg./mL (range 0–305 pg./mL) and 310 pg./mL (range 183–382 pg./mL) for rhesus and cynomolgus macaques, respectively. ENG had no clinical effect on hemoglobin and blood chemistry parameters nor on the thickness of the endometrial lining or uterus volume.

Conclusion

This study indicates that both one-fourth and one-third of the ENG implants are effective, long-acting, reversible, and safe contraceptive to use in macaques.