bluuebunny/crossref_metadata_2025 huggingface dataset:
Methodological Leeway and Obstacles in Qualitative Research: Reflections on Procedural and Practical Issues in Tanzania
Authors: Telaky Said Nuhu , Mwanyoka Iddi
Published: March 2024

Despite being subject to criticism, qualitative research methodology remains a unique and valuable approach in collecting rich and informative data. However, this may vary from one context to another and researchers understanding of the context. Grounded on the decolonization notion of qualitative research, this paper explains leeways and obstacles in conducting research, reflecting upon the procedural and practical aspects that represent the reality in Tanzania based on two cases. Our paper emphasizes that it is essential to understand and capture the real-world reflective of the voices of the population whom the study targets, which may be easier for local/native researchers. This is because the local/native researchers may be able to explain the research processes and findings in consideration of the socio-cultural settings and political environment. The paper acknowledges that qualitative research requires patience and time, which may have financial implications. It also acknowledges that some populations are facing research fatigue exacerbated by inadequate research dissemination plans. Understanding the context of the study area or topic and applying appropriate methodological approaches to overcome obstacles and gather required adequate and relevant information is thus of importance.
Influence of runner blade number on hydraulic performance and flow control in draft tube of Francis turbine
Authors: Lu Jiahao , Su Chenhan , Tao Ran
Published: March 2024

As a widely used core component of hydropower generation, the stable and safe operation of the Francis turbine plays a very important role in engineering applications. Therefore, the effects of different rotor blade numbers on the hydraulic performance and flow control of the draft tube of the Francis turbine are of great research value. This paper focuses on the rotor blade number 13, 14, 15, 16, and 17 in the prohibited and stabilized operating zones, each of which is taken as a working condition point. (Condition αref - HM and Condition 2 αref - HM). Computational Fluid Dynamics (CFD) numerical simulations were performed and analyzed. In terms of hydraulic performance, the increase in the number of blades increases the efficiency and power of the turbine under Condition αref - HM by 2.26% and 0.0021 MW respectively. The efficiency and power of the turbine under Condition αref - HM is also elevated, with the efficiency reaching a maximum of 91.77% at blade number 15, and the power of the same turbine reaching a maximum of 0.182 MW at runner blade number 13. From the 3D flow analysis of the turbine, the increase in the number of blades does not significantly change the flow state of the turbine’s draft tube. By defining the turbulence energy E, the fast Fourier transform of the turbulence energy signals on the two monitoring surfaces of the draft tube is used to obtain its main frequency, and the amplitude and phase at the typical main frequency are visualized, through which we can analyze the vortex band motion state on the two monitoring surfaces of the draft tube, and speculate the change of pressure pulsation of the draft tube. Such an analysis method has a guiding significance for us to improve the performance and stability of the turbine, which can be achieved by increasing or decreasing the number of blades.
Prévalence et facteurs associés à la co-consommation d’alcool et de tabac dans la commune de Natitingou, Bénin
Authors: N’Tcha Koffi , Houeto David , Sambieni N’koué Emmanuel
Published: March 2024

Introduction :

La consommation d’alcool et la consommation de tabac entraînent chacune des risques importants pour la santé. L’objectif de cette étude était d’étudier la prévalence de la co-consommation d’alcool et de tabac ainsi que les facteurs associés dans la commune de Natitingou en 2016.

Méthodes :

Il s’agissait d’une étude transversale à caractère analytique. L’enquête s’est déroulée en octobre 2016 et a porté sur un échantillon de 270 sujets. Elle a été menée selon une technique de sondage aléatoire à plusieurs degrés. Les données collectées ont été analysées avec le logiciel R.

Résultats :

Sur les 270 sujets interrogés, 72,2 % étaient des hommes. L’âge moyen était de 30,7 ± 9,2 ans. La prévalence de la co-consommation était de 33,7 % [IC95% : 28,1 %–39,7 %]). Les facteurs associés à la co-consommation d’alcool et de tabac étaient : le sexe masculin (ORa = 2,1 ; p = 0,023), la dipsomanie (ORa = 1,4 ; p = 0,032), le fait d’avoir des amis buveurs ou fumeurs (ORa = 2,8 ; p = 0,004), le fait de suivre les publicités des médias sur les boissons alcoolisées (ORa = 1,9 ; p = 0,029) et le faible coût /accessibilité des deux substances (ORa = 2,1 ; p = 0,011).

Conclusion :

Cette étude a montré qu’il est important de dépasser la prévention centrée sur la personne qui consiste à sensibiliser et à prendre en charge pour adopter des mesures de prévention structurelle (notamment législatives).
Status of the Health Promoting University (HPU) globally and its relevance for emerging African HPUs: an integrative review and bibliometric analysis
Authors: Tafireyi Cecil G. S. , Grace Jeanne M.
Published: March 2024

Background:

The Health Promoting Universities (HPU) concept is undertheorized, with no African university belonging to the International Network of Health Promoting Universities (IHPU).

Aim:

The study aimed to investigate the status of the HPU concept globally to inform emerging HPUs, more specifically in Africa, regarding its implementation.

Methods:

An integrative literature review of studies conducted between 1 January 2013 and 5 November 2023 was conducted from online databases (PubMed, Scopus, Web of Science, Lilacs, CINAHL and Medline). A VOS bibliometric analysis viewer was used to extract and analyze further relevant information that could have been missed in the review.

Results:

From 1128 records, 22 ( N = 22) articles including two reports met the inclusion criteria. The main findings were that: (1) the HPU network is growing as a global network though undertheorized and less reported on, (2) the implementation of the HPU depends on a plethora of underpinning philosophies such as salutogenic and whole systems approach, and diverse programs and initiatives, 3) the terms HPU and healthy universities are often used interchangeably but the whole systems approach appears to be consistent in many HPU interventions. However, five contextual challenges that emanated from this review were discussed, including the definition of the HPU concept, theories for the HPU concept, measurement of the HPU concept, coordination and methods for measuring the HPU concept status. These challenges present obstacles to measuring the status of the HPU concept beyond the number of affiliated universities and HPU initiatives.

Conclusion:

Despite the challenges, the HPU concept is gaining momentum globally, as evidenced by the growing list of universities (HPU network) involved and the proliferation of interventions/initiatives targeting university students.
Temporal Dimensions of Crisis and Online Hotel Reviews: A Social Support Perspective of Narcissists During the Pandemic
Authors: Yousaf Salman , Min Kim Jong
Published: March 2024

This study sought to investigate the impact of the COVID-19 crisis on the online reviewing behavior of individuals with narcissistic traits. We conducted a textual analysis of online reviews submitted to TripAdvisor.com for hotels in New York City, covering the period from August 1, 2019, to July 31, 2022. This time frame allowed us to examine the phases before the COVID-19 crisis, during the early stages of the pandemic, and in the later stages of the crisis. We observed that the negative correlation between narcissism and review ratings was less evident during the initial phase of the COVID-19 crisis but became more pronounced as the crisis progressed. Conversely, the positive correlation between narcissism and the perceived helpfulness of reviews was stronger in the early stages of the COVID-19 crisis compared with the later stages. This suggests that the behavior of posting online reviews may serve as a form of social support mechanism, particularly utilized by narcissistic individuals to address their vulnerabilities, which was more apparent during the early phase of the COVID-19 crisis. These findings open new avenues for research and have practical implications for professionals in the hospitality, tourism, and service industries, especially in understanding consumer behavior during crisis periods.
An evaluation of FinTech in Bangladesh
Authors: Huda SSM Sadrul , Hossain Mohammad Fahim , Rahman Sristy Mastura , Nazmul Shahriar Bin , Hasan Radif
Published: March 2024

This paper presents an overview of technologies used in the financial services sector in Bangladesh, which is popularly known as FinTech. Bangladesh’s fintech industry still needs to catch up with developed countries like Japan, the United States, and the UK. The paper found that though the Fintech industry in Bangladesh is progressing well, the level and types of technologies used currently in Bangladesh need to catch up to the developed world. The current technologies used in developed countries to offer financial services are blockchain, big data, reg data, etc. Bangladesh offers a few Fintech services, such as MFC and mobile banks. As the country progresses toward a cashless society and digital banking, updated technologies have to be adopted for the operational efficiency and security of the system. The information in the paper is collected from secondary sources.
Opinions of UK General Dental Practitioners on the Restoration of Posterior Root Filled Teeth: a Vignette Survey
Authors: Kasperek Dariusz , Haque Afzal , Albadri Sondos , Jarad Fadi
Published: March 2024

Objective:

To investigate factors which influence UK general dental practitioners (GDPs) when restoring posterior root filled teeth.

Method:

An electronic survey was designed to explore current strategies of treatment of posterior root filled teeth by UK-based GDPs working in primary care. Three vignette cases included in the questionnaire explored a variety of tooth, patient, and financial factors. The survey was distributed by email and social media platforms between December 2018 and February 2019.

Results:

A total of 528 valid responses were collected. The majority of participants (84.1%) regularly restored posterior root filled teeth with an indirect restoration. Presence of persistent symptoms post root canal treatment (RCT) completion would impact the management of 85% of the surveyed respondents. Referral to a specialist, deferral of provision of the definitive restoration, and fear of litigation were reported by the GDPs as influencing factors.

Conclusion:

This survey highlights that decision making regarding restoration of root filled teeth is a multifactorial process. Tooth, patient, and financial factors were all shown to influence the restorative management of the posterior root filled teeth.
How to have healthy conversations: Contemporary Evidence and Behaviour Change Tools in support of Delivering Better (Oral) Health
Authors: Gallagher Jennifer E. , Godson Jenny H. , Marshman Zoe
Published: March 2024

The aim of this paper is to provide dental professionals with insight into how the science of behaviour change can be used to support patients to change their oral health behaviours. The paper describes how the fourth version of Delivering Better Oral Health (DBOHv4) published in November 2021, brings together the theory plus key principles and practical tools in Chapter 3 “Behaviour change”, to help front-line clinicians achieve the best effect. DBOH is freely available to all online at gov.uk and is a key resource for dental teams for the prevention of oral diseases.
Parieto-occipital scalp arteriovenous malformation with drainage into the posterior superior sagittal sinus: A case report
Authors: Ibraheem Kareem , Salloum Omar H , Hroub Osama , Herbawi Abd Al Rahman , Albandak Maram , Shawar Hobaib , Bassal Sharif
Published: March 2024

This case report presents the unique clinical presentation of an 18-year-old female patient with an 8-year history of a progressively enlarging pulsatile mass in the left parieto-occipital region of her scalp. Remarkably, there was no history of trauma, headache, or other associated neurological deficits. Advanced imaging techniques, including computed tomography angiography and magnetic resonance imaging, revealed a vascular lesion consistent with an arteriovenous malformation beneath the scalp. Notably, the arteriovenous malformation’s nidus was primarily supplied by branches of bilateral superficial temporal and occipital arteries, with a more pronounced involvement on the left side. Further magnetic resonance imaging characterization confirmed the diagnosis as a high parieto-occipital arteriovenous malformation/dural arteriovenous fistula. This case underscores the importance of a multidisciplinary approach involving neurosurgery and interventional radiology to the diagnosis and management of complex vascular lesions, particularly when they occur in unusual anatomical locations, like in our patient. The long-term clinical course and outcomes of such cases warrant continued investigation.
Circular Economy Implementation Status of Selected ASEAN Countries
Authors: Javed Tariq , Said Fareyha , Zainal Dalilawati , Jalil Azlina Abdul
Published: March 2024

Developed countries have adopted the circular economy concept to solve environmental problems. This study underpins the paradox theory to investigate the circular economy’s implementation status in the ASEAN region through the circular economy index. The circular economy index disclosure data for top companies in the ASEAN region was collected through an automated content analysis approach using DICTION on the annual/sustainability reports. The findings show that most public companies from the ASEAN region disclose the circular economy indicators in their annual/sustainability reports. The environment-sensitive firms are disclosing the circular economy indicators actively compared to the non-environment sensitive companies. Based on the results, this study provides theoretical and practical implications. This study is also limited because it is based only on the ASEAN region. Future studies can underpin other theoretical support and provide a comparative analysis across the continents.
The grammars of globalisation and the languages of regionalism: The war in Ukraine as a milestone and a test
Authors: Bach Daniel C
Published: March 2024

The article reviews transformations observed in the post-soviet space and raises the question of their implications for students of comparative regionalisms. It is first argued that such a discussion deserves to be more systematically related to that of the shifting ‘grammars’ of globalization. Unlike what was the case in the 1990s, globalization refers today to a fragmented, multipolar, yet globalized, world. Interdependency is perceived as a source of insecurity and strategic vulnerability. With Russia’s invasion of Ukraine, the article also stresses, a pillar of post-colonial and post-imperial international relations, uti possidetis, is also being tested and contested. Interactions with the diversity, or ‘languages,’ of regionalisms are then addressed through the identification of five distinctive threads: colonial and imperial legacies; regionalism as sovereignty or regime enhancement; the EU as a model of holistic and developmental integration; regionalization through defragmentation and connectivity; and regionalization without region-building. The article concludes to the resilience of debates and cognitive representations that were discarded in the aftermath of the cold war.
Combined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam
Authors: Xie Hao , Zhao Jialian , Tu Haiya , Wang Wenyang , Hu Yaoqin
Published: March 2024

Background

The exact median effective dose (ED50) of intranasal dexmedetomidine combined with oral midazolam sedation for magnetic resonance imaging (MRI) examination in children remains unknow and the aim of this study was to determine the ED50 of their combination.

Methods

This is a prospective dose-finding study. A total of 53 children aged from 2 months to 6 years scheduled for MRI examination from February 2023 to April 2023 were randomly divided into group D (to determine the ED50 of intranasal dexmedetomidine) and group M (to determine the ED50 of oral midazolam). The dosage of dexmedetomidine and midazolam was adjusted according to the modified Dixon’s up-and-down method, and the ED50 was calculated with a probit regression approach.

Results

The ED50 of intranasal dexmedetomidine when combined with 0.5 mg∙kg− 1 oral midazolam was 0.39 µg∙kg− 1 [95% confidence interval (CI) 0.30 to 0.46 µg∙kg− 1] while the ED50 of oral midazolam was 0.17 mg∙kg− 1 (95% CI 0.01 to 0.29 mg∙kg− 1) when combined with 1 µg∙kg− 1 intranasal dexmedetomidine. The sedation onset time of children with successful sedation in group D was longer than in group M (30.0[25.0, 38.0]vs 19.5[15.0, 35.0] min, P < 0.05). No other adverse effects were observed in the day and 24 h after medication except one dysphoria.

Conclusion

This drug combination sedation regimen appears suitable for children scheduled for MRI examinations, offering a more precise approach to guide the clinical use of sedative drugs in children.

Trial registration

Chinese Clinical Trial Registry, identifier: ChiCTR2300068611(24/02/2023).
HIV and hepatitis B, C co-infection and correlates of HIV infection among men who have sex with men in Rwanda, 2021: a respondent-driven sampling, cross-sectional study
Authors: Remera Eric , Tuyishime Elysee , Kayitesi Catherine , Malamba Samuel S. , Sangwayire Beata , Umutesi Justine , Ruisenor-Escudero Horacio , Oluoch Tom
Published: March 2024

Background

Men who have sex with men (MSM) are a key population group disproportionately affected by HIV and other sexually transmitted infections (STIs) worldwide. In Rwanda, the HIV epidemic remains a significant public health concern, and understanding the burden of HIV and hepatitis B and C coinfections among MSM is crucial for designing effective prevention and control strategies. This study aims to determine the prevalence of HIV, hepatitis B, and hepatitis C infections among MSM in Rwanda and identify correlates associated with HIV infection within this population.

Methods

We used respondent-driven sampling (RDS) to recruit participants between November and December 2021. A face-to-face, structured questionnaire was administered. Testing for HIV infection followed the national algorithm using two rapid tests: Alere Combo and STAT PAK as the first and second screening tests, respectively. Hepatitis B surface antigen (HBsAg) and anti-HCV tests were performed. All statistics were adjusted for RDS design, and a multivariable logistic regression model was constructed to identify factors associated with HIV infection.

Results

The prevalence of HIV among MSM was 6·9% (95% CI: 5·5–8·6), and among HIV-positive MSM, 12·9% (95% CI: 5·5–27·3) were recently infected. The prevalence of hepatitis B and C was 4·2% (95% CI: 3·0–5·7) and 0·7% (95% CI: 0·4–1·2), respectively. HIV and hepatitis B virus coinfection was 0·5% (95% CI: 0·2–1·1), whereas HIV and hepatitis C coinfection was 0·1% (95% CI: 0·0–0·5), and no coinfection for all three viruses was observed. MSM groups with an increased risk of HIV infection included those who ever suffered violence or abuse because of having sex with other men (AOR: 3·42; 95% CI: 1·87–6·25), those who refused to answer the question asking about ‘ever been paid money, goods, or services for sex’ (AOR: 10·4; 95% CI: 3·30–32·84), and those not consistently using condoms (AOR: 3·15; 95% CI: 1·31–7·60).

Conclusion

The findings suggest more targeted prevention and treatment approaches and underscore the importance of addressing structural and behavioral factors contributing to HIV vulnerability, setting interventions to reduce violence and abuse against MSM, promoting safe and consensual sexual practices, and expanding access to HIV prevention tools such as condoms and preexposure prophylaxis (PrEP).
Development, validation, and reliability of the Chrononutrition Profile Questionnaire-Pregnancy (CPQ-P)
Authors: Kok Ee Yin , Kaur Satvinder , Mohd Shukri Nurul Husna , Abdul Razak Nurliyana , Takahashi Masaki
Published: March 2024

Background

During pregnancy, physiological changes can affect eating and sleeping habits, which may eventually have negative consequences for maternal and foetal health. To better understand these changes, it is essential to develop a reliable questionnaire that addresses lifestyle habits such as snacking and daytime napping. This study aimed to determine the validity and reliability of the Chrononutrition Profile Questionnaire-Pregnancy (CPQ-P).

Methods

A total of 399 women in their second and third trimester of pregnancy were recruited from government maternal and child health clinics in Kuala Lumpur and Putrajaya and completed a self-administered online questionnaire. Content validity was conducted with an expert panel consisting of 4 members. Confirmatory factor analysis (CFA) using maximum likelihood was conducted to determine the construct validity. Internal consistency was determined by Cronbach’s alpha coefficient (CAC), while the test-retest reliability was conducted using intraclass correlation coefficient (ICC).

Results

The questionnaire had an appropriate content validity index of 0.91. The CPQ-P consists of 22 items, measuring 5 constructs, including morning chrono-habits, sleeping habits, evening eating, temporal eating, and pregnancy symptoms. The factor model showed good fit with χ2/df = 2.486, GFI = 0.893, CFI = 0.912, and RMSEA = 0.065. The 22 items in CPQ-P showed fair to excellent test-retest reliability (ICC: 0.42 to 0.98). The 5 constructs in CPQ-P were found to have a good to excellent internal consistency (α = 0.612–0.963).

Conclusions

The CPQ-P is a valid and reliable tool for assessing lifestyle habits during pregnancy. The questionnaire can be used to identify areas where pregnant women may need additional support or intervention to adopt healthy behaviours and reduce the risk of adverse maternal and foetal outcomes.

Trial registration

NCT05700136 (clinicaltrials.gov). Trial registration date: 26/01/2023.
Epidemiology of congenital polydactyly and syndactyly in Hunan Province, China
Authors: Zhou Xu , Li Ting , Kuang Haiyan , Zhou Ying , Xie Donghua , He Jian , Xiao Juan , Chen Chanchan , Jiang Yurong , Fang Junqun , Wang Hua
Published: March 2024

Objective

To describe the prevalence and epidemiology of congenital polydactyly and syndactyly in Hunan Province, China, 2016–2020.

Methods

Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2016–2020. Prevalence of birth defects (polydactyly or syndactyly) is the number of cases per 1000 births (unit: ‰). Prevalence and 95% confidence intervals (CI) were calculated by the log-binomial method. Chi-square trend tests (χ2trend) were used to determine trends in prevalence by year. Crude odds ratios (ORs) were calculated to examine the association of each demographic characteristic with polydactyly and syndactyly.

Results

Our study included 847,755 births, and 14,459 birth defects were identified, including 1,888 polydactyly and 626 syndactyly cases, accounting for 13.06% and 4.33% of birth defects, respectively. The prevalences of total birth defects, polydactyly, and syndactyly were 17.06‰ (95%CI: 16.78–17.33), 2.23‰ (95%CI: 2.13–2.33), and 0.74‰ (95%CI: 0.68–0.80), respectively. Most polydactyly (96.77%) and syndactyly (95.69%) were diagnosed postnatally (within 7 days). From 2016 to 2020, the prevalences of polydactyly were 1.94‰, 2.07‰, 2.20‰, 2.54‰, and 2.48‰, respectively, showing an upward trend (χ2trend = 19.48, P < 0.01); The prevalences of syndactyly were 0.62‰, 0.66‰, 0.77‰, 0.81‰, and 0.89‰, respectively, showing an upward trend (χ2trend = 10.81, P = 0.03). Hand polydactyly (2.26‰ vs. 1.33‰, OR = 1.69, 95%CI: 1.52–1.87) and hand syndactyly (0.43‰ vs. 0.28‰, OR = 1.42, 95%CI: 1.14–1.76) were more common in males than females. Polydactyly (2.67‰ vs. 1.93‰, OR = 1.38, 95%CI: 1.26–1.51) and syndactyly (0.91‰ vs. 0.62‰, OR = 1.47, 95%CI: 1.26–1.72) were more common in urban areas than in rural areas. Compared to maternal age 25–29, hand polydactyly was more common in maternal age < 20 (2.48‰ vs. 1.74‰, OR = 1.43, 95%CI: 1.01–2.02) or ≥ 35 (2.25‰ vs. 1.74‰, OR = 1.30, 95%CI: 1.12–1.50).

Conclusion

In summary, we have described the prevalence and epidemiology of polydactyly and syndactyly from hospital-based surveillance in Hunan Province, China, 2016–2020. Our findings make some original contributions to the field, which may be valuable for future research.
Pregnancy health in a multi-state U.S. population of systemically underserved patients and their children: PROMISE cohort design and baseline characteristics
Authors: Boone-Heinonen Janne , Lyon-Scott Kristin , Springer Rachel , Schmidt Teresa , Vesco Kimberly K. , Booman Anna , Dinh Dang , Fortmann Stephen P. , Foster Byron A. , Hauschildt Jenny , Liu Shuling , O’Malley Jean , Palma Amy , Snowden Jonathan M. , Stratton Kalera , Tran Sarah
Published: March 2024

Background

Gestational weight gain (GWG) is a routinely monitored aspect of pregnancy health, yet critical gaps remain about optimal GWG in pregnant people from socially marginalized groups, or with pre-pregnancy body mass index (BMI) in the lower or upper extremes. The PROMISE study aims to determine overall and trimester-specific GWG associated with the lowest risk of adverse birth outcomes and detrimental infant and child growth in these underrepresented subgroups. This paper presents methods used to construct the PROMISE cohort using electronic health record data from a network of community-based healthcare organizations and characterize the cohort with respect to baseline characteristics, longitudinal data availability, and GWG.

Methods

We developed an algorithm to identify and date pregnancies based on outpatient clinical data for patients 15 years or older. The cohort included pregnancies delivered in 2005–2020 with gestational age between 20 weeks, 0 days and 42 weeks, 6 days; and with known height and adequate weight measures needed to examine GWG patterns. We linked offspring data from birth records and clinical records. We defined study variables with attention to timing relative to pregnancy and clinical data collection processes. Descriptive analyses characterize the sociodemographic, baseline, and longitudinal data characteristics of the cohort, overall and within BMI categories.

Results

The cohort includes 77,599 pregnancies: 53% had incomes below the federal poverty level, 82% had public insurance, and the largest race and ethnicity groups were Hispanic (56%), non-Hispanic White (23%) and non-Hispanic Black (12%). Pre-pregnancy BMI groups included 2% underweight, 34% normal weight, 31% overweight, and 19%, 8%, and 5% Class I, II, and III obesity. Longitudinal data enable the calculation of trimester-specific GWG; e.g., a median of 2, 4, and 6 valid weight measures were available in the first, second, and third trimesters, respectively. Weekly rate of GWG was 0.00, 0.46, and 0.51 kg per week in the first, second, and third trimesters; differences in GWG between BMI groups were greatest in the second trimester.

Conclusions

The PROMISE cohort enables characterization of GWG patterns and estimation of effects on child growth in underrepresented subgroups, ultimately improving the representativeness of GWG evidence and corresponding guidelines.
Anastomosis selection in liver transplantation for recipients with unusable recipient hepatic arteries: a bayesian network meta-analysis
Authors: Warsinggih  , Aryanti Citra , Uwuratuw Julianus Aboyaman , Syarifuddin Erwin , Lusikooy Ronald Erasio , Faruk Muhammad
Published: March 2024

Background

The anastomosis of donor and recipient hepatic arteries is standard in liver transplantations. For transplant recipients with unusable hepatic arteries, appropriate artery selection should be conducted using evidence-based considerations; therefore, this network meta-analysis (NMA) aimed to analyze the most suitable alternative recipient artery for anastomosis during liver transplantations.

Methods

Comprehensive searches of the Scopus, Cochrane Library, and MEDLINE databases were conducted to analyze observational studies containing non-standard anastomoses in liver transplantations that used the splenic artery, aorta, celiac, or branches of the gastric artery. The outcome parameters included intraoperative components, complications, and survival data. This NMA used the BUGSnet package in R studio and the results were presented in a Forest plot, league table, and SUCRA plot.

Results

Among the 13 studies included in this NMA, 5 arteries were used for the anastomoses. The splenic artery anastomosis showed a high risk of thrombosis and a low risk of stenosis (OR 1.12, 95% CI 0.13–3.14) and biliary tract abnormalities (OR 0.79, 95% CI 0.36–1.55). In addition, the graft survival (OR 1.08; 95% CI 0.96–1.23) and overall survival (1-year survival OR 1.09, 95% CI 0.94–1.26; 5-year survival OR 1.95% CI 0.83–1.22) showed favorable results using this artery. Constraints to the use of the splenic artery were longer operation and cold ischemic times. However, the duration of hospital stay (MD 1.36, 95% CI -7.47 to 10.8) was shorter than that when the other arteries were used, and the need for blood transfusions was minimal (MD -1.74, 95% CI -10.2 to 6.7).

Conclusion

In recipients with unusable hepatic arteries, the splenic artery of the patient should be the first consideration for anastomosis selection in liver transplantations.
Technology, data, people, and partnerships in addressing unmet social needs within Medicaid Managed Care
Authors: Hogg-Graham Rachel , Scott Allison M. , Clear Emily R. , Riley Elizabeth N. , Waters Teresa M.
Published: March 2024

Background

Individuals with unmet social needs experience adverse health outcomes and are subject to greater inequities in health and social outcomes. Given the high prevalence of unmet needs among Medicaid enrollees, many Medicaid managed care organizations (MCOs) are now screening enrollees for unmet social needs and connecting them to community-based organizations (CBOs) with knowledge and resources to address identified needs. The use of screening and referral technology and data sharing are often considered key components in programs integrating health and social services. Despite this emphasis on technology and data collection, research suggests substantial barriers exist in operationalizing effective systems.

Methods

We used qualitative methods to examine cross-sector perspectives on the use of data and technology to facilitate MCO and CBO partnerships in Kentucky, a state with high Medicaid enrollment, to address enrollee social needs. We recruited participants through targeted sampling, and conducted 46 in-depth interviews with 26 representatives from all six Kentucky MCOs and 20 CBO leaders. Qualitative descriptive analysis, an inductive approach, was used to identify salient themes.

Results

We found that MCOs and CBOs have differing levels of need for data, varying incentives for collecting and sharing data, and differing valuations of what data can or should do. Four themes emerged from interviewees’ descriptions of how they use data, including 1) to screen for patient needs, 2) to case manage, 3) to evaluate the effectiveness of programs, and 4) to partner with each other. Underlying these data use themes were areas of alignment between MCOs/CBOs, areas of incongruence, and areas of tension (both practical and ideological). The inability to interface with community partners for data privacy and ownership concerns contributes to division. Our findings suggest a disconnect between MCOs and CBOs regarding terms of their technology interfacing despite their shared mission of meeting the unmet social needs of enrollees.

Conclusions

While data and technology can be used to identify enrollee needs and determine the most critical need, it is not sufficient in resolving challenges. People and relationships across sectors are vital in connecting enrollees with the community resources to resolve unmet needs.
Evaluating the cross-cultural competence instrument for healthcare professionals (CCCHP) among nurses in Okinawa, Japan
Authors: Shirai Chieko , Nonaka Daisuke , Kobayashi Jun
Published: March 2024

Background

To provide better quality healthcare services to patients with different linguistic and cultural backgrounds, the cross-cultural competence of medical professionals is important. However, assessing and improving the cross-cultural competence of healthcare professionals is difficult in Japan, as there is no standardized scale to measure the competence. This study’s purpose was to translate the Cross-Cultural Competence instrument for Healthcare Professionals (CCCHP), which was developed and used in Europe, and to examine its reliability and validity among Japanese nurses.

Methods

During June and July 2021, nursing staff were invited to take web- and paper-based surveys in Okinawa Japan. The CCCHP (five-factor model with 27 items across motivation, attitude, skills, emotion, and knowledge) was translated using a combination translation method, and a five-point Likert scale was used for responses. Exploratory and confirmatory factor analyses and known-group method were used to examine structural validity, while Cronbach’s alpha coefficient was used to test reliability.

Results

A total of 294 responses were analyzed; 77.2% had more than five years of experience. Since the fit index indicated that the five-factor model was not a good fit, it was modified to a four-factor model (J-CCCHP24) by moving three variables, removing the knowledge factor, and using the error covariance of the variables. The fit index after the modification was improved to comparative fit index (CFI) = 0.92, Tucker-Lewis index (TLI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, and standardized root mean square residual (SRMR) = 0.06, and Cronbach’s alpha was 0.85. The mean scores of J-CCCHP24 were significantly higher in the group with a history of overseas travel, higher foreign language skill, training in intercultural care, experience of foreign patient care, and intercultural interactions outside the workplace than in the group without these characteristics.

Conclusion

This study confirmed the validity and reliability of the modified Japanese version of the CCCHP (four-factor model with 24 items). The results suggest that the exposure to different cultures on a personal level may help improve nurses' cross-cultural competence. Further refinement of this scale for practical use would encourage the implementation of necessary countermeasures to improve the cross-cultural competence of Japanese healthcare professionals.
Isolation of Burkholderia pseudomallei from a goat in New Caledonia: implications for animal and human health monitoring and serological tool comparison
Authors: Desoutter Anais , Deshayes Thomas , Vorimore Fabien , Klotoe Bernice , Durand Benoit , Colot Julien , Wagner-Lichtenegger Gabriel , Steinmetz Ivo , Tuanyok Apichai , Laroucau Karine
Published: March 2024

Background

Melioidosis is a serious bacterial infection caused by Burkholderia pseudomallei, a gram-negative bacterium commonly found in soil and water. It can affect both humans and animals, and is endemic in regions such as Southeast Asia and Northern Australia. In recent years, there have been reports of an emergence of human melioidosis in other areas, including New Caledonia.

Results

During standard laboratory analysis in New Caledonia in 2021, a strain of B. pseudomallei was isolated from a goat. The strain was characterized using both MLST and WGS techniques and was found to cluster with previously described local human strains from the area. In parallel, several serological tests (CFT, ELISA, Luminex (Hcp1, GroEL, BPSS1840), arrays assay and a latex agglutination test) were performed on animals from the farm where the goat originated, and/or from three other neighboring farms. Using two commercial ELISA kits, seropositive animals were found only on the farm where the infected goat originated and tests based on recombinant proteins confirmed the usefulness of the Hcp1 protein for the diagnosis of melioidosis in animals.

Conclusions

Despite the regular reports of human cases, this is the first confirmed case of melioidosis in an animal in New Caledonia. These results confirm the presence of the bacterium in the region and highlight the importance of vigilance for both animal and human health. It is critical that all health partners, including breeders, veterinarians, and biologists, work together to monitor and prevent the spread of the disease.
Evaluation of the presence of gingivitis as confounding factor in assessing inflammatory status in serum and saliva of dogs with diabetes mellitus
Authors: Franco-Martinez Lorena , Muñoz-Prieto Alberto , Busato Francesca , Karveliene Birute , Stadaliene Inga , Ceron Jose J. , Carrillo Juana D. , Garcia-Martinez Juan D. , Dabrowski Roman , Pardo-Marín Luis , Martinez-Subiela Silvia , Tvarijonaviciute Asta
Published: March 2024

The aim of this study was to evaluate the changes in the serum and salivary inflammatory markers induced by Diabetes mellitus (DM) in dogs and to assess the possible confounding effect of gingivitis. A panel of 13 cytokines was measured in the serum and saliva of dogs diagnosed with DM and compared with healthy dogs without gingivitis (control group 1; CG1) and dogs with gingivitis but otherwise healthy (control group 2; CG2). The results of the present study showed statistically significantly higher levels of IL-8, KC-like and MCP1 in the serum of dogs with DM compared to CG1 dogs. In the case of saliva, the DM group presented statistically higher GM-CSF, IL6, IL15, and MCP1 levels compared to CG1, and lower KC-like chemokine compared to CG2. Finally, gingivitis produced changes in saliva, with salivary levels of GM-CSF, IL-6, IL-7, IL-15, IP-10, KC-like, IL-10, IL-18, MCP1, TNFα being statistically significantly higher in the saliva of CG2 dogs compared to CG1. The results of the present study indicate that dogs with DM have altered cytokine levels in serum and saliva compared to healthy dogs. In addition, this study highlights the importance of taking oral health into account when determining cytokines in dogs, as gingivitis can significantly alter their concentrations. .
Editorial for special issue—human precision cut lung slices: an Ex vivo platform for therapeutic target discovery and drug testing in lung disease
Authors: Koziol-White Cynthia J. , Panettieri Reynold A.
Published: March 2024

Publications utilizing precision cut lung slices (PCLS) steadily increased from the 1970’s, with a significant increase in 2010, to tripling by 2023. PCLS have been used to study a vast array of pulmonary diseases and exposures to pathogens and toxicants to understand pathogenesis of disease but also to examine basic cellular mechanisms that underly lung biology. This Special Issue will highlight new, exciting, and novel research using PCLS, while acknowledging the substantial fund of knowledge that has been gained using this platform.
Temporal dynamics of stress response in Halomonas elongata to NaCl shock: physiological, metabolomic, and transcriptomic insights
Authors: Yu Junxiong , Zhang Yue , Liu Hao , Liu Yuxuan , Mohsin Ali , Liu Zebo , Zheng Yanning , Xing Jianmin , Han Jing , Zhuang Yingping , Guo Meijin , Wang Zejian
Published: March 2024

Background

The halophilic bacterium Halomonas elongata is an industrially important strain for ectoine production, with high value and intense research focus. While existing studies primarily delve into the adaptive mechanisms of this bacterium under fixed salt concentrations, there is a notable dearth of attention regarding its response to fluctuating saline environments. Consequently, the stress response of H. elongata to salt shock remains inadequately understood.

Results

This study investigated the stress response mechanism of H. elongata when exposed to NaCl shock at short- and long-time scales. Results showed that NaCl shock induced two major stresses, namely osmotic stress and oxidative stress. In response to the former, within the cell’s tolerable range (1–8% NaCl shock), H. elongata urgently balanced the surging osmotic pressure by uptaking sodium and potassium ions and augmenting intracellular amino acid pools, particularly glutamate and glutamine. However, ectoine content started to increase until 20 min post-shock, rapidly becoming the dominant osmoprotectant, and reaching the maximum productivity (1450 ± 99 mg/L/h). Transcriptomic data also confirmed the delayed response in ectoine biosynthesis, and we speculate that this might be attributed to an intracellular energy crisis caused by NaCl shock. In response to oxidative stress, transcription factor cysB was significantly upregulated, positively regulating the sulfur metabolism and cysteine biosynthesis. Furthermore, the upregulation of the crucial peroxidase gene (HELO_RS18165) and the simultaneous enhancement of peroxidase (POD) and catalase (CAT) activities collectively constitute the antioxidant defense in H. elongata following shock. When exceeding the tolerance threshold of H. elongata (1–13% NaCl shock), the sustained compromised energy status, resulting from the pronounced inhibition of the respiratory chain and ATP synthase, may be a crucial factor leading to the stagnation of both cell growth and ectoine biosynthesis.

Conclusions

This study conducted a comprehensive analysis of H. elongata’s stress response to NaCl shock at multiple scales. It extends the understanding of stress response of halophilic bacteria to NaCl shock and provides promising theoretical insights to guide future improvements in optimizing industrial ectoine production.
A late eating midpoint is associated with increased risk of diabetic kidney disease: a cross-sectional study based on NHANES 2013–2020
Authors: Lu Chun-feng , Cang Xiao-min , Liu Wang-shu , Wang Li-hua , Huang Hai-yan , Wang Xue-qin , Zhao Li-hua , Xu Feng
Published: March 2024

Background

Modifying diet is crucial for diabetes and complication management. Numerous studies have shown that adjusting eating habits to align with the circadian rhythm may positively affect metabolic health. However, eating midpoint, eating duration, and their associations with diabetic kidney disease (DKD) are poorly understood.

Methods

The National Health and Nutrition Examination Survey (2013–2020) was examined for information on diabetes and dietary habits. From the beginning and ending times of each meal, we calculated the eating midpoint and eating duration. Urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g and/or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 were the specific diagnostic criteria for DKD.

Results

In total, details of 2194 subjects with diabetes were collected for analysis. The overall population were divided into four subgroups based on the eating midpoint quartiles. The prevalence of DKD varied noticeably (P = 0.037) across the four categories. When comparing subjects in the second and fourth quartiles of eating midpoint to those in the first one, the odds ratios (ORs) of DKD were 1.31 (95% CI, 1.03 to 1.67) and 1.33 (95% CI, 1.05 to 1.70), respectively. And after controlling for potential confounders, the corresponding ORs of DKD in the second and fourth quartiles were 1.42 (95% CI, 1.07 to 1.90) and 1.39 (95% CI, 1.04 to 1.85), respectively.

Conclusions

A strong correlation was found between an earlier eating midpoint and a reduced incidence of DKD. Eating early in the day may potentially improve renal outcomes in patients with diabetes.
A MgAl-LDH-CuS nanosheet-based thermo-responsive composite hydrogel with nir-responsive angiogenesis inhibitor releasing capability for multimode starvation therapy
Authors: Liu Xueyan , Hu Tingting , Jia Yijiang , Yang Shuqing , Yang Yu , Cui Zhuolin , Wang Tao , Liang Ruizheng , Tan Chaoliang , Wang Yuji
Published: March 2024

The rapid proliferation of tumors is highly dependent on the nutrition supply of blood vessels. Cutting off the nutrient supply to tumors is an effective strategy for cancer treatment, known as starvation therapy. Although various hydrogel-based biomaterials have been developed for starvation therapy through glucose consumption or intravascular embolization, the limitations of single-mode starvation therapy hinder their therapeutic effects. Herein, we propose a dual-function nutrition deprivation strategy that can block the nutrients delivery through extravascular gelation shrinkage and inhibit neovascularization through angiogenesis inhibitors based on a novel NIR-responsive nanocomposite hydrogel. CuS nanodots-modified MgAl-LDH nanosheets loaded with angiogenesis inhibitor (sorafenib, SOR) are incorporated into the poly(n-isopropylacrylamide) (PNIPAAm) hydrogel by radical polymerization to obtain the composite hydrogel (SOR@LDH-CuS/P). The SOR@LDH-CuS/P hydrogel can deliver hydrophobic SOR with a NIR-responsive release behavior, which could decrease the tumor vascular density and accelerate cancer cells apoptosis. Moreover, the SOR@LDH-CuS/P hydrogel exhibits higher (3.5 times) compressive strength than that of the PNIPAAm, which could squeeze blood vessels through extravascular gelation shrinkage. In vitro and in vivo assays demonstrate that the interruption of nutrient supply by gelation shrinkage and the prevention of angiogenesis by SOR is a promising strategy to inhibit tumor growth for multimode starvation therapy.
Construction of programmed time-released multifunctional hydrogel with antibacterial and anti-inflammatory properties for impaired wound healing
Authors: Peng Yuan , Guo Yicheng , Ge Xin , Gong Yali , Wang Yuhan , Ou Zelin , Luo Gaoxing , Zhan Rixing , Zhang Yixin
Published: March 2024

The successful reprogramming of impaired wound healing presents ongoing challenges due to the impaired tissue microenvironment caused by severe bacterial infection, excessive oxidative stress, as well as the inappropriate dosage timing during different stages of the healing process. Herein, a dual-layer hydrogel with sodium alginate (SA)-loaded zinc oxide (ZnO) nanoparticles and poly(N-isopropylacrylamide) (PNIPAM)-loaded Cu5.4O ultrasmall nanozymes (named programmed time-released multifunctional hydrogel, PTMH) was designed to dynamically regulate the wound inflammatory microenvironment based on different phases of wound repairing. PTMH combated bacteria at the early phase of infection by generating reactive oxygen species through ZnO under visible-light irradiation with gradual degradation of the lower layer. Subsequently, when the upper layer was in direct contact with the wound tissue, Cu5.4O ultrasmall nanozymes were released to scavenge excessive reactive oxygen species. This neutralized a range of inflammatory factors and facilitated the transition from the inflammatory phase to the proliferative phase. Furthermore, the utilization of Cu5.4O ultrasmall nanozymes enhanced angiogenesis, thereby facilitating the delivery of oxygen and nutrients to the impaired tissue. Our experimental findings indicate that PTMHs promote the healing process of diabetic wounds with bacterial infection in mice, exhibiting notable antibacterial and anti-inflammatory properties over a specific period of time.