bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost-effectiveness analysis of proactive home visits compared with site-based community health worker care on antenatal care outcomes in Mali: a cluster-randomised trial
Authors: Ogbuoji Osondu , Shahid Minahil , Zimmerman Armand , Liu Jenny X , Kayentao Kassoum , Whidden Caroline , Treleaven Emily , Traoré Coumba , Sogoba Mahamadou , Doumbia Saibou , Boettiger David Charles , Cissé Amadou Beydi , Keita Youssouf , Berthé Mohamed , Johnson Ari
Published: December 2024

Introduction

Despite recommendations from the WHO, antenatal care (ANC) coverage remains low in many low-income and middle-income countries (LMICs). Community health workers (CHWs) can play an important role in expanding ANC coverage through pregnancy identification, provision of health education, screening for complications, delivery of therapeutic care and referral to higher levels of care. However, despite the success of CHW programmes in various countries, WHO has called for additional research to develop evidence-based models that optimise CHW service delivery and that can be replicated across geographies.

Methods

The ProCCM Trial was a cluster-randomised controlled trial to compare proactive home visits by CHWs (intervention, 69 village clusters) to the provision of CHW care at community fixed sites only (control, 68 village clusters) in the Bankass health district in Central Mali. In this study, we conducted a cost-effectiveness analysis of proactive CHW home visits in improving ANC utilisation, a secondary outcome of the ProCCM trial. We analysed five ANC outcomes: (1) number of ANC contacts, (2) at least one ANC contact, (3) at least four ANC contacts, (4) at least eight ANC contacts and (5) ANC initiated in the first trimester. We assumed two perspectives, a CHW programme’s and the Full ANC programme’s perspective, which included facility-based as well as community-based ANC. We estimated programme costs, incremental cost-effectiveness ratios (ICERs) and probabilities of the intervention being more cost-effective than the control at different willingness-to-pay (WTP) thresholds.

Results

Proactive home visits were cost-saving from the CHW programme’s perspective (ICERs: −$21.39 to −$79.20 per ANC utilisation outcome) and from the Full ANC programme perspective (ICERs: −$1.70 to −$6.30 per ANC utilisation outcome) compared with the fixed-site CHW care. The likelihood of the intervention being more cost-effective than the control was 100% at WTP thresholds $0 per ANC utilisation outcome and between $12.5 and $50.00 per ANC utilisation outcome in the CHW- and Full ANC programme perspectives, respectively.

Conclusion

Our results provide evidence that proactive home visits produce more value per dollar spent as a means of improving the uptake of ANC services compared with fixed-site CHW services.

Trial registration number

NCT02694055.
Inequalities in ownership and availability of home-based vaccination records in 82 low- and middle-income countries
Authors: Cata-Preta Bianca O , Santos Thiago M , Wendt Andrea , Arroyave Luisa , Mengistu Tewodaj , Hogan Daniel R , Barros Aluisio J D , Victora Cesar G , Danovaro-Holliday M Carolina
Published: December 2024

Introduction

Home-based records (HBRs) are widely used for recording health information including child immunisations. We studied levels and inequalities in HBR ownership in low-income and middle-income countries (LMICs) using data from national surveys conducted since 2010.

Methods

We used data from national household surveys (Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS)) from 82 LMICs. 465 060 children aged 6–35 months were classified into four categories: HBR seen by the interviewer; mother/caregiver never had an HBR; mother/caregiver had an HBR that was lost; and reportedly have an HBR that was not seen by the interviewer. Inequalities according to age, sex, household wealth, maternal education, antenatal care and giving birth in an institutional setting were studied, as were associations between HBR ownership and vaccine coverage. Pooled analyses were carried out using country weights based on child populations.

Results

An HBR was seen for 67.8% (95% CI 67.4% to 68.2%) of the children, 9.2% (95% CI 9.0% to 9.4%) no longer had an HBR, 12.8% (95% CI 12.5% to 13.0%) reportedly had an HBR that was not seen and 10.2% (95% CI 9.9% to 10.5%) had never received one. The lowest percentages of HBRs seen were in Kiribati (22.1%), the Democratic Republic of Congo (24.5%), Central African Republic (24.7%), Chad (27.9%) and Mauritania (35.5%). The proportions of HBRs seen declined with age and were inversely associated with household wealth and maternal schooling. Antenatal care and giving birth in an institutional setting were positively associated with ownership. There were no differences between boys and girls. When an HBR was seen, higher immunisation coverage and lower vaccine dropout rates were observed, but the direction of this association remains unclear.

Interpretation

HBR coverage levels were remarkably low in many LMICs, particularly among children from the poorest families and those whose mothers had low schooling. Contact with antenatal and delivery care was associated with higher HBR coverage. Interventions are urgently needed to ensure that all children are issued HBRs, and to promote proper storage of such cards by families.
Contribution of domestic animals’ feces to the occurrence of diarrhoea among children aged 6–48 months in Sidama region, Ethiopia: a laboratory-based matched case-control study
Authors: Gunsa Gorfu Geremew , Haddis Alemayehu , Ambelu Argaw
Published: December 2024

Background

In developing countries, due to improper management of domestic animals’ exposures, under-five (U5) children have been affected by diarrhoea. However, there is no evidence that shows the presence of diarrhoea-causing pathogens in the faeces of U5 children and animals residing in the same houses in the Sidama region, Ethiopia.

Methods

A laboratory-based matched case-control study was conducted on children aged 6–48 months in the Sidama region of Ethiopia from February to June 2023. The study enrolled 113 cases, and 113 controls visited the selected health facilities during the study period. Faecal specimens from the case and control children and domestic animals were collected using transport media. Data were collected at children-residing homes by interviewing caretakers using the KoboCollect application. The presence of diarrhoea-causing pathogens (Campylobacteria, Escherichia coli, non-typhoidalsalmonella,ShigellaandCryptosporidium) was detected using culture media, biochemical tests, gram stain, catalase and oxidase tests. The diarrhoea risk factors were identified using conditional logistic regressions and the random forest method using R.4.3.2.

Results

Of the faecal specimens diagnosed, 250 (64.1%) tested positive for one or more pathogens. Faecal specimens from chickens tested more positive forE. coliandCampylobacteria. Of the pairs of faecal specimens taken from case children and animals living in the same house, 104 (92%) tested positive for one or more similar pathogens. Among the factors, disposing of animal waste in an open field, storing drinking water in uncovered containers, caretakers poor knowledge about the animals’ faeces as a risk factor for diarrhoea and ≤2 rooms in the living house were significantly associated with diarrhoea.

Conclusion

The finding shows that diarrhoea-causing pathogens are transmitted from domestic animals’ faeces to children aged 6–48 months in the Sidama region. The improper management of animals’ faeces and related factors were the predominant risk factors for diarrhoea.
Components of cognitive–behavioural therapy for mitigating core symptoms in attention-deficit hyperactivity disorder: a systematic review and network meta-analysis
Authors: Matsumoto Kazuki , Hamatani Sayo , Kunisato Yoshihiko , Mizuno Yoshifumi
Published: December 2024

Question

Cognitive–behavioural therapy (CBT) is frequently implemented for individuals with attention-deficit hyperactivity disorder (ADHD). It is still unknown which specific components are effective, because CBT is a complex intervention with several components. The objective of this review was to assess the efficacy of CBT components for ADHD.

Study selection and analysis

Building on definitions of the components used in CBT strategies, we conducted network meta-analyses to evaluate the efficacy at both the treatment level (ie, combinations of these components) and the component level (ie, individual component). Primary outcome was treatment response of ADHD core symptoms. Secondary outcomes were total ADHD symptoms, inattention symptoms, hyperactivity-impulsivity symptoms and dropout from the treatment. We searched MEDLINE (via PubMed), Embase, PsycINFO, ClinicalTrials.gov and Cochrane Library for literature published up to 31 March 2022. This review included only randomised controlled trials.

Findings

43 trials with 3817 participants were included in the network meta-analyses. Third-wave therapy (OR=4.80, 95% credible interval (CrI) 2.50 to 9.10), behaviour therapy (OR=3.50, 95% CrI 1.70 to 7.30) and CBT (OR=3.10, 95% CrI 1.70 to 5.70) were treatments that demonstrated superior efficacy compared with placebo. The component-level analyses showed organisational strategies (incremental OR (iOR)=2.03, 95% CI 1.27 to 3.24) and third-wave components (iOR=1.95, 95% CI 1.30 to 2.93) were associated with increase in treatment response. Problem-solving techniques (incremental standardised mean difference=0.42, 95% CI 0.01 to 0.83) were associated with a reduction in inattention symptoms.

Conclusions

Our findings suggest that the optimal treatment package for ADHD may include organisational strategies, third-wave components and problem-solving techniques.

PROSPERO registration number

CRD42022323898.
Strategic interventions and a novel model for the integration of community pharmacy and primary care in Spain: qualitative insights
Authors: Piquer-Martinez Celia , Urionagüena Amaia , Benrimoj Shalom I. , Calvo Begoña , García-Cárdenas Victoria , Amador-Fernandez Noelia , Gastelurrutia Miguel A , Martinez Martinez Fernando
Published: December 2024

Objectives

To explore the opinions and perceptions of key stakeholders on the integration between community pharmacy and primary care, within the Valencian Autonomous Community. Specific objectives include identifying strategic interventions to facilitate this integration. Additionally, the manuscript discusses the formulation of a novel model for the integration of community pharmacy and primary care.

Design

Qualitative, with data from five virtual focus groups (FG) and 12 semistructured interviews analysed thematically using NVivo and interventions prioritised through a virtual nominal group technique.

Setting

Valencian Autonomous Community (Spain).

Participants

FG involved community pharmacists (CP) and primary care stakeholders including general practitioners, primary care nurses, general practitioner pharmacists, social services managers and administrators. Interviewees were government representatives and professionals from organisations. Selection was through snowball sampling and invitations by Official Colleges of Pharmacists.

Results

Five themes emerged, revealing the multifaceted nature of integrating community pharmacies and primary care. ‘Integration’ was identified as an ambitious target, anchored in collaboration and communication efforts. The role of CP was particularly noted for their direct patient interaction and trust, vital in fostering medication adherence. Barriers like role ambiguity and regulatory environment were highlighted. Seven interventions were identified to enable integration, with three of them prioritised: ‘bidirectional communication’, ‘protocol standardisation’ and ‘multidisciplinary team strengthening’. These interventions, linked with prior components of health system integration, led to a pioneer integration model.

Conclusions

Recognising stakeholder insights is essential in shaping workable, practical and adaptable models for integration. Tailoring these temporal models to stakeholders' immediate needs and strategic priorities may serve as effective starting points for integration. Support from professional bodies and proactive stakeholders’ engagement will optimise the integration success and its acceptance across healthcare levels.
Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards
Authors: Galle Anna , Berghman Helga , D’Hauwers Silke , Vaerewijck Nele , Valente Emanuelle Pessa , Mariani Ilaria , Bomben Arianna , delle Vedove Stefano , Lazzerini Marzia
Published: December 2024

Objectives

To examine quality of maternal and newborn care (QMNC) around childbirth in facilities in Belgium during the COVID-19 pandemic and trends over time.

Design

A cross-sectional observational study.

Setting

Data of the Improving MAternal Newborn carE in the EURO region study in Belgium.

Participants

Women giving birth in a Belgian facility from 1 March 2020 to 1 May 2023 responded a validated online questionnaire based on 40 WHO standards-based quality measures organised in four domains: provision of care, experience of care, availability of resources and organisational changes related to COVID‐19.

Primary and secondary outcome measures

Quantile regression analysis was performed to assess predictors of QMNC; trends over time were tested with the Mann‐Kendall test.

Results

897 women were included in the analysis, 67% (n=601) with spontaneous vaginal birth, 13.3% (n=119) with instrumental vaginal birth (IVB) and 19.7% (n=177) with caesarean section. We found overall high QMNC scores (median index scores>75) but also specific gaps in all domains of QMNC. On provision of care, 21.0% (n=166) of women who experienced labour reported inadequate pain relief, 64.7% (n=74) of women with an instrumental birth reported fundal pressure and 72.3% (n=86) reported that forceps or vacuum cup was used without their consent. On experience of care, 31.1% (n=279) reported unclear communication, 32.9% (n=295) reported that they were not involved in choices,11.5% (n=104) stated not being treated with dignity and 8.1% (n=73) experienced abuse. Related to resources, almost half of the women reported an inadequate number of healthcare professionals (46.2%, n=414). Multivariable analyses showed significantly lower QMNC scores for women with an IVB (−20.4 in the 50th percentile with p<0.001 and 95% CI (−25.2 to −15.5)). Over time, there was a significant increase in QMNC Score for ‘experience of care’ and ‘key organisational changes due to COVID-19’ (trend test p< 0.05).

Conclusions and relevance

Our study showed several gaps in QMNC in Belgium, underlying causes of these gaps should be explored to design appropriate interventions and policies.

Trial registration number

NCT04847336.
Exploring residents’ perspectives on their professional identity in general practice residency in the Netherlands: a qualitative study
Authors: Al-Sabiry Miami , Slootweg Irene , Numans Mattijs E , van Mook Walther NKA , Barnhoorn Pieter
Published: December 2024

Objectives

Educational initiatives in residency may lack alignment with residents’ learning objectives. Furthermore, they may overlook residents’ struggle to find fulfilment in their work. Professional identity formation (PIF) is a conceptual lens through which to explore the alignment of educational initiatives with residents’ learning objectives. Few empirical studies have examined PIF in residency in general. PIF outcomes in general practice (GP) residency, from the perspective of residents, are poorly represented in the current literature. This study aimed to explore residents’ perspectives on their professional identity to inform PIF learning objectives in GP residency.

Design

A qualitative descriptive study using a list of predetermined questions to guide focus group interviews.

Setting

Data collection took place between winter and autumn 2019 at four GP training institutes across the Netherlands.

Participants

92 third (final) year GP residents participated in focus group interviews.

Results

Residents’ overall perspectives hinged on how to negotiate the endlessness of the profession. This endlessness was reported to manifest in four areas, namely, the GP: as an accessible healthcare provider, as a spider in the care-web, providing personalised care and maintaining a work–life balance.

Conclusions

GP residents’ narratives highlighted an increasingly challenging profession and posited the importance of guided negotiation for their PIF. Deploying the concept of subjectification in residents’ guided negotiation of the profession’s endlessness possibly improves the supervisor–resident educational alliance. Furthermore, awareness of issues related to work–life balance and fostering residents’ sense of belonging and collegiality may contribute to improving their well-being and sense of fulfilment in their work.
Measuring technology-facilitated sexual violence and abuse: a scoping review protocol of existing measurements
Authors: Pak Sharon Hoi Lam , Choi Edmond Pui Hang , Wu Chanchan , Chau Pui Hing , Bradbury-Jones Caroline
Published: December 2024

Introduction

Technology-facilitated sexual violence and abuse (TFSVA) refers to a range of behaviours in which digital technologies are used to facilitate both virtual and face-to-face sexual harm. The proliferation of smartphone usage and increasing internet penetration rates across the world have made it easier for individuals to become perpetrators and victims of TFSVA. Since empirical studies of TFSVA remain limited in the academic arena, and there is an absence of evidence to support the development of a standardised TFSVA measurement, this review aims to explore what TFSVA measurements are currently available and their potential use in measuring TFSVA.

Methods and analysis

This scoping review will be structured according to the Joanna Briggs Institute recommended framework. Keywords related to ‘technology’, ‘sexual violence’ and ‘measure’ will be used. Any paper related to measurements of TFSVA will be included without limitation to any population or setting. A search will be conducted from database inception until May 2024 for published literature in English and Chinese electronic databases, which included PubMed, Embase, CINAHL, Scopus, ProQuest, Web of Science, Chinese National Knowledge Infrastructure, SinoMed, Index to Taiwan Periodical Literature and Ariti Library. Screening and study selection will be conducted by two independent reviewers. Data will be extracted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. The PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) Framework will be used to report the findings.

Ethics and dissemination

Since the scoping review methodology consists of reviewing and collecting data from publicly available materials, this study does not require ethics approval. This scoping review has the potential to serve as the most appropriate way to explore existing evidence related to this emerging phenomenon. The results of this review are expected to highlight various types of TFSVA measurement developed in different settings. Further work is required to develop measurements adapted for specific populations and tested to ensure acceptability and cultural competence. The results will be disseminated through a peer-reviewed publication and conference presentations.

Review registration

The protocol of this review was registered within the Open Science Framework (https://doi.org/10.17605/OSF.IO/Q5ETW) on 13 March 2024.
Mainstreaming control interventions for neglected tropical diseases into the health system: a scoping review protocol
Authors: Bilchut Awraris Hailu , Gebre Teshome , Seife Fikre , Enbiale Wendemagegn , Tamiru Adugna , Yohanes Tsegaye , Yohannes Amsayaw , Adane Yosef , Merdekios Behailu , Kebede Biruck , Kebede Fikreab , Deribe Kebede , Evans Jennifer , Burton Matthew J , Habtamu Esmael
Published: December 2024

Introduction

The WHO neglected tropical diseases (NTD) roadmap (2021–2030) proposed a shift in approach to addressing NTDs through accountability for impact, implementing integration across NTDs, mainstreaming in national health systems and ensuring country ownership. However, a major challenge has been the dearth of evidence on how to implement this shift in a resource-limited setting. The objective of this scoping review is to understand the extent and type of evidence on the mainstreaming or integration of programmes and/or interventions against NTDs into the national health system.

Methods

Research articles of any methodology, series, evaluations and reports published from 1995 in the English language on any peer-reviewed platforms, and WHO, universities and government or implementing partners websites that report and discuss mainstreaming or integration implementation practices or experiences of any interventions against NTDs into the health system will be included. The main databases searched on 30 October 2024 were Medical Literature Analysis and Retrieval System Online (Ovid), Embase (Ovid), Global Health (Ovid), Cochrane Database of Systematic Reviews and CENTRAL on the Cochrane Library (Wiley), and WHO Global Index Medicus. Following piloting, screening and data extraction will be undertaken independently by at least two people. Any disagreements that arise between the reviewers at each stage of the screening and selection process will be resolved through discussion, or with an additional reviewer/s. Thematic analysis will be conducted guided by the project INTEGRATE framework and the Primary Health Care Performance Initiative conceptual framework. Key information or evidence relevant to the mainstreaming of interventions against NTDs into the health system such as mainstreamed interventions and the level of health system where the mainstreaming occurred, the effectiveness of the mainstreaming, contextual differences in health system organisation between settings, and challenges and promising practices will be summarised.

Ethics and dissemination

Ethical approval will not be sought as our review will only include published data. The findings will be published in a peer-reviewed journal and will be disseminated at national and international research and programme review platforms.
Investigating context-specific sedentary behaviours and cardiometabolic health in college-based young adults (CONTEXT-SB): a protocol for a longitudinal observational study
Authors: Diana Jake Christopher , Chauntry Aiden James , Cowley Emma , Paterson Craig , Struder Jeb F , Pagan-Lassalle Patricia , Meyer Michelle L , Lin Feng-Chang , Moore Justin B , Hanson Erik D , Stoner Lee
Published: December 2024

Background

Sedentary behaviour (SB) is detrimental to cardiometabolic disease (CMD) risk, which can begin in young adulthood. To devise effective SB-CMD interventions in young adults, it is important to understand which context-specific SB (CS-SB) are most detrimental for CMD risk, the lifestyle behaviours that cluster with CS-SBs and the socioecological predictors of CS-SB.

Methods and analysis

This longitudinal observational study will recruit 500 college-aged (18–24 years) individuals. Two laboratory visits will occur, spaced 12 months apart, where a novel composite CMD risk score (eg, arterial stiffness, metabolic and inflammatory biomarkers, heart rate variability and body fat distribution) will be calculated, and questionnaires to measure lifestyle behaviours and levels of the socioecological model will be administered. After each laboratory visit, total SB (activPAL) and CS-SB (television, transportation, academic/occupational, leisure computer, ‘other’; ecological momentary assessment) will be measured across 7 days.

Ethics and dissemination

This study has received full ethical approval, and participants provide written informed consent. Our hypothesis is that certain CS-SB will show stronger associations with CMD risk, compared with total sedentary behaviour (T-SB), even after accounting for coexisting lifestyle behaviours. We also expect a range of intra-individual, inter-individual and physical environmental socioecological factors will predict CS-SB. Findings addressing both the primary and any secondary research aims will be submitted for publication in a high-impact peer-reviewed journal.
Falls prevention in an older adult mental health ward through a quality improvement initiative
Authors: Oyeneyin Babatunde , Beech Hayley , Marshall Alison , Head Karen
Published: December 2024

Falls in the inpatient units are the most frequently reported patient safety incidents and their consequences can be devastating. Risk factors for falls are broadly categorised into two factors—‘extrinsic and intrinsic’ and while the effect of functional mental health conditions on falls has not been extensively studied, older adults with dementia are at a higher risk of falling. Their impact could lead to delayed functional recovery, distress, increased length of hospital stays and an increased fear of falling.

Quality improvement (QI) methods have been demonstrated as one strategic approach to reducing falls in mental health older person wards. We completed QI work at Surrey and Borders Partnership NHS Foundation Trust, to reduce fall incidents in Victoria Ward—an older person ward treating people with functional mental health disorders. We generated a theory of change and then tested several change ideas developed by the team. Using this approach, outcomes resulted in a reduction in the rate of falls from 9.5 falls per 1000 bed days to 4.6 falls per 1000 bed days.
Implementation strategies of fall prevention interventions in hospitals: a systematic review
Authors: Spoon Denise , de Legé Thomas , Oudshoorn Christian , van Dijk Monique , Ista Erwin
Published: December 2024

Background

The effectiveness of implementing fall prevention interventions (FPI) among hospitalised adults exhibits variability. Our review explored implementation strategies for FPIs, how these strategies are operationalised and their impact on fall rates and adherence.

Methods

Databases were searched up to October 2024 for studies reporting the implementation of FPIs in hospitalised adults. Studies were eligible if they reported at least one implementation strategy, reported a fall rate per 1000 patient days and had a control group. Implementation strategies were classified using the Expert Recommendations for Implementing Change (ERIC) taxonomy, and operationalised based on the prerequisites of Proctor.

Results

The implementation strategies from the 48 included studies could all be categorised in the existing ERIC strategies. Almost all studies (96%) used at least one implementation strategy from the ‘train and educate stakeholders’ domain. The second-most used domain was ‘develop stakeholder relationships’. The median number of implementation strategies per study was 6 (IQR 4–9). None of the studies reported all prerequisites per individual strategy, we found a median number of prerequisites per strategy of 2 (IQR 1–3). The action was discerned for all implementation strategies, since this was how we identified the implementation strategies. The actor was identified in 47% of the strategies, while all other prerequisites were reported less frequently. After the implementation of FPIs, the median decline in fall rate was 0.9 (IQR -1.8–.3) per 1000 patient days. Across the 17 studies that measured adherence, the median adherence rate to the FPIs was 65% (IQR 29–87).

Conclusion

This review emphasises that the documented strategies for implementing FPIs do not provide adequate details in their reporting. This, in turn, hinders clinicians and researchers from optimally guiding their quality improvement projects.

PROSPERO registration number

CRD42018091173.
Implantable cardioverter defibrillator deactivation and end-of-life: British Heart Rhythm Society practical consensus guideline
Authors: Thomas Honey , Wallace Jane , Foley Paul , Johnson Miriam J
Published: December 2024

Implantable cardioverter defibrillators (ICDs) are implanted in increasing numbers of patients with the aim of treating ventricular arrhythmias in high-risk patients and reducing their risk of dying. Individuals are also living longer with these devices. As a result, a greater number of patients with an ICD will deteriorate either with worsening cardiac failure, another non-cardiac condition or general frailty and will have a limited prognosis. Frequently they will be cared for by non-cardiac teams who may be less familiar with ICDs. Therefore, to ensure the person receives high-quality end-of-life care, they should have the opportunity to consider and discuss the option to deactivate the shock function of their ICD. If the ICD shock therapy is not discontinued, there is an increased risk that as a person reaches the last days of life, the ICD may deliver painful shocks which are distressing. There is also a risk that the device may delay the person’s natural death which the person would not have chosen if they had been given the opportunity to discuss discontinuation. The British Heart Rhythm Society has developed a practical document to support all healthcare professionals who are caring for patients who have an ICD. This includes descriptions of different device types, ethical and legal aspects, timing and nature of ICD discussions and practical advice regarding how the devices may be deactivated. It aims to promote awareness and timely discussion between professionals and patients and to encourage best practice.
Stability of the thin shell from traversable Schwarzschild-like wormholes
Authors: Liempi Luis , Orellana Fabián , Cataldo Mauricio
Published: December 2024

This article analyses the stability of thin-shell wormholes constructed from non-asymptotically flat wormholes and the vacuum Schwarzschild solution. The construction of these spherically symmetric thin shells focuses on a specific class of wormholes characterized by a shape function that is linearly dependent on the radial coordinate. This introduces angular defects, which can be either deficits or excesses in the solid angle. To analyze the stability of these structures, we employ linear perturbations around a static solution, using a master equation to describe the behavior of stable equilibrium regions. The study is systematically divided to examine both positive and negative surface energy densities, and it delves into various gravitational redshift functions. Finally, it is concluded that the interaction of an external force on the thin shell significantly influences the behaviour of stable regions. It is demonstrated that, in certain cases, the matter supporting the thin shell may be non-exotic, fully satisfying all energy conditions.
Nonlinear Transient Heat Transfer and Optimisation of Multidirectional (1D/2D/3D) Functionally Graded Porous Composites
Authors: Kumar Samarjeet , Kar Vishesh Ranjan
Published: December 2024

In this paper, the steady and transient heat transfer behaviours of multidirectional (1D/2D/3D) functionally graded composite plates are investigated. Also, two different porosity types, i.e., even and uneven distributions, are considered along with material gradation. Here, the spatial/temperature-dependent effective material properties of these highly heterogeneous composites with porosity are evaluated using the extended Voigt’s homogenisation scheme via multi-variable power-law functions and further verified with the representative volume element (RVE) scheme. In continuation, generalised mathematical models are developed by including material nonlinearity using the cubic-polynomial-based temperature-dependent constitutive model. The Poisson’s and Laplace’s equations are utilised for steady and transient heat transfer problems, respectively, and the weak form is derived using the Galerkin method. Further, coupled finite element method (FEM)–finite difference method (FDM) is adopted via Picard’s successive iteration and Crank–Nicolson technique to compute the nonlinear transient temperature. The proposed model is verified by comparing it with the previously reported results. In addition, the effects of heterogeneity, porosity, power-law indices and boundary conditions on the steady/transient heat transfer responses of multidirectional functionally graded plates are examined and discussed in detail. At last, the optimum material distributions are obtained using the response surface methodology (RSM) by minimising the heat transfer responses.
Silver Chemical Mechanical Polishing with the Synergy of Hydrogen Peroxide and 5-methyl-1H-benzotriazole
Authors: Jiang Liang , Chen Yu , Zhang Yongshun , Chen Yushan , Lei Rui , Qian Linmao
Published: December 2024

Silver is a promising interconnect material. Silver chemical mechanical polishing (CMP) requires further research. This study investigated the effects of hydrogen peroxide (H2O2) and 5-methyl-1H-benzotriazole (5-MBTA) on silver CMP. The results indicate that H2O2 and 5-MBTA exhibit synergy in the silver CMP, greatly improving surface quality and material removal rate (MRR). After adding 10 mmol l−1 5-MBTA to 1 wt% H2O2, the surface roughness S
a drops from 27 nm to as low as 1.16 nm, while the MRR increases from 26 nm min−1 to 220 nm min−1. The silver substrate shows no processing damage caused by CMP. For the mechanism, H2O2 oxidizes silver to form soluble Ag[(OH)2]− and Ag2O. Consequently, this enhances corrosion and causes corrosion holes on the polished silver surface. Upon adding 5-MBTA to H2O2, 5-MBTA reacts with silver ions to form Ag-5-MBTA based on the X-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy results. For one thing, Ag-5-MBTA inhibits corrosion according to the electrochemical experimental results, preventing corrosion holes. Hence, the surface quality is improved. In addition, the silver surface’s hardness becomes lower according to the atomic force microscopy results, presumably due to incoordination between Ag2O and Ag-5-MBTA. Therefore, the MRR increases. This study presents a high-quality CMP solution for silver interconnects.
The Interaction Between Dietary Fat Level, n‐3 LC‐PUFA, and Zinc on Their Postprandial Absorption Kinetics in Atlantic Salmon (Salmo salar)
Authors: Fang HaoHang , Sissener Nini H. , Sæle Øystein , Sigholt Trygve , Philip Antony J. Prabhu
Published: December 2024

Two short‐term feeding trials were conducted on Salmo salar, with the interaction between dietary zinc (Zn) and fat level in trial 1 and with the interaction between dietary Zn and n‐3 long‐chain polyunsaturated fatty acids (n‐3 LC‐PUFA) in trial 2, focusing on postprandial plasma parameters, intestinal Zn and fat uptake and transport. After 4‐week feeding interventions, samples were collected at different postprandial time points, ranging from 0 to 36/38 h after feeding. Results showed that increased Zn level in feed significantly increased the postprandial plasma Zn level in trial 1 (8–9°C). On the contrary, the postprandial plasma Zn level was not affected by the dietary Zn under higher temperature conditions (trial 2, 10−12°C). Further, analyzed markers related to intestinal Zn uptake and transport were not affected by dietary fat level and n‐3 LC‐PUFA. In addition, analyzed markers related to intestinal fat uptake and transport were not affected by dietary Zn. Intestinal Zn transport plays a key role in regulating body Zn storage, while intestinal fat transport influences lipid accumulation within the intestine. Understanding how these processes respond to dietary components is critical for maintaining fish health and welfare.
A De Novo Mutation in ACTC1 and a TTN Variant Linked to a Severe Sporadic Infant Dilated Cardiomyopathy Case
Authors: Acuña-Ochoa Jose G. , Balderrábano-Saucedo Norma A. , Cepeda-Nieto Ana C. , Alvarado-Cervantes Maria Y. , Ibarra-Garcia Vianca L. , Barr Daniel , Gage Matthew J. , Pfeiffer Ryan , Hu Dan , Barajas-Martinez Hector
Published: December 2024

Structural or electrophysiologic cardiac anomalies may compromise cardiac function, leading to sudden cardiac death (SCD). Genetic screening of families with severe cardiomyopathies underlines the role of genetic variations in cardiac‐specific genes. The present study details the clinical and genetic characterization of a malignant dilated cardiomyopathy (DCM) case in a 1‐year‐old Mexican child who presented a severe left ventricular dilation and dysfunction that led to SCD. A total of 132 genes (48 structure‐ and 84 electrical‐related genes) were examined by next generation sequencing to identify potential causative mutations in comparison to control population. In silico analysis identified only two deleterious heterozygous mutations within an evolutionarily well‐conserved region of the sarcomeric genes ACTC1/cardiac actin (c.664G > A/p.Ala222Thr) and TTN/titin (c.33250G > A/p.Glu11084Lys). Further pedigree analysis revealed the father of the index case to carry with the TTN mutation. Surprisingly, the ACTC1 mutation was not harbored by any first‐degree family member. Computational 3D modeling of the mutated proteins showed electrostatic and conformational shifts of cardiac actin compared to wild‐type version, as well as changes in the stability of the compact/folded states of titin that normally contributes to avoid mechanic damage. In conclusion, our findings suggest a likely pathogenic de novo mutation in ACTC1 in coexpression of a TTN variant as possible causes of an early onset of a severe DCM and premature death. These results may increase the known clinical pathogenic variations that may critically alter the structure of the heart, whose fatality could be prevented when rapidly detected.
Characterization and Biofilm Inhibition of Multidrug‐Resistant Acinetobacter baumannii Isolates
Authors: Yadav Poonam , Shrestha Sreska , Basyal Deepak , Tiwari Ananda , Sah Ranjit , Sah Anil Kumar , Yadav Bishal , Willcox Mark , Mishra Shyam Kumar
Published: December 2024

Multidrug‐resistant (MDR) Acinetobacter baumannii poses a significant therapeutic challenge due to its resistance to multiple antibiotics and its ability to form biofilm. This study aimed to characterize MDR A. baumannii isolates for their biofilm‐forming capabilities and the presence of common biofilm‐related genes at a tertiary care university hospital in Nepal. In addition, it assessed the efficacy of various compounds, particularly essential oils, in inhibiting biofilm formation. Identification and antibiotic sensitivity testing of A. baumannii isolates from clinical specimens were conducted according to the guidelines of the American Society for Microbiology. Isolates were screened for motility profiles, biofilm production in a microtiter plate assay, and the presence of biofilm‐related gene(s) by conventional polymerase chain reaction. The ability of cinnamaldehyde, ethylenediaminetetraacetic acid (EDTA), Tween 80, amino acids (glycine and glutamic acid), and natural plant extracts to inhibit biofilm formation was also tested using the microtiter plate system. Out of the total 200 A. baumannii isolates, 195 were MDR, with 192 able to produce biofilms. Among them, 83.1% were strong biofilm producers. In this study, 42.0% and 66.2% of the isolates exhibited twitching motility and surface‐associated motility, respectively. Thirty MDR A. baumannii isolates from medical devices contained biofilm‐related genes csuE, ompA, bap, and blaPER−1, in 90.0%, 53.3%, 46.6%, and 26.6% of strains, respectively. Cinnamaldehyde (0.875 mg/mL) was the most effective compound, inhibiting biofilm formation by 77.3%, followed by ethanolic extract of onion (77.2%), 0.5% Tween 80 (76.8%), and essential oil of ginger (70.8%). The majority of A. baumannii clinical isolates were strong biofilm producers and often possessed the biofilm‐related genes csuE and ompA. Essential oils at 200 mg/L, along with Tween 80, were the most effective (≥ 67%) at inhibiting the formation of biofilms. These findings help to understand biofilm production and provide valuable insights into MDR A. baumannii isolates in this clinical setting.
Research on Fermentation Technology for a Dendrobium officinale Leaf–Sweet Potato Koji Compound Beverage
Authors: Zhang Zhenlin , Yin Zhichao , Wang Yanhong , Fang Xingtang , Chen Xi , Zhang Chunlei , Xue Qingqing , Cheng Weiwei , Hu Meihua , Zhu Yixuan , Yao Yin
Published: December 2024

Dendrobium officinale leaf contains various physiologically active substances. However, no previous studies have reported on the use of D. officinale leaf extract in fermented sweet potato beverages. In this study, Dendrobium officinale leaf and sweet potato were used as raw materials to produce a compound fermented beverage flavored with D. officinale leaf. A sweet potato vinegar folk production method was used, and beneficial microorganisms, including Rhizopus, yeast, and lactic acid bacteria, were inoculated into the fermentation. The quantity of D. officinale leaves, concentration of the sweet potato koji, fermentation time, and temperature during the fermentation process were optimized using orthogonal experiments and analysis of variance. The results indicated that a D. officinale leaf extract of 30%, sweet potato koji concentration of 30%, fermentation time of 5 days, and temperature of 30°C were optimal for beverage formation. Under these conditions, the fermentation broth had a mild flavor of D. officinale leaf and a moderately sweet and sour taste, the biofilm was a transparent gelatinous film, and the utilization efficiency of carbohydrates was high. Excellent flavor, color, and stability of the sweet potato beverage were obtained, with a total sugar content of 15.88 mg/mL and a final pH of 2.65.
Experience of Burden of Care and Support Needs of Informal Caregivers of Persons With Severe Mental Disorders in Rural South Africa: A Qualitative Study
Authors: Silaule Olindah , Nkosi Nokuthula G. , Adams Fasloen
Published: December 2024

Severe mental disorders are chronic and disabling conditions marked by serious functional impairments. As a result, persons with severe mental disorders require long‐term care from their family, relatives, or friends. Providing care is accompanied by negative experiences that result in distress for the caregivers, and as such, they require support to cope with their caregiving responsibilities. This study was aimed at exploring the experiences and support needs of informal caregivers caring for persons with severe mental disorders in rural South Africa. A descriptive qualitative approach was used to explore the experiences and support needs of the informal caregivers. Ten semistructured interviews were conducted with 12 informal caregivers who were purposely selected to participate between January and June 2022. Data were analysed using reflexive thematic analysis. The themes presented in this paper are caregivers’ experience of burden in the caregiving role and caregivers’ expressed support needs. The informal caregivers reported burdens related to dealing with the chronic and disabling nature of severe mental disorders, role and financial strain, and stigmatisation from family and community. Support needs include access to mental health services, empowerment, and social support from family, government, and religious and community organisations. The findings highlight the complexity of caregiver burden experienced by informal caregivers of persons with severe mental disorders, which calls for multisectoral collaboration in the planning and development of support services for informal caregivers, particularly in sub‐Saharan Africa where access to community mental health services is limited.
BNN‐LSTM‐DE Surrogate Model–Assisted Antenna Optimization Method Based on Data Selection
Authors: Sun Jinlong , Tian Yubo , Zhu Zhiwei
Published: December 2024

The use of surrogate models in assisting evolutionary algorithms for antenna optimization has achieved significant research outcomes. The construction of surrogate model primarily depends on two aspects; one is the selection of datasets, and the other is the model’s structure and performance. This paper proposes a novel dataset selection method aimed at enhancing the performance of the constructed surrogate model. Additionally, based on Bayesian neural network (BNN) and leveraging the advantages of handling sequence data with long short‐term memory (LSTM), a BNN‐LSTM surrogate model is introduced. After training, this surrogate model is used as the fitness evaluation function, enabling optimization design based on differential evolution (DE) algorithm. Experimental validations are conducted using the optimizations of a dual‐frequency slotted patch antenna and a rectangular cut‐corner ultrawideband antenna as examples. Results demonstrate that the proposed surrogate model exhibits high accuracy, providing a guidance for antenna optimization.
Relevance of the Human Microbiome in Breast Cancer: A Global Bibliometric and Visual Analysis
Authors: Javed Faqeeha , Ahmad Shahzad , Issrani Rakhi , Zeeshan Hafiz Muhammad , Iqbal Abid , Syed Eiman , Alam Mohammad Khursheed , Prabhu Namdeo
Published: December 2024

Background: The human microbiome is a treasure trove of biological importance that plays countless roles in the metabolism, immunity, and overall health of the host. Conversely, it actively contributes to the emergence of numerous pathological conditions, such as cancer. The last 10 years has seen a great deal of exploration and investigation into the mysterious relationship between breast cancer and the human microbiome. This study aims to conduct a bibliometric analysis to explore the role of microbiome in breast cancer, identifying key research trends and potential microbial markers.

Methodology: The Web of Science (WoS) database was queried between 2013 and July 10, 2023. Analysis was carried out using R for papers with the terms “Breast Cancer,” “Bacteria,” and “Inflammation,” and a total of 339 articles published in the last decade were reviewed.

Results: After 2019, there was a rise in the number of publications. The United States was the most dominant and had the highest level of collaborations. Breast cancer, inflammation, bacteria, dysbiosis, and the microbiome were the most frequently used keywords. With 11 papers published, “Cancers” was the most cited source for studies on breast cancer etiology, pathophysiology, and inflammation caused by bacteria.

Conclusion: Despite that microbial signatures have been established for various subtypes of breast cancer, the crux of healthy microbiome yet needs to be detected. This review represents a modest attempt to compile the body of knowledge regarding the relationship between breast cancer and the human microbiome.