bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring Sexual Intelligence for Evaluating Sexual Health
Authors: Husain Waqar , Kiran Abeera , Qasim Umara , Gul Saleha , Iftikhar Javairia
Published: January 2023

The current paper reports four consecutive studies that were conducted to link sexual health with a new construct of sexual intelligence by developing and validating a new scale to measure sexual intelligence. Sexual intelligence was defined as “the ability to perceive, understand and respond to sexual needs and desires in a personal and social context.” Sexual Intelligence Scale (SIS), comprising of 8 items in English and 2 factors (sexual knowledge & sexual behavior), was developed and validated by involving 959 respondents in the process of 4 consecutive studies. The validity of SIS was tested step by step for its face, content, factorial, convergent, discriminant, and predictive validities. The reliability was measured through internal consistency and item-total & item-scale correlations. The study found significantly higher levels of sexual intelligence in men as compared to women. Sexual intelligence, moreover, had significant positive correlations with age, education, emotional intelligence, social intelligence, sexual health, and satisfaction with life. Sexual health was linked with sexual intelligence and the SIS was accepted as a reliable and valid tool to measure sexual intelligence.
Time Is of the Essence: Individualizing Academic Intervention for Students of Transition Age
Authors: Ford Jeremy W. , Kern Amanda M. , Gorman Julia P. , Mooney Conor D.
Published: January 2023

Individualizing instruction is a time-consuming aspect of classroom practice. Testing multiple interventions, and monitoring each to see which is most effective for a student can be prohibitively time consuming. However, Brief Experimental Analysis (BEA) is an assessment procedure that can be used to quickly identify an intervention that is likely to be successful with an individual student. BEA provides teachers with a method to efficiently collect data and predict which intervention is most likely to be successful before a significant amount of time and resources are invested. The BEA process can be used with students at a variety of grade levels for the purpose of academic and behavior intervention. This paper describes how to implement BEA in reading with students with intellectual disabilities in order to prepare them for opportunities in postsecondary education. We will also discuss how to overcome hurdles that practitioners may experience implementing the process.
Organizational Innovation in Long Term Care Enabled by Collaboration Between Government Agencies: A Critical Realist Case Study
Authors: Shannon Kay , Neville Stephen
Published: January 2023

Long term care for older people is a highly regulated sector providing accommodation, health, and social care to vulnerable older adults. Older adults in New Zealand are among the highest users of long term care services globally. Traditionally those requiring specialist care for dementia are housed apart from other residents. In an example of organizational innovation, 1 provider relocated residents to a secure village where residents requiring specialist dementia care would be desegregated. We utilized a critical realist case study to explain the role of intersectoral collaboration among government agencies in supporting the transition while managing risk and ensuring regulatory compliance
Toward a New Understanding of Hispanic-Serving Community Colleges
Authors: Doran Erin
Published: January 2023

Purpose: The purpose of this article is to synthesize the literature around Hispanic-Serving Institutions (HSIs), community colleges, and Latina/o/x community college students to propose practices specifically for community colleges that are officially designated HSIs or want to be more Latinx-serving. Argument: Utilizing the conceptual framework for servingness in HSIs by Garcia et al., this essay makes the case for ways that Latinx-serving, research-based practices can be implemented in Hispanic-serving community colleges. Conclusions: As more 2-year colleges reach the threshold for the HSI designation, they may look for ways to implement policies and practices that boost the access and attainment of Latina/o/x students and enhance practices that may benefit students from other minoritized groups as well.
Book review: Joshua Neves and Bhaskar Sarkar (Eds.), Asian Video Cultures
Authors: Ross Julian
Published: January 2023

Joshua Neves and Bhaskar Sarkar (Eds.), Asian Video Cultures. Durham: Duke University Press, 2017, 368 pp., $28.95. ISBN 978-0-8223-6899-1 (Paperback)
Sharon Dunwoody’s Legacy: Three Timely Lessons for Us
Authors: Peters Hans Peter
Published: January 2023

Sharon Dunwoody gained international reputation for her research on science journalism and media risk communication. Drawing on her publications published over more than four decades and the author’s long-lasting collaboration with her, this commentary elaborates on three of her most characteristic beliefs and orientations and suggests that they may serve as timely lessons for us to critically reflect on current assumptions and practices: substance over showmanship, improving one-way communication, and respecting the audience.
LN-MRSCAE: A novel deep learning based denoising method for mechanical vibration signals
Authors: Du Wenliao , Yang Lingkai , Wang Hongchao , Gong Xiaoyun , Zhang Lianying , Li Chuan , Ji Lianqing
Published: January 2023

Vibration signals are used to monitor the running state of mechanical equipment, but always suffer from a lot of noise in the acquisition process. In order to eliminate noise interference as much as possible, a multilevel residual convolution autoencoder network based noise learning method (LN-MRSCAE) is proposed in this paper. The LN-MRSCAE consists of a deep convolutional autoencoder network and multilevel residual, in which the learning noise module encodes and decodes the noise components, combining with a residual module to obtain the denoised signal. The multilevel residual structure is designed to address the gradient disappearance in network learning and improve the training speed. In specific, the noise learning replaces the traditional clean signal learning. Instead of learning the characteristics of the original clean signal, just learn the characteristics of the noise signal. The effectiveness of LN-MRSCAE network denoising is verified by classic analog signal and actual bearing vibration signals with different faults. The results show that the LN-MRSCAE model is superior to the latest models, and the noise component of the signal is obviously suppressed.
The good, the bad, the ugly: Predictors of positive and negative experiences of traditional and nontraditional graduate students
Authors: Strukel David , White Linda , Alhabash Saleem
Published: January 2023

Nontraditional students pursuing an advanced degree face unique challenges as compared to full-time traditional students. Current and former masters and PhD students ( N = 266) were surveyed to examine differences in their educational experiences and emotional outcomes, and determinants of their positive and negative graduate education experiences. Traditional and nontraditional students differed significantly on most of the variables. Compared to traditional students, nontraditional students reported higher positive emotional experiences. Simple linear ordinary least squares (OLS) regression models were used to examine the determinants of positive and negative experiences during graduate education. Self-fulfillment motives were the strongest predictors of positive emotional experiences, while stress and anxiety uniformly predicted negative experiences; with variability in determinants of emotional experiences between traditional and nontraditional students.
Signaling through the IL-6-STAT3 Pathway Promotes Proteolytically-Active Macrophage Accumulation Necessary for Development of Small AAA
Authors: Patel Raj , Hall SarahRose , Lanford Hayes , Ward Nicholas , Grespin R. Tyler , Figueroa Mario , Mattia Victoria , Xiong Ying , Mukherjee Rupak , Jones Jeffrey , Ruddy Jean Marie
Published: January 2023

Introduction

Elevated interleukin-6 (IL-6) plasma levels have been associated with abdominal aortic aneurysm (AAA), but whether this cytokine plays a causative role in the degenerative remodeling or represents an effect from the inflammatory cascades initiated by infiltrating leukocytes remained unclear. This project aims to demonstrate that within the aortic wall, signaling from IL-6 through the STAT3 transcription factor is necessary for infiltration of proteolytically-active macrophages and development of small AAA.

Methods

Following measurement of baseline infrarenal aortic diameter (AoD, digital microscopy), C57Bl/6 and IL-6 knockout (IL-6KO) mice underwent AAA induction by application of peri-adventitial CaCl2 (0.5 M) +/− implantation of an osmotic mini-pump delivering IL-6 (4.36 µg/kg/day over 21 days). At the terminal procedure, AoDs were measured by digital microscopy and aortas harvested for immunoblot (pSTAT3/STAT3), matrix metalloproteinase (MMP) quantification, or flow cytometric analysis of macrophage content. Plasma was collected for cytokine analysis.

Results

IL-6 infusion significantly increased the plasma IL-6 levels in C57Bl/6 and IL-6KO animals. The C57Bl/6 + CaCl2 group developed AAA (AoD >50% above baseline) but IL-6KO + CaCl2 did not. In the IL-6KO + IL-6+CaCl2 group, AAA developed to match that of C57Bl/6 + CaCl2 mice. STAT3 activity was significantly increased in animals with advanced stages of dilation (>40% from baseline), compared to those with ectasia (≤25%). Although cytokine profiles did not support T-cells or neutrophils as being active contributors in this stage of aortic remodeling, changes in the profile of elaborated MMPs suggested macrophage activity with a trend toward alternatively activated pathways. Flow cytometry confirmed significantly increased macrophage abundance specifically in animals with upregulated STAT3 activity and advanced aortic dilation.

Conclusion

In this murine model of AAA, progressive dilation to development of true AAA was only accomplished when IL-6 signaling upregulated STAT3 activity to effect accumulation of proteolytically-active macrophages. This pathway warrants further investigation to identify potential therapeutic avenues to abrogate growth of small AAA.
Surgical techniques in the management of pediatric anterior cruciate ligament tears: Current concepts
Authors: Tang Chun , Kwaees Tariq Adam , Accadbled Franck , Turati Marco , Green Daniel W , Nicolaou Nicolas
Published: January 2023

Background:

Anterior cruciate ligament injury in the child and adolescent patient remains a controversial topic when considering management, especially regarding surgical choices. Treatment variations are seen not just when comparing different countries but also within nations. This arises partly as contemporary treatment is mostly inferred from the adult population who physiologically and in terms of outcomes differ significantly from children. There is an increasing body of evidence for this cohort of patients who have specific challenges and difficulties when determining the optimum treatment.

Methods:

Within this article, we will summarize the current evidence for surgical management of anterior cruciate ligament injury for the pediatric patient.

Results and Conclusions:

There remain many controversies and gaps inthe treatment of Paediatric Anterior cruciate ligament reconstruction and this high risk cohort continues to cause difficulty in identifying the best mode of surgical management.

Level of evidence:

level IV.
ST-Segment Elevation Myocardial Infarction on the Line: Inadvertent Arterial Infusion of Vasopressors Causing Acute Myocardial Infarction
Authors: Ezeh Ebubechukwu , Smith Kyle , Perdoncin Maddie , Gilbert Brittany , Rueda Carlos , Tackett Eva
Published: January 2023

Central venous catheters (CVCs), regarded as lines of life, are helpful in hemodynamic monitoring and delivering medications to patients. However, there are several complications that can result from the placement of CVCs. This includes accidental arterial puncture, which has a temporal association with hemorrhage, hematoma, and stroke. Infusion of vasopressors through such a mispositioned arterial CVC further increases the risk of these complications with potential end-organ ischemia. Here, we discuss the case of a 76-year-old woman who developed a myocardial infarction, heart failure, and subarachnoid hemorrhage following the arterial infusion of vasopressors through a malpositioned CVC.
Multiple Imputation for Partial Recording Periodontal Examination Protocols
Authors: Preisser J.S. , Shing T. , Qaqish B.F. , Divaris K. , Beck J.
Published: January 2023

Aim:

Partial-mouth recording protocols often result in underestimation of population prevalence and extent of periodontitis. We posit that multiple imputation of measures such as clinical attachment loss for nonselected tooth sites in partial-mouth samples can reduce bias in periodontitis estimates.

Methods:

Multiple imputation for correlated site-level dichotomous outcomes in a generalized estimating equations framework is used to impute site-level binary indicators for clinical attachment loss exceeding a fixed threshold in partial-mouth samples. Periodontitis case definitions are applied to the imputed “complete” dentitions, enabling estimation of prevalence and other summaries of periodontitis for partial-mouth samples as if for full-mouth examinations. A multiple imputation-bootstrap procedure is described and applied for point and variance estimation of these periodontitis measures. The procedure is evaluated with pseudo-partial-mouth samples based on random site selection protocols of 28 to 84 periodontal sites repeatedly generated from full-mouth periodontal examinations of 3,621 participants in the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) survey.

Results:

Multiple imputation applied to partial-mouth samples overestimated periodontitis mean extent, defined as the number of sites with clinical attachment loss 3 mm or greater, by 9.5% in random site selection protocols with 84 sites and overestimated prevalence by 5% to 10% in all the evaluated protocols.

Conclusions:

In the 2013 to 2014 NHANES data, multiple imputation of site-level periodontal indicators provides less biased estimates of periodontitis prevalence and extent than has been reported from estimates based on the direct application of full-mouth case definitions to partial-mouth samples. Multiple imputation provides a promising solution to the longstanding, vexing problem of estimation bias in partial-mouth recording, with potential application to a wide array of case definitions, periodontitis measures, and partial recording protocols.

Knowledge Transfer Statement:

Partial-mouth sampling, while a resource-efficient strategy for obtaining oral disease estimates, often results in underestimation of periodontitis metrics. Multiple imputation for nonselected periodontal sites produces pseudo-full-mouth data sets that may be analyzed and combined to produce estimates with small bias.
MARS1 mutations linked to familial trigeminal neuralgia via the integrated stress response
Authors: Wang Anni , Song Zimu , Zhang Xu , Xiao LiFei , Feng Yan , Qi Chong , Zhang Guohuan , Bai Jinbo , Liu Yang , Sun Tao , Meng Fangang , Wang Feng
Published: January 2023

Background

While new genetic analysis methods are widely used in the clinic, few researchers have focused on trigeminal neuralgia (TN) with familial clustering (≥ 2 TN patients in one kindred family). Previous literature suggests that familial trigeminal neuralgia (FTN) may be associated with inherited genetic factors. To date, few next-generation sequencing studies have been reported for FTN. This study investigated the pathogenic mechanism of FTN by using whole-exome sequencing (WES) technology, which may enhance our understanding of human TN pathophysiology. 

Method

We performed WES for 7 probands from families of FTN. Sanger sequencing was performed for two control groups (FTN family members group and nonfamilial TN subject group) to potentially identify new FTN-related gene mutations. In families where FTN probands carried potentially pathogenic gene mutations, the ribonucleic acid (RNA) of FTN probands and related family members, as well as nonfamilial TN patients were analysed by RNA sequencing (RNA-seq) to confirm differential gene expression.

Results

Seven probands were derived from 3 Chinese families. WES and Sanger sequencing identified MARS1 mutation c.2398C > A p.(Pro800Thr) in Family 1. MARS1 mutation was confirmed in 14/26 [53.8%] members of Family 1 in FTN family member group, while none of nonfamilial TN subjects had this MARS1 mutation. RNA-seq showed that 3 probands in Family 1 had higher expression of Fosl1 (Fos-like antigen 1) and NFE2 (Nuclear factor, erythroid 2) than 3 subjects in the nonfamilial TN subject group. Fosl1 and NFE2 are genes related to integrated stress response (ISR).

Conclusion

MARS1 mutations may cause chronic activation of ISR, contribute to ISR pathophysiological changes in FTN, and cause/accelerate peripheral nerve degeneration. The findings of this study can enrich our knowledge of the role of molecular genetics in TN in humans.
Genetic analyses and detection of point mutations in the acetylcholinesterase-1 gene associated with organophosphate insecticide resistance in fall armyworm (Spodoptera frugiperda) populations from Uganda
Authors: Omuut Geresemu , Mollel Happyness G. , Kanyesigye Dalton , Akohoue Félicien , Adumo Aropet Stella , Wagaba Henry , Otim Michael H.
Published: January 2023

Background

The fall armyworm (FAW), Spodoptera frugiperda; J.E. Smith (Lepidoptera: Noctuidae), is now an economically important pest that causes huge losses to maize productivity in sub-Saharan Africa. Variations in sub-population genetics and the processes of rapid adaptation underpinning the invasion remain unclear. For this, the genetic identity and diversity of FAW populations in Uganda were revealed by sequencing 87 samples (collected across the country). Based on the partial mitochondrial cytochrome oxidase I (COI) gene polymorphisms, we further examined the mitochondrial haplotype configuration and compared the FAW in Uganda with sequences from other parts of the world. The molecular target for organophosphate and carbamate resistance, acetylcholinesterase, was also investigated.

Results

Analysis of the partial COI gene sequences showed the presence of both rice (predominant) and corn strain haplotypes, with a haplotype diversity of 0.382. Based on the COI marker, pairwise difference distribution analyses, and neutrality tests, showed that the FAW populations in Uganda and the rest of Africa are evolving neutrally, but those in America and Asia are undergoing expansion. Our findings support observations that invasive FAW populations throughout the rest of Africa and Asia share a common origin. Sequencing of the S. frugiperda ace-1 gene revealed four amino acid substitutions, two of which (A201S and F290V) were previously shown to confer organophosphate resistance in both S. frugiperda and several other insect species. The other two previously reported new variations in positions g-396 and g-768, are presumed to be related to the development of insecticide resistance.

Conclusions

This research has increased our knowledge of the genetics of FAW in Uganda, which is critical for pest surveillance and the detection of resistance. However, due to the low gene polymorphism of COI, more evolutionary studies incorporating the Spodoptera frugiperda whole-genome sequence are required to precisely understand the FAW population dynamics, introduction paths, origin, and subsequent spread.
Changes of cardiac output and velocity time integral in blood return at the end of renal replacement therapy predict fluid responsiveness in critically Ill patients with acute circulatory failure
Authors: Huang Daozheng , Ma Jie , Wang Shouhong , Qin Tiehe , Song Feier , Hou Tieying , Ma Huan
Published: January 2023

Objectives

To observe if blood return, also defined as the blood infusion test (BIT) could predict fluid responsiveness in critically ill patients with acute circulatory failure and renal replacement therapy (RRT).

Methods

This was a single-center, prospective, diagnostic accuracy study. Before BIT, the passive leg raise test (PLRT) was performed to record the change of cardiac output (ΔCO) by pulse contour analysis, and ΔCO >  = 10% was defined as the fluid responder. Meanwhile, the change in velocity time integral (ΔVTI) was recorded by ultrasound. Later, the ΔCO and ΔVTI during BIT were recorded 5–10 min after PLRT. The receiver-operating characteristic curves of ΔCO and ΔVTI of BIT were performed in predicting the fluid responder defined by PLRT.

Results

A total of 43 patients with acute circulatory failure undergoing RRT were enrolled in the present study, and 25 patients (58.1%) were recognized as responders during PLRT. According to the receiver-operating characteristic curves, the cutoff value of ΔCO was 10% and ΔVTI was 9% during BIT with the area under curve of 0.96 and 0.94, respectively.

Conclusions

BIT in RRT could identify fluid responsiveness in critically ill patients with shock.

Trial registration

ChiCTR-DDD-17010534. Registered on 30/01/2017 (retrospective registration).
Evaluation of gut microbiota of iranian patients with celiac disease, non-celiac wheat sensitivity, and irritable bowel syndrome: are there any similarities?
Authors: Naseri Kaveh , Dabiri Hossein , Olfatifar Meysam , Shahrbaf Mohammad Amin , Yadegar Abbas , Soheilian-Khorzoghi Mona , Sadeghi Amir , Saadati Saeede , Rostami-Nejad Mohammad , Verma Anil K. , Zali Mohammad Reza
Published: January 2023

Background and aims

Individuals with celiac disease (CD), non-celiac wheat sensitivity (NCWS), and irritable bowel syndrome (IBS), show overlapping clinical symptoms and experience gut dysbiosis. A limited number of studies so far compared the gut microbiota among these intestinal conditions. This study aimed to investigate the similarities in the gut microbiota among patients with CD, NCWS, and IBS in comparison to healthy controls (HC).

Materials and methods

In this prospective study, in total 72 adult subjects, including CD (n = 15), NCWS (n = 12), IBS (n = 30), and HC (n = 15) were recruited. Fecal samples were collected from each individual. A quantitative real-time PCR (qPCR) test using 16S ribosomal RNA was conducted on stool samples to assess the relative abundance of Firmicutes, Bacteroidetes, Bifidobacterium spp., and Lactobacillus spp.

Results

In all groups, Firmicutes and Lactobacillus spp. had the highest and lowest relative abundance respectively. The phylum Firmicutes had a higher relative abundance in CD patients than other groups. On the other hand, the phylum Bacteroidetes had the highest relative abundance among healthy subjects but the lowest in patients with NCWS. The relative abundance of Bifidobacterium spp. was lower in subjects with CD (P = 0.035) and IBS (P = 0.001) compared to the HCs. Also, the alteration of Firmicutes to Bacteroidetes ratio (F/B ratio) was statistically significant in NCWS and CD patients compared to the HCs (P = 0.05).

Conclusion

The principal coordinate analysis (PCoA), as a powerful multivariate analysis, suggested that the investigated gut microbial profile of patients with IBS and NCWS share more similarities to the HCs. In contrast, patients with CD had the most dissimilarity compared to the other groups in the context of the studied gut microbiota.
Association between walking and square dancing-oriented leisure-time physical activity and cognitive function among middle-aged and elderly people in Southwest China
Authors: Li Xu , Peng Anjiao , Li Lin , Chen Lei
Published: January 2023

Background

Southwest China is facing a serious aging problem across the country, but the status of cognitive function in middle-aged and elderly people in this region is superior to the national average. This study intends to reveal the leisure-time physical activity (LTPA) pattern in this region and explore whether this pattern is beneficial for cognitive function.

Methods

The data came from the 2019–2021 baseline survey on cognitive function of a natural population cohort conducted by West China Hospital of Sichuan University. A structured questionnaire was used to investigate the LTPA status of the participants, and the Mini-Mental State Examination was used to evaluate their cognitive function. Then, we used multiple linear regression to analyze the association between LTPA and cognitive level, and further subgroup analysis was carried out according to sex, age and waist-to-hip ratio.

Results

A total of 2697 participants were enrolled, with an average age of 66.19 ± 6.68 years. The average cognitive function score was 27.23 ± 2.72, of which 8.60% indicated mild cognitive impairment. Their median LTPA level was 24.50 MET-hours per week, of which 70.37% reached the activity level recommended by WHO, with the main types being walking (1340 cases, 49.68%), square dancing (270 cases, 10.01%), or walking + square dancing (172 cases, 6.38%). Multiple linear regression showed that cognitive function increased with the amount of LTPA from 11.25 MET-hours/week to 36.40 MET-hours/week (β 0.09 for 11.25 ~ 24.50 MET-hours/week, β 0.38 for 24.50 ~ 36.40 MET-hours/week) but stabilized at more (β 0.39 for ≥36.40 MET-hours/week). The positive association persisted even for those who only walked (β 0.37 for 24.50 ~ 36.40 MET-hours/week, P = 0.008).

Conclusions

Middle-aged and elderly people in Southwest China hold a relatively high level of LTPA status, and walking and square dancing-oriented LTPA are positively correlated with cognitive function.
Hyperlactatemia is a predictor of mortality in patients undergoing continuous renal replacement therapy for acute kidney injury
Authors: Kim Seong Geun , Lee Jinwoo , Yun Donghwan , Kang Min Woo , Kim Yong Chul , Kim Dong Ki , Oh Kook-Hwan , Joo Kwon Wook , Kim Yon Su , Han Seung Seok
Published: January 2023

Background

Hyperlactatemia occurs frequently in critically ill patients, and this pathologic condition leads to worse outcomes in several disease subsets. Herein, we addressed whether hyperlactatemia is associated with the risk of mortality in patients undergoing continuous renal replacement therapy (CRRT) due to acute kidney injury.

Methods

A total of 1,661 patients who underwent CRRT for severe acute kidney injury were retrospectively reviewed between 2010 and 2020. The patients were categorized according to their serum lactate levels, such as high (≥ 7.6 mmol/l), moderate (2.1–7.5 mmol/l) and low (≤ 2 mmol/l), at the time of CRRT initiation. The hazard ratios (HRs) for the risk of in-hospital mortality were calculated with adjustment of multiple variables. The increase in the area under the receiver operating characteristic curve (AUROC) for the mortality risk was evaluated after adding serum lactate levels to the Sequential Organ Failure Assessment (SOFA) and the Acute Physiology and Chronic Health Evaluation (APACHE) II score-based models.

Results

A total of 802 (48.3%) and 542 (32.6%) patients had moderate and high lactate levels, respectively. The moderate and high lactate groups had a higher risk of mortality than the low lactate group, with HRs of 1.64 (1.22–2.20) and 4.18 (2.99–5.85), respectively. The lactate-enhanced models had higher AUROCs than the models without lactates (0.764 vs. 0.702 for SOFA score; 0.737 vs. 0.678 for APACHE II score).

Conclusions

Hyperlactatemia is associated with mortality outcomes in patients undergoing CRRT for acute kidney injury. Serum lactate levels may need to be monitored in this patient subset.
Quality intrapartum care expectations and experiences of women in sub-Saharan African Low and Low Middle-Income Countries: a qualitative meta-synthesis
Authors: Ahmed Salma A. E. , Mahimbo Abela , Dawson Angela
Published: January 2023

Background

Woman-centred maternity care is respectful and responsive to women’s needs, values, and preferences. Women’s views and expectations regarding the quality of health services during pregnancy and childbirth vary across settings. Despite the need for context-relevant evidence, to our knowledge, no reviews focus on what women in sub-Saharan African Low and Low Middle-Income Countries (LLMICs) regard as quality intrapartum care that can inform quality guidelines in countries.

Methods

We undertook a qualitative meta-synthesis using a framework synthesis to identify the experiences and expectations of women in sub-Saharan African LLMICs with quality intrapartum care. Following a priori protocol, we searched eight databases for primary articles using keywords. We used Covidence to collate citations, remove duplicates, and screen articles using a priori set inclusion and exclusion criteria. Two authors independently screened first the title and abstracts, and the full texts of the papers. Using a data extraction excel sheet, we extracted first-order and second-order constructs relevant to review objectives. The WHO framework for a positive childbirth experience underpinned data analysis.

Results

Of the 7197 identified citations, 30 articles were included in this review. Women’s needs during the intrapartum period resonate with what women want globally, however, priorities regarding the components of quality care for women and the urgency to intervene differed in this context given the socio-cultural norms and available resources. Women received sub-quality intrapartum care and global standards for woman-centred care were often compromised. They were mistreated verbally and physically. Women experienced poor communication with their care providers and non-consensual care and were rarely involved in decisions concerning their care. Women were denied the companion of choice due to cultural and structural factors.

Conclusion

To improve care seeking and satisfaction with health services, woman-centred care is necessary for a positive childbirth experience. Women must be meaningfully engaged in the design of health services, accountability frameworks, and evaluation of maternal services. Research is needed to set minimum indicators for woman-centred outcomes for low-resource settings along with actionable strategies to enhance the quality of maternity care based on women’s needs and preferences.
The effects of intravenous remifentanil on umbilical artery serum-derived exosomes in parturients undergoing epidural anesthesia: a randomized trial
Authors: Wang Liangrong , Li Juan , Yang Xiaodan , Xiong Yicheng , Wang Zilu , Li Li , Li Xinmiao , Zhang Hang , Chen Yong , Lin Lina , Xiong Xiangqing
Published: January 2023

Background

Umbilical artery serum-derived exosomes (UEs) serve as messengers for maternal–fetal information exchange and cellular regulation. Intravenous remifentanil could be considered as an effective adjunct to epidural anesthesia in providing a favorable analgesia effect for cesarean section (C-section), but its effects on UEs are currently unknown.

Methods

From 01/12/2021 to 30/06/2022, eligible parturients scheduled for repeated C-section at the First Affiliated Hospital of Wenzhou Medical University were randomized to receive either an intravenous bolus (0.15 μg/kg) followed by a continuous infusion (0.075 μg/kg/min) of remifentanil or normal saline throughout the procedure. The primary outcome was the number of UEs. Secondary outcomes included the size and protein amount of UEs, the vital signs, visceral pain score, sedation score, maternal satisfaction score, Apgar score, the incidence of neonatal asphyxia, umbilical arterial pH, and the presence of complications.

Results

Nanoparticle tracking analysis indicated similar size of UEs between the two groups, but the number and protein amount of UEs were increased in the remifentanil group  compared to the control group (P < 0.05). In parturients receiving remifentanil, visceral pain scores were decreased, which was accompanied by the increased scores of maternal satisfaction with the anesthetic method (P < 0.05). Other maternal and neonatal outcomes were comparable between the two groups (P > 0.05).

Conclusion

The intravenous administration of remifentanil increased the number of UEs in parturients undergoing repeated C-section under epidural anesthesia, with improved birth experience and minimal neonatal complications.
Perinatal outcomes of singletons following double vitrification-warming procedures: a retrospective study using propensity score analysis
Authors: Shen Xiaoyue , Ding Min , Yan Yuan , Huang Chenyang , Wang Shanshan , Zhou Jianjun , Xing Jun
Published: January 2023

Background

Although repeated cryopreservation is an occasional occurrence, the effect on perinatal outcomes is unclear. Therefore, the aim of this study was to evaluate the perinatal outcomes of singletons after embryo re-cryopreservation.

Methods

In this retrospective study, a total of 647 singleton live births after blastocyst freeze-thaw embryo transfer cycles were investigated. They were divided into two groups: vitrified-warmed blastocysts (once-vitrified group) and vitrified-warmed blastocysts derived from thawed cleaved embryos (re-vitrified group). Propensity score matching (PSM) was used to control for potential confounding factors.

Results

A total of 592 infants were included in the once-vitrified group, and 55 infants were included in the re-vitrified group. After PSM, 108 cases were generated for comparison. The median gestational age was 38 weeks for both groups, and the birthweights were comparable (3390.6 ± 601.5 g vs. 3412.8 ± 672.6 g, P > 0.05). The incidence of preterm birth (PTB) (20.4% vs. 16.7%), low birthweight (LBW) (3.7% vs. 7.4%), macrosomia (11.1% vs. 16.7%) and large for gestational age (LGA) (29.6% vs. 22.2%) were not significantly different between the two groups. Logistic regression analysis indicated that double vitrification-warming procedures did not affect the occurrence of PTB (OR, 2.58 [95% CI, 0.77, 8.63]), LBW (OR, 0.83 [95% CI, 0.08, 8.29]), macrosomia (OR, 0.60 [95% CI, 0.13, 2.69]), or LGA (OR, 1.51 [95% CI, 0.53, 4.27]) (P > 0.05, for all).

Conclusion

Our findings demonstrate that double vitrification-warming procedures do not increase the risk of adverse neonatal outcomes compared with those of once-vitrified embryos.
Conservative surgical approach towards placenta accreta spectrum disorders for uterine preservation
Authors: Mohamed Siraj Shahul Hameed , Tan Kok Hian , Wright Ann M
Published: January 2023

Objective

We previously described a technique for repair of the myometrial defect at repeat Caesarean section which increases residual myometrial thickness thereby potentially reducing future niche-related complications. Here we describe how this technique can be modified for use for placenta accreta spectrum disorders, in line with emerging evidence that this is more a disorder of myometrial deficiency than morbid adherence.

Design

The surgical performance of peripartum hysterectomy was compared with that of the modified technique in all women having repeat Caesarean delivery for placenta accreta spectrum disorder in a tertiary unit in Singapore between December 2019 and October 2021.

Methods

Modification of the original technique involved the systematic delivery of the placenta starting from its most posterior attachment after uterine exteriorization. This is followed by the identification, mobilization, and apposition of the boundaries of myometrial defects as described previously.

Results

Ten women had Caesarean hysterectomy and ten had Caesarean section using the modified approach. Age and gestational age at delivery were similar for the two groups. Women in the modified technique group had had fewer prior Caesarean sections and had a lower body mass index. Operating time, estimated blood loss and need for transfusion were all lower in the myometrial repair group but without statistical significance. There were no visceral injuries in the repair group but there was one bladder injury in the hysterectomy group.

Conclusion

The modified approach provides an effective alternative to peripartum hysterectomy with favourable surgical profile and allows uterine conservation with restoration of myometrial thickness.
Plasma concentration and eGFR in preterm and term neonates receiving gentamicin or successive amikacin therapy
Authors: Singu Bonifasius Siyuka , Ndeunyema Milka Ndapandula , Ette Ene I. , Pieper Clarissa Hildegard , Verbeeck Roger Karel
Published: January 2023

Background

Gentamicin and amikacin are aminoglycoside antibiotics which are renally excreted and known to be nephrotoxic. Estimate of glomerular filtration rate (eGFR) per body surface area is lower in neonates than in adults and exposure to these drugs could lead to more suppression in kidney function. The aim of this study was to determine maximum and minimum plasma concentrations (Cmax and Cmin), time to reach Cmin levels of gentamicin and amikacin, and to assess eGFR in preterm and term neonates.

Methods

Two groups of patients were recruited, 44 neonates receiving gentamicin (5 mg/kg/24 h) and 35 neonates receiving amikacin (15 mg/kg/24 h) by slow intravenous injection. Patients on amikacin had been on gentamicin before being switched to amikacin. Two blood samples were drawn for the determination of the maximum and minimum plasma concentration. Primary outcomes were determination of Cmax, Cmin, and the time it took to clear the aminoglycoside to a plasma concentration below the toxicity threshold (gentamicin: < 1 mcg/mL; amikacin: < 5 mcg/mL.

Results

Therapeutic range for Cmax of gentamicin (15–25 mcg/mL) or amikacin (30–40 mcg/mL) was achieved in only 27.3 and 2.9% of neonates, respectively. Percentage of neonates reaching plasma concentrations below the toxicity threshold within the 24-hour dosing interval was 72.7% for gentamicin and 97.1% for amikacin. Positive correlation between gentamicin clearance and postnatal age borderline statistical significance (p = 0.007), while the correlation between amikacin clearance and postnatal age was poor and not statistically significant (r2 = − 0.30, p = 0.971).

Conclusion

Although eGFR decreased significantly as a function of postnatal age in neonates receiving amikacin, the majority (91.4%) of these neonates were able to clear the drug to < 5 mcg/mL within a 24-hour dosing interval.
Does health literacy moderate the psychological pathways of physical activity from guideline awareness to behavior? A multi-group structural equation modeling
Authors: Tajima Takayuki , Harada Kazuhiro , Oguma Yuko , Sawada Susumu S.
Published: January 2023

Background

Awareness, knowledge, beliefs, and behavioral intentions of physical activity (PA) guidelines may be important mediating factors for promoting PA. However, these pathways of the psychological process to PA behavior have not been examined. These pathways may differ depending on health literacy levels. This study investigated the pathways to PA, from guideline awareness to behavior, and further examined whether they differed by health literacy.

Methods

A cross-sectional study was conducted with 7,000 Japanese participants aged 20–69 years. The participants were registered with an Internet survey company. Participants’ awareness, knowledge, beliefs, and behavioral intentions regarding the PA guidelines of Japan, the volume of moderate-to-vigorous intensity PA, activity level, and health literacy were examined through a questionnaire. The PA pathways, from guideline awareness to behavior, were examined by structural equation modeling (SEM), with PA behavior as the dependent variable. Multi-group SEM was conducted to examine the moderating effect of health literacy on PA pathways. Health literacy scores were dichotomized into high and low groups in multi-group modeling by the median split.

Results

SEM revealed that PA guideline awareness directly affects PA behavior and has certain indirect effects through the mediation of knowledge, beliefs, and behavioral intentions. Furthermore, the multi-group SEM showed that the proportion of indirect effects (path coefficient [PC]: 0.11, 95% confidence interval [CI]: 0.10–0.13) was higher than direct effects (PC: 0.07, 95%CI: 0.03–0.11) in the high-health literacy group. In contrast, the proportion of direct effects (PC: 0.22, 95%CI: 0.15–0.30) was higher than indirect effects (PC: 0.06, 95%CI: 0.05–0.07) in the low-health literacy group.

Conclusions

PA guideline awareness is both directly and indirectly associated with PA behavior, mediated by psychological pathways of knowledge, beliefs, and behavioral intentions, and influenced by health literacy. These results suggest that health literacy should be considered when implementing PA guideline-based interventions.
Additional risk factors improve mortality prediction for patients hospitalized with influenza pneumonia: a retrospective, single-center case–control study
Authors: Bai Yu , Guo Yiqun , Gu Li
Published: January 2023

Background

Severe influenza, especially influenza pneumonia, causes large numbers of deaths each year. Some patients who develop severe influenza have no known risk factors. In this study we investigated risk factors for mortality of patients with influenza A-related pneumonia who have different basic conditions. We also evaluated the power of pneumonia severity assessment tools in Chinese patients hospitalized with influenza A-related pneumonia. Together, these results could provide a basis for a screening method that has improved ability for the early identification of critical patients who will have poor prognoses in clinical practice.

Methods

This single-center, retrospective case–control study included 152 adult patients with severe influenza over six influenza seasons. Data for diagnoses and demographics, as well clinical data, laboratory findings, treatment methods, 30-day and 60-day outcomes of the patients were collected. Patients who had any of the risk factors for severe influenza were included in the high-risk group, and those that had no known risk factors were included in the low-risk group.

Results

The PSI, CURB-65 and PIRO-CAP tools all underestimated the mortality rate of patients hospitalized with influenza A-related pneumonia, and this underestimate was more pronounced for low-risk patients. D-dimer (Odds ratio [OR] = 1.052, 95% confidence interval [CI] 1.001–1.106, p = 0.045) and direct bilirubin (OR = 1.143, 95%CI 1.049–1.246, p = 0.002) were independent risk factors for mortality of patients with influenza A-related pneumonia. When used in combination with ferritin and D-dimer, the area under receiver operator characteristic curve (AUCROC) was 0.851 (95%CI 0.780–0.922, p < 0.001), 0.840 (95%CI 0.763–0.916, p < 0.001) and 0.829 (95%CI 0.748–0.911, p < 0.001) for PSI, CURB-65 and PIRO-CAP, respectively, which was higher than that obtained using PSI, CURB-65 and PIRO-CAP alone.

Conclusions

The findings demonstrate that currently used community-acquired pneumonia (CAP) scoring systems could underestimate the risk of influenza A-related pneumonia mortality. D-dimer was shown to be an independent risk factor of mortality for influenza A-related pneumonia in hospitalized patients, and a combination of D-dimer with ferritin could improve the predictive value of PSI, CURB-65 and PIRO-CAP for adverse prognoses of patients with influenza A-related pneumonia.
Awareness of cervical cancer and its associated socio-demographic factors among Yemeni immigrant women in Malaysia
Authors: Azzani Meram , Ba-Alawi Eshrak , Atroosh Wahib Mohammed , Yadav Hematram
Published: January 2023

Background

Studies have revealed that a higher proportion of women affected by cervical cancer are from some minority groups of immigrant women. Hence, this study was conducted to assess Yemeni immigrant women’s awareness of cervical cancer and its associated socio-demographic factors.

Methods

A cross-sectional study was conducted among 370 Yemeni women in Selangor and Kuala Lumpur, Malaysia. Data on the awareness of symptoms/signs, risk factors, and screening programme were collected using Cervical Cancer Awareness Measurement (Cervical CAM) questionnaire.

Results

More than 74% of the study participants were unable to recall any warning symptoms/signs, and 73% were unable to recall any risk factors. The factors associated with the awareness of symptoms and risk factors were age (95% CI 4.22–5.22,p = 0.039), marital status (95% CI 4.05–7.87,p = 0.021), employment (95% CI 3.89–5.77,p = 0.046) and the number of children (95% CI 5.33–6.54,p = 0.041).

Conclusion

The findings underline the need for public awareness campaigns to improve public awareness of cancer symptoms and risk factors among underserved communities.
A framework to improve quality of hospital-based physiotherapy: a design-based research study
Authors: Steenbruggen Rudi A. , Maas Marjo J. M. , Hoogeboom Thomas J. , Brand Paul L. P. , van der Wees Philip J.
Published: January 2023

Background

A quality framework for hospital-based physiotherapy is lacking. This study aims to design a framework, building on the currently available literature, to improve the quality of hospital-based physiotherapy.

Methods

A multidisciplinary panel of six representatives of hospital-based physiotherapy and their key stakeholders (patients, medical specialists, hospital management and professional association) was set up. We used brainwriting to sample ideas and the ‘decision-matrix’ to select the best ideas.

Results

The first round of brainwriting with an online panel of six experienced participants yielded consensus on seven possible methods for quality improvement of hospital-based physiotherapy [1]: continuing education [2] ,feedback on patient reported experience measures and patient reported outcome measures [3] ,a quality portfolio [4] ,peer observation and feedback [5] ,360 degree feedback [6] ,a management information system, and [7] intervision with intercollegiate evaluation. Placing these methods in a decision matrix against four criteria (measurability, acceptability, impact, accessibility) resulted in a slight preference for a management information system, with almost equal preference for five other methods immediately thereafter. The least preference was given to a 360-degree feedback.

Conclusions

In the design of a framework for improving the quality of hospital-based physiotherapy, all seven suggested methods were perceived as relevant but differed in terms of advantages and disadvantages. This suggests that, within the framework, a mixture of these methods may be desirable to even out respective advantages and disadvantages.