bluuebunny/crossref_metadata_2025 huggingface dataset:
Facial and systemic mucormycosis caused by Lichtheimia corymbifera in a goat: case report and literature review of fungal infections in goats
Authors: Semenova Varvara , Rodrigues Hoffmann Aline , Wolking Rebecca M. , Choi Eunju April
Published: March 2024

An 8-y-old Pygora doe was presented to the University of California–Davis, Veterinary Medical Teaching Hospital because of non-healing facial swelling of 2-wk duration. The lesion grew despite medical treatment, causing discomfort masticating, little-to-no airflow from the right nasal passage, and led to euthanasia. On gross examination, a large facial mass with a draining tract through the skin and hard palate was identified. On section, the mass was brown-pink, homogeneous, and friable. Abscess-like masses were identified in the lungs and kidney. Histopathology of the face, including oral and nasal cavities, salivary glands, and lymph nodes, as well as the lung and kidney lesions, revealed large areas of necrosis with numerous wide ribbon-like, mostly aseptate, fungal hyphae consistent with zygomycetes. PCR for fungal organisms performed on formalin-fixed, paraffin-embedded tissue from the face identified Lichtheimia corymbifera (formerly Absidia corymbifera) of the order Mucorales and an Aspergillus sp. The lesion was suspected to have started either as a fungal rhinitis or dental feed impaction, subsequently spreading to the face and systemically to the lungs and kidney. We describe here the lesions associated with facial mucormycosis in a goat and present a literature review of L. corymbifera infection in veterinary species and fungal infections in goats.
Safety Assessment of Hydroxyethyl Urea as Used in Cosmetics
Authors: Akinsulie Alice , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Fiume Monice , Heldreth Bart
Published: March 2024

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of Hydroxyethyl Urea, which is reported to function as a humectant and a hair and skin conditioning agent. The Panel reviewed the available data to determine the safety of this ingredient. The Panel concluded that Hydroxyethyl Urea is safe in cosmetics in the present practices of use and concentration described in the safety assessment when formulated to be non-irritating.
Water Safety Practices Along the Water Service Chain in Addis Ababa: A Cross-Sectional Study in a Cosmopolitan City
Authors: Sisay Shegaw Fentaye , Gari Sirak Robele , Ambelu Argaw
Published: March 2024

This study investigated water safety practices and risk levels along Addis Ababa’s water supply service chain. The data came from 23 random woredas, 384 random households, 115 microbiological water quality tests, and diagnostic inspections from source to point of use. Findings from this study indicate that the surface water sources (53%) and the water source catchments (62%) are characterized by very high-risk and high risk contamination levels respectively. Conversely, the water treatment process (5%) and temporary reservoir (20%) indicates a low risk level. Whereas the water distribution system (40%), water source boreholes (44%), and Household level (29%) water safety practices are identified as medium risk levels. The microbial analysis of the drinking water at the source and point of use indicated low (<11 CFU/100 ml) to high levels (>100 CFU/100 ml) of risk with significant levels of contamination at the household level. Moreover, the household-level water safety practice assessment revealed intermediate to very high levels of risks. The Chi2 test shows that water supply type is significantly associated with occupation(X2(12,384) = 23.44, P < .05) and education(X2(8,384) = 15.4, P < .05). Multinomial regression analysis also showed better occupation is associated with increased access to safe bottled water compared to safe piped water on premises. It can be concluded that the water safety practice encountered low to very high levels of risk of contamination at different components along the water supply service chain and the household level. This study suggests ways to improve Addis Ababa residents’ health and well-being through water safety interventions. These include safeguarding water sources, supporting local safe water businesses, providing household water treatment, and handling options, and addressing the barriers and incentives for adopting safe water practices.
Children's motivation for moderate-to-vigorous physical activity during the Daily Mile: A theory of planned behaviour perspective
Authors: Gray Phillip M. , Evans Andrew L.
Published: March 2024

Sustained motivation for Daily Mile participation at higher physical activity intensities may contribute to the attainment of children's daily moderate-to-vigorous physical activity (MVPA) targets and long-term health benefits. However, individual variability exists in the amount of MVPA accumulated by children during the Daily Mile. The current study explored children's motivation for participating in the Daily Mile at MVPA intensity, using a theory of planned behaviour framework. Twenty-five children (mean age = 10.07 ± 0.60 years) from the Northwest of England were recruited to the study; 52% were female and 88% were White. Participants completed a questionnaire, with an open-ended response format, probing behavioural, control, and normative beliefs for participation in the Daily Mile at MVPA intensity. Template analysis was conducted independently by two researchers to identify main themes and subthemes. Findings showed that children possessed a range of behavioural, control, and normative beliefs about MVPA participation during the Daily Mile. Prominent behavioural beliefs included fitness enhancement, implications for concentration and learning, positive affective states, and pain and discomfort. Key control beliefs included weather, space and health restrictions, and distractions from peers. Finally, peers and parents were salient normative beliefs. Children possessed a range of modal beliefs in relation to MVPA participation during the Daily Mile. Implications of the findings, and methods for practitioners seeking to maximise the contribution of the Daily Mile to children's daily MVPA targets are discussed.
Evaluation blogs, podcasts, and webinars in 2023: A roundup review
Authors: Aston Thomas
Published: March 2024

This is a review and roundup of evaluation blogs, podcasts, and webinars in 2023 with a personal commentary on the trends which emerged during the period. To write this, I reviewed hundreds of blogs and dozens of podcasts and webinars. The roundup is organized around key trends that emerged throughout the year: (1) evaluators’ responses to Artificial Intelligence; (2) decolonizing evaluation; (3) the never-ending debate about experimental methods in evaluation, and (4) system change evaluation. I then add a series of honorable mentions that fall outside of (or adjacent to) the key trends but are noteworthy on their own merits.
A case of early intraventricular haemorrhage following ventriculoperitoneal shunt: An entity requiring consideration
Authors: Kaushal Himanshu , Wahane Madhugandha , Goyal Gourav , Sarna Sudha , Sarna Mukesh Kumar
Published: March 2024

The ventriculoperitoneal shunt (VP shunt) is one of the most common neurosurgical procedures performed in daily practice. Various complications following a VP shunt are as follows: post-procedure shunt-related infections, shunt block, shunt displacement or exteriorisation and haemorrhage associated with it. Delayed intraventricular haemorrhage is a relatively uncommon complication following the aforementioned procedure. Here we present an atypical case of a 72-year-old male who presented with subarachnoid haemorrhage with hydrocephalus and underwent a VP shunt, following which the patient had early intraventricular haemorrhage (eIVH) with an unfortunate outcome. Here, we propose pathophysiology and risk factors for eIVH.
Deciphering the Mechanism of Siwu Decoction Inhibiting Liver Metastasis by Integrating Network Pharmacology and In Vivo Experimental Validation
Authors: Chu Xuelei , Xie Feiyu , Hou Chengzhi , Zhang Xin , Wang Sijia , Xie Hongting , An Chen , Li Ying , Zhao Leyi , Xue Peng , Zhu Shijie
Published: March 2024

Background:

Siwu Decoction (SWD) is a well-known classical TCM formula that has been shown to be effective as a basis for preventing and reducing liver metastases (LM). However, the active ingredients and potential molecular mechanisms remain unclear.

Objective:

This study aimed to systematically analyze the active ingredients and potential molecular mechanisms of SWD on LM and validate mechanisms involved.

Materials and methods:

The active ingredients in SWD were extracted by UHPLC-MS/MS in a latest study. Protox II was retrieved to obtain toxicological parameters to detect safety. Swiss Target Prediction database was exploited to harvest SWD targets. Five databases, Gene Cards, DisGeNET, Drugbank, OMIM, and TTD, were employed to filter pathogenic targets of LM. STRING database was utilized to construct the protein–protein interaction network for therapeutic targets, followed by Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. GEPIA database and the Human Protein Atlas were taken to observe the expression of core genes and proteins. ImmuCellAI algorithm was applied to analyze the immune microenvironment and survival relevant to core genes. Molecular docking was performed to verify the affinity of SWD effective ingredients to core targets. In vivo experiments were carried out to validate the anti-LM efficacy of SWD and verify the pivotal mechanisms of action.

Results:

Eighteen main bioactive phytochemicals identified were all non-hepatotoxic. PPI network acquired 118 therapeutic targets, of which VEGFA, CASP3, STAT3, etc. were identified as core targets. KEGG analysis revealed that HIF-1 pathway and others were critical. After tandem targets and pathways, HIF-1/VEGF was regarded as the greatest potential pathway. VEGFA and HIF-1 were expressed differently in various stages of cancer and normal tissues. There was a negative regulation of immunoreactive cells by VEGFA, which was influential for prognosis. Molecular docking confirmed the tight binding to VEGFA. This study revealed the exact effect of SWD against LM, and identified significant inhibition the expression of HIF-1α, VEGF, and CD31 in the liver microenvironment.

Conclusion:

This study clarified the active ingredients of SWD, the therapeutic targets of LM and potential molecular mechanisms. SWD may protect against LM through suppressing HIF-1/VEGF pathway.
Native Aortic Valve Resection Using a Novel Blade-Based Device
Authors: Navarra Emiliano , Bollen Xavier , Zito Francesco , de Kerchove Laurent , El Khoury Gebrine , Parla Astarci
Published: March 2024

Objective:

The aim of this study was to validate the use of a new resection device in patient candidates for surgical aortic valve replacement. We evaluated the efficacy of this new circular blade to resect the aortic valve and the efficacy to collect the debris during the resection.

Methods:

For this study, a single size instrument was used, with an external diameter of 22 mm, and patients were selected on the basis of the preoperative assessment of the aortic diameters.

Results:

From October 2018 to June 2019, 10 patient candidates for surgical aortic valve replacement were selected to undergo native aortic valve resection using a new device, before surgical valve implantation. The mean age of the patients was 74 ± 7.6 years, and 8 of 10 were male. The mean aortic annulus diameter, measured before the procedure, was 25.7 ± 1.57 mm. The resection was complete in 9 (90%) patients. In 1 patient, due to an imprecise positioning of the device, the valve resection was partial. None of the patients showed signs or symptoms due to debris embolism. In all patients, the postoperative course was uneventful.

Conclusions:

These preliminary results show that resection of the aortic valve using a circular foldable blade is feasible. This prototype, used during conventional surgery even through a small incision, provided an efficient tool to easily resect the valve without debris release.
Are early pregnancies implanted close to the tubal ostia at increased risk of miscarriage? A prospective observational study
Authors: Abdullahi Idle Salwa , Ferrara Laura , Vasireddy Archana , Andersen Katherine , Johns Jemma , Barrett James , Ross Jackie A
Published: March 2024

Introduction:

The aim of this article is to assess any association between the risk of miscarriage and the distance of an early pregnancy from the closest tubal ostia.

Methods:

Early pregnancy was defined as a gestational sac ⩽ 15 mm mean diameter within the upper half of the endometrial cavity. The shortest distance from the gestational sac (chorionic membrane) to the closest tubal ostia and the interostial distance were measured. The outcomes for pregnancies at varying distances from a tubal ostia were compared using Fisher’s exact test. The receiver operating characteristic curve assessed the distance from the sac to the ostia as a predictor of miscarriage. A Wilcoxon rank-sum test was used to assess any difference in the distance from the ostia between women who miscarried and those who did not.

Results:

Outcome data were available for 212/230 patients. The relative risk of miscarriage was 5/6 (83%) in the group with gestational sacs ⩽ 4 mm from the ostium versus 70/206 (34%) > 4 mm ( p = 0.02). The proportion of miscarriages was 11/20 (55%) if the distance from the tubal ostium was ⩽5 mm versus 64/192 (33%) if >5 mm ( p = 0.08). There was a good neonatal outcome for those with live births.

Conclusion:

The risk of first trimester miscarriage was high with early pregnancies implanted close to the tubal ostia, but this finding did not reach statistical significance. A larger study is needed to establish whether 4 or 5 mm could be used as a clinically useful criterion for defining early pregnancies that are at increased risk of miscarriage.
Infective endocarditis due to Citrobacter koseri following testicular trauma: case report and literature review
Authors: Casallas-Barrera Julian Orlando , Poveda-Henao Claudia Marcela , Mantilla-Viviescas Karen Andrea , Silva-Monsalve Edwin
Published: March 2024

Infective endocarditis (IE) is a condition with low prevalence but high mortality rates within intensive care units. Microbiologically, most cases are attributed to Gram-positive cocci, while Gram-negative bacilli are less commonly involved. This case report describes a patient with IE caused by Citrobacter koseri (C. koseri) with secondary bacteremia due to blunt testicular trauma and epididymitis. We conducted a review of the literature to assess the clinical and associated risk factors of this underreported condition. Elderly and urinary tract infections could be associated with this entity. Cefazolin was used as the final targeted treatment. The use of precision medicine in IE is required for specific interventions.
Opinion leaders and crisis communication during the COVID-19 pandemic: A study of theme evolution and emotional impact on Twitter
Authors: Wang Yan , Yang Shuang , An Xinying
Published: March 2024

This study uses Twitter data from the early stages of the pandemic to analyze the evolution of topics during different time periods and attempts to investigate the content and emotional impact of opinion leaders on public opinion evolution under different themes, in order to understand their role in shaping public discourse and emotions. Divide the life cycle into three stages; NLTK emotional analysis and dynamic topic models (DTMs) are employed to extract and analyze topic words. The results showed that there were significant differences between opinion leaders and followers in terms of hot topics and their evolution trends: (1) In terms of hot topics, opinion leaders have always been paying attention to measures and methods aimed at the public, while followers usually have persist in seeking information and dissatisfaction. (2) In terms of identifying and evolving hot topics, opinion leaders have shifted from the impact of the epidemic on individuals and resources to government responses and policies, while followers are more inclined to express people's growing concerns and dissatisfaction with crisis management. The content of opinion leaders has a significant relationship with evolving public opinion, highlighting the importance of understanding their role in crisis communication. Opinion leaders are also categorized into five types, each with different audience sizes, contents, emotions, and network structures, and they impact public opinion differently. This study identifies and analyzes the characteristics and impact mechanisms of opinion leaders in crisis communication. It hopes to contribute to understanding crisis communication dynamics in the digital era and provide insights into effective communication strategies during crises.
Who earns the iron rice bowl? Major marketability and state sector jobs among college-educated workers in urban China
Authors: Yao Man , Han Siqi
Published: March 2024

In China, state sector employees enjoy a persistent organizational premium, but surprisingly few studies have examined which college-educated workers tend to work in the state sector. In this study, we focus on one key dimension in horizontal stratification in higher education—field of study—to examine patterns of state sector employment among college-educated workers in China according to the occupational specificity and profit orientation of their college majors. Using data from three nationally representative surveys in urban China, we find that college graduates majoring in less occupationally specific and less profitable fields (i.e. those with lower marketability) are more likely to work in the state sector, and this pattern is more pronounced during the later period of marketization reform. Moreover, family resources in the form of a father working in the state sector can weaken the field-to-sector association, and we observe greater intergenerational mobility into state sector employment among college graduates majoring in fields with lower marketability. These findings highlight the field-to-sector relationship as a unique mechanism of China's horizontal stratification in higher education and school-to-work transition. They also underscore the significance of considering organizational contexts when examining the educational stratification in labor market outcomes.
Evaluating the Impact of Teachers’ Personal and Professional Resources in Elementary Education on School-Based Human Resource Management: A Case Study in Indonesia
Authors: Ghufron Syamsul , Fitriyah Fifi Khoirul , Sodikin Mokhamad , Saputra Nopriadi , Amin Siti Maghfirotun , Muhimmah Hitta Alfi
Published: March 2024

Teachers are the key to the success of the learning process, so teacher perceptions are fundamental in supporting educational goals. This study aims to evaluate the impact of teachers’ personal and professional resources in elementary education on school-based human resource management. This research method is a cross-sectional study involving 474 elementary school teachers in Magetan Regency, East Java, Indonesia. The collected data was structured by PLS Structural Equation Modeling and analyzed by SmartPLS version 3.0 application. The study results found that all aspects of teachers’ personal resources (years of service, teachers’ online learning perception, and positive mental health) affect school-based management. Meanwhile, aspects of teacher certification status and literacy learning implementation affect school-based human resource management for teachers’ professional resources. Interestingly, the status of teachers, whether public or contracted, does not affect school-based management. This study benefits the government in formulating education policies, especially in implementing the teacher certification program and improving the competence of teachers and school principals. Further research is needed on strategies to improve the quality of school-based management especially in human resource.
Assessing Research Productivity and Quality Across Disciplines in the School of Arts and Sciences at the Lebanese American University
Authors: Sayyed Katia
Published: March 2024

The academic performance of faculty members, as reflected by their research productivity and quality, is a crucial factor in determining aninstitution’s reputation and ranking. However, research productivity varies across academic disciplines and is influenced by multiple factors. In this study we investigate the impact of the academic discipline on research productivity and quality among faculty members in the School of Arts and Sciences at the Lebanese American University, and explore potential factors that could affect their research productivity. We measure research productivity and quality using indicators such as publication count, publication pattern preferences, and average number of citations per publication. Additionally, we assess the effects of individual, institutional and occasional factors on research productivity through a questionnaire distributed to faculty members. Our findings indicate that faculty members in hard disciplines tend to be more productive and have more cited works than their counterparts in soft disciplines, but both groups target top journals at similar rates. Furthermore, international collaboration is a significant predictor of advanced research productivity in hard disciplines. Additionally, both groups agree that teaching loads can limit the time available for research and that the research funding and equipment should be improved. Finally, we note the COVID-19 lockdown and the economic crisis in Lebanon have decreased research activity among faculty members in hard disciplines.
Application of Aleppo pine extract for skin burn treatment
Authors: Salhi Najoua , El Guourrami Otman , Balahbib Abdelaali , Rouas Lamiae , Moussaid Siham , Moutawalli Amina , Benkhouili Fatima Zahra , Ameggouz Mouna , Ullah Riaz , Alotaibi Amal , Bouyahya Abdelhakim , Tan Ching Siang , Ming Long Chiau , El Abbes Faouzi My , Cherrah Yahya
Published: March 2024

Objective:

To investigate the Pinus halepensis extracts and determine its healing and antibacterial effects, and to evaluate the treatment of skin burns.

Methods:

Aqueous and ethanolic extracts and topical based on Aleppo pine plant extracts were prepared. Thirty male and female Wistar rats were used to study the cutaneous toxicity of extracts from the bark of P. halepensis. The extracts’ healing potential for burn wounds were also assessed by evaluating the clinical and macroscopic aspects of the wounds. The antibacterial activity of crude extracts of P. halepensis as well as its wound healing abilities was verified in this investigation.

Results:

In animals with acute dermal toxicity, there were no signs of treatment-related toxicity or death. The extracts of these plants could be transformed into phytomedicines for the treatment of infected wounds. The results demonstrated that formulated ointments are successful in treating second-degree burns in rats and may be suitable for the short-term therapeutic treatment of second-degree burns.

Conclusion:

This study successfully answered our problem, regarding the efficacy of our extract for treating second-degree burns in rats. Further studies are needed to confirm these results by identifying the molecules responsible for these activities and examining their mechanism of action.
The urgency of properly engaged dialogue in urban research in the context of the new landscape of ‘shitification’
Authors: Lees Loretta
Published: March 2024

In my plenary for Dialogues in Urban Research I called for properly engaged dialogue in urban research and discussed my own attempts throughout my career (located as an outside-insider) to do just this. I am excited that those urban scholars invited to respond to my paper are on board – here I reply to the thoughtful and generous points made by Myfanwy Taylor; Steve Millington, Chloe Steadmann and Nikos Ntouris; Norma Rantisi; Jennifer Foster; John Lauermann; and Mark Boyle. I make the point that properly engaged dialogue is now more urgent than ever in the context of the new landscape of ‘shitification’.
Human papillomavirus and bladder cancer: literature review and meta-analysis
Authors: Dolgasheva Daria S. , Ibragimova Marina K. , Tsyganov Matvey M. , Litviakov Nikolai V.
Published: March 2024

Background

The aim of this study was to evaluate data over the past 25 years to assess the prevalence of the virus in patients with bladder cancer and to evaluate the association between human papillomavirus (HPV) and bladder cancer risk.

Main text

Major databases were searched for published studies from October 1995 to May 2022. The present study evaluated the prevalence of HPV in patients with bladder cancer and the prevalence according to patients' ethnicity. The incidence of HPV in bladder cancer patients varies widely, ranging from complete absence of the virus in tissues to 64.6%. The meta-analysis was performed using Meta-Essentials_1.5 software. Begg’s and Egger’s methods were used to assess publication bias. Cochran’s Q test was used to assess heterogeneity and the I2 index was employed for calculating the variation in the pooled estimations.

Conclusions

A weak association of HPV infection with the risk of bladder cancer was found. The risk of bladder cancer with HPV infection has clear ethnic characteristics and is statistically significant in Arabs and Asians.
SWAT + input data preparation in a scripted workflow: SWATprepR
Authors: Plunge Svajunas , Szabó Brigitta , Strauch Michael , Čerkasova Natalja , Schürz Christoph , Piniewski Mikołaj
Published: March 2024

Input data collection, quality assurance and preparation are central but time_consuming steps in environmental modeling. Errors due to manual processing of model input data can result in an incorrect representation of an environmental system and may consequently lead to implausible model simulations. Correct input data preparation and thorough quality check at an early stage of the model setup procedure are essential to build confidence in model simulation results. Typically, in environmental model applications, many steps in the input data preparation phase have to be repeated with the inflow of new, additional or corrected data. In this study, we selected the widely used SWAT + ecohydrological model as an illustrative example to investigate challenges related to input data preparation. To assist in these tasks, we developed an R package named SWATprepR, which provides functions for typical and repeating SWAT + model input data preparation tasks. The package supports the preparation of weather input files, atmospheric deposition, soil parameters, crop rotations, and observed (control or calibration) data, to name a few, presently with focus on European applications. The SWATprepR functions are integrated in R script workflows and can help SWAT + modelers to avoid repetitive tasks, secure reproducibility and transparently document the data processing steps. Application of the package is illustrated with a test case of a SWAT + model for a small catchment in central Poland.
Intra-population variability of the saccular, utricular and lagenar otoliths of the garfish Belone belone (Linnaeus, 1760) from South-Western Ionian Sea (Central Mediterranean Sea)
Authors: D’Iglio Claudio , Albano Marco , Famulari Sergio , Carnevale Alex , Savoca Serena , Spanò Nunziacarla , Capillo Gioele
Published: March 2024

The garfish Belone belone represents the only valid endemic Belone species for the Mediterranean Sea and the eastern Atlantic Ocean. It shows a wide global distribution range, with a high commercial value and ecological relevance in the pelagic domain. Despite this, there needs to be more knowledge regarding the otoliths of this species, with the total absence of descriptions regarding asterisci and lapilli from Mediterranean populations and a lack of studies on the reliability of shape analysis on its sagittae. The present paper aims to provide the first main contours description of the three otoliths pairs from a Mediterranean population, providing an accurate investigation of morphology, morphometry, and intra-specific variability of sagittae, lapilli, and asterisci. Results showed (i) the absence of directional bilateral asymmetry and sexual asymmetry for the three otoliths pairs, (ii) a different morphology and morphometry of sagittae, lapilli and asterisci than those described in the literature, and (iii) an enhanced variability between sagittae morphometry and shape between the three investigated size classes. All these data confirmed the reliability of the studied species of shape analysis, showing a geographical and size-related variability of otoliths features probably related to genetics, environmental conditions, and life habits variations.
A systematic review of the types, workload, and supervision mechanism of community health workers: lessons learned for Indonesia
Authors: Nida Sofwatun , Tyas Agatha Swasti Ayuning , Putri Nidya Eka , Larasanti Ayudina , Widoyopi Aldhea Ayu , Sumayyah Rima , Listiana Saetia , Espressivo Aufia
Published: March 2024

Background

Community health workers (CHWs) have demonstrated capability to improve various health indicators, however, many programmes require support in meeting their objectives due to subpar performance and a high rate of CHW attrition. This systematic review investigated the types of CHWs, their workloads, and supervision practices that contribute to their performance in different countries.

Methods

The search was carried out in November 2022 in Medline, Embase, and Neliti for studies published in Indonesian or English between 1986 and 2022 that reported public health services delivered by CHWs who live and serve the community where they live but are not considered health professionals. The findings were synthesised using a thematic analysis to assess key factors influencing the performance of CHWs.

Results

Sixty eligible articles were included in this review. CHWs were responsible for more than two diseases (n = 35) and up to fifteen, with more than eighteen activities. Their roles covered the human life cycle, from preparation for pregnancy, care for newborns, health for children, adolescents, and productive age to elderly individuals. They were also involved in improving environmental health, community empowerment, and other social issues hindering access to health services. They carried out promotive, preventive, and curative interventions. The CHW-population ratio varied from eight to tens of thousands of people. Some CHWs did not have a clear supervision system. Challenges that were often faced by CHWs included inappropriate incentives, inadequate facilities, insufficient mentoring, and supervision, many roles, and a broad catchment area. Many studies revealed that CHWs felt overburdened and stressed. They needed help to balance their significant work and domestic tasks.

Conclusions

Effective planning that considered the scope of work of CHWs in proportion to their responsibilities and the provision of necessary facilities were crucial factors in improving the performance of CHWs. Supportive supervision and peer-supervision methods are promising, however, any CHW supervision required a detailed protocol. This systematic review emphasised the opportunity for CHW management system improvement in Indonesia.
Equity in prenatal healthcare services globally: an umbrella review
Authors: Ladak Zeenat , Grewal Nagma , Kim Minji Olivia , Small Stephanie , Leber Alexia , Hemani Mehdiya , Sun Qiuyu , Hamza Deena M. , Laur Celia , Ivers Noah M. , Falenchuk Olesya , Volpe Richard
Published: March 2024

Background

Timely, appropriate, and equitable access to quality healthcare during pregnancy is proven to contribute to better health outcomes of birthing individuals and infants following birth. Equity is conceptualized as the absence of differences in healthcare access and quality among population groups. Healthcare policies are guides for front-line practices, and despite merits of contemporary policies striving to foster equitable healthcare, inequities persist. The purpose of this umbrella review is to identify prenatal healthcare practices, summarize how equities/inequities are reported in relation to patient experiences or health outcomes when accessing or using services, and collate equity reporting characteristics.

Methods

For this umbrella review, six electronic databases were searched (Medline, EMBASE, APA PsychInfo, CINAHL, International Bibliography of the Social Sciences, and Cochrane Library). Included studies were extracted for publication and study characteristics, equity reporting, primary outcomes (prenatal care influenced by equity/inequity) and secondary outcomes (infant health influenced by equity/inequity during pregnancy). Data was analyzed deductively using the PROGRESS-Plus equity framework and by summative content analysis for equity reporting characteristics. The included articles were assessed for quality using the Risk of Bias Assessment Tool for Systematic Reviews.

Results

The search identified 8065 articles and 236 underwent full-text screening. Of the 236, 68 systematic reviews were included with first authors representing 20 different countries. The population focus of included studies ranged across prenatal only (n = 14), perinatal (n = 25), maternal (n = 2), maternal and child (n = 19), and a general population (n = 8). Barriers to equity in prenatal care included travel and financial burden, culturally insensitive practices that deterred care engagement and continuity, and discriminatory behaviour that reduced care access and satisfaction. Facilitators to achieve equity included innovations such as community health workers, home visitation programs, conditional cash transfer programs, virtual care, and cross-cultural training, to enhance patient experiences and increase their access to, and use of health services. There was overlap across PROGRESS-Plus factors.

Conclusions

This umbrella review collated inequities present in prenatal healthcare services, globally. Further, this synthesis contributes to future solution and action-oriented research and practice by assembling evidence-informed opportunities, innovations, and approaches that may foster equitable prenatal health services to all members of diverse communities.
Knowledge and practice of community pharmacists regarding the safety of drugs during pregnancy: a cross-sectional study from a developing country
Authors: Koni Amer A. , Qashoa Hamzah , Musa Abeer Abo , Masri Maen , Hazem Walaa , Taha Sari , Daifallah Aiman , Al-Jabi Samah W. , Abushanab Amani S , Zyoud Sa’ed H.
Published: March 2024

Background

Drug use during pregnancy can cause unfavorable fetal and maternal outcomes. Information sharing is essential for pharmacists’ role within intricate, modern healthcare systems. Community pharmacists (CPs) have demonstrated unsatisfactory knowledge across various pharmacological domains in most developing countries. This study aimed to explore the knowledge and practices of CPs regarding medications and herb safety during pregnancy.

Methods

A cross-sectional study was conducted in a developing country using a self-administered questionnaire. A sample of CPs working in the northern governorates of the West Bank was selected by convenience sampling. The questionnaire included questions on sociodemographic characteristics, practices and knowledge. Descriptive and inferential statistics were calculated using the Statistical Package for the Social Sciences (SPSS) to analyze the data.

Results

A total of 207 questionnaires were completed. Most respondents had only a bachelor’s degree (89.9%) but did not participate in continuous professional development (CPD) (71.0%). Almost one-third of the CP workload involved dispensing drugs to pregnant women. The majority of the participants reported that they inquire about pregnancy status (59.9%), refer to scientific sources (82.6%), and contact a prescribing physician (51.2%) in cases of uncertainty. A higher knowledge score was associated with receiving a master’s degree and CPD programs. Most CPs identified folic acid, paracetamol and amoxicillin as safe, while tetracycline, isotretinoin, enalapril, pseudoephedrine and ibuprofen were among the drugs mostly reported as unsafe. Castor oil, Senna, St. John’s wort and ginseng were the most frequently reported herbs as unsafe.

Conclusions

Despite the gaps in knowledge about herb pharmacology, CPs demonstrated acceptable knowledge and practice regarding drug safety during pregnancy. CPD is recommended for addressing gaps in knowledge and practice. Future research evaluating knowledge and practice may benefit from developing a specific, accurate, validated instrument.
Validation of primary and outcome data quality in a Swedish population-based breast cancer quality registry
Authors: Palmér Sofia , Blomqvist Carl , Holmqvist Marit , Lindman Henrik , Lambe Mats , Ahlgren Johan
Published: March 2024

Background

Population-based cancer quality registries are of great importance for the improvement of cancer care. However, little is known about the quality of recurrence data in cancer quality registries. The aim of this study was to evaluate data quality in the regional Breast Cancer Quality Registry of Central Sweden, with emphasis on the validity of recorded information on recurrence.

Methods

Validation by re-abstraction was performed on a random sample of 800 women with primary invasive breast cancer stage I-III diagnosed between 1993 and 2010, of which 400 had at least one registered recurrence and 400 had no registered recurrence. Registry data were compared with data from medical records. Exact agreement, correlation and kappa values, sensitivity and specificity were calculated.

Results

Seven hundred forty-seven women (93%) were available for analysis. Exact agreement was high for diagnostics, tumor characteristics, surgery, and adjuvant oncological treatment (90% or more for most variables). The registry’s sensitivity was low for regional recurrence (47%), but higher for local and distant recurrence (80% and 75%), whereas specificity was overall high (≥ 95%). Combining all recurrence categories irrespective of localization improved sensitivity to 90% with a specificity of 91%. In 87% of women, the date of first recurrence according to medical records fell within ± 90 days of the date recorded in the registry.

Conclusions

While the quality of data in the regional Breast Cancer Quality Registry was generally high, data accuracy on recurrences was lower. The overall precision of identifying any recurrence, irrespective of localization, was high. However, the accuracy of classification of recurrences (local, regional or distant) was lower, with evidence of underreporting for each of the recurrence categories. Given the importance of recurrence-related outcomes in the assessment of quality of care, efforts should be made to improve the reporting of recurrences.
Prevention of malaria in pregnancy through health education intervention programs on insecticide-treated nets use: a systematic review
Authors: Onyinyechi Opara Monica , Ismail Suriani , Nashriq Mohd Nazan Ahmad Iqmer
Published: March 2024

Malaria is a widespread and prevalent disease that affects human population globally, particularly in tropical countries. Malaria is a major health issue in sub-Saharan Africa and it contributes to morbidity and mortality among individuals in Africa. Pregnant women have been also reported as high risk of people been infected with malaria. This review attempted to evaluate the various methods used for health education programs and the effectiveness of the programs in improving ITNs among pregnant women.

Methods The search involved various databases; EBCOHOST, MEDLINE, CINAHL, Cochrane library, ScienceDirect, PubMed, SAGE, Sringer link, Web of Science and Wiley Online Library. It was limited to full text research articles that report intervention studies, written in English Language, published between 2003 to 2022. The key words were “malaria”, “malaria prevention”, “health education”, “insecticide-treated nets”, “utilization”, “pregnant women”.

Results A total of eleven articles met the inclusion criteria and included in the review. Six studies reported randomized controlled trials (RCTs) while five reported non-randomized controlled trials (NRCT).

Conclusions There are evidences from the results which showed that health education programs were improved among pregnant women due to the use of ITNs and LLINS utilization. Furthermore, additional interventions directed at significant others need to be implemented, considering their important role in determining pregnant women’s use of ITNs.
Incidence and determinants of diabetic ketoacidosis among people with diabetes in Woldiya comprehensive specialized hospital, Ethiopia: a retrospective cohort study
Authors: Zewdu Beyene , Belachew Tefera , Ahmed Kemal , Tilahun Lehulu , Dagnaw Kirubel
Published: March 2024

Introduction

Diabetic ketoacidosis is an acute complication of diabetes mellitus that is characterised by hyperglycemia, acidosis, and ketonuria. Diabetes is the most challenging public health problem in the twenty-first century for both developed and developing countries.

Objective

To assess the incidence of Diabetic ketoacidosis and its determinants among adult people with diabetes at an Ethiopian Hospital.

Method

An institution-based retrospective cohort study was conducted among 390 adult people with diabetes attending services at Wolida Comprehensive Specialized Hospital. The consecutive sampling method was used to select study participant charts. Data were collected using a checklist prepared from different literature. The data were entered into EPI data version 4.6.0.5 and exported to STATA version 14.0 for further analysis. The Wiebull model was the best fitted model that was selected using the log-likelihood ratio method and the Akakian information criterion. Hazard ratios with their 95% confidence interval and p-value were computed.

Result

From the total 405 charts reviewed, 390 adult charts were included for analysis. A total of 121 DKA occurred from 5471 person–months of observation. The overall incidence rate of diabetic ketoacidosis was found to be 2.2 per 100 person-months (95% CI: 1.8- 2.6). Being urban dweller (AHR: 0.59, 95% CI: 0.36–0.99), having no family history of DM (AHR: 0.55, 95%CI: 0.31—0.97), presence of infection (AHR: 2.60, 95%CI = 1.06–6.39), having of any comorbidities (AHR: 4.31, 95% CI: 1.70–10.90), and having poor glycemic control (AHR: 7.45, 95% CI: 3.84–14.47) were significant determinants.

Conclusion and recommendations

The overall incidence of diabetic ketoacidosis in study area was relatively high. Poor glycemic control, the presence of infection, and comorbidity were determinants of diabetic ketoacidosis. There is a need to have close follow-up of people with diabetes who have comorbidity, infection, and poor glycemic control.
The relative and combined ability of stress hyperglycemia ratio and N-terminal pro-B-type natriuretic peptide to predict all-cause mortality in diabetic patients with multivessel coronary artery disease
Authors: Wang Le , Wang Chen , Lang Jia-chun , Xu Rong-di , Cong Hong‑liang , Zhang Jing‑xia , Hu Yue‑cheng , Li Ting-ting , Liu Chun-wei , Yang Hua , Li Wen‑yu
Published: March 2024

Background

Stress hyperglycemia ratio (SHR) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are independently associated with increased mortality risk in diabetic patients with coronary artery disease (CAD). However, the role of these biomarkers in patients with diabetes and multivessel disease (MVD) remains unknown. The present study aimed to assess the relative and combined abilities of these biomarkers to predict all-cause mortality in patients with diabetes and MVD.

Methods

This study included 1148 diabetic patients with MVD who underwent coronary angiography at Tianjin Chest Hospital between January 2016 and December 2016. The patients were divided into four groups according to their SHR (SHR-L and SHR-H) and NT-proBNP (NT-proBNP-L and NT-proBNP-H) levels. The primary outcome was all-cause mortality. Multivariate Cox regression analyses were performed to evaluate the association of SHR and NT-proBNP levels with all-cause mortality.

Results

During a mean 4.2 year follow-up, 138 patients died. Multivariate analysis showed that SHR and NT-proBNP were strong independent predictors of all-cause mortality in diabetic patients with MVD (SHR: HR hazard ratio [2.171; 95%CI 1.566–3.008; P < 0.001; NT-proBNP: HR: 1.005; 95%CI 1.001–1.009; P = 0.009). Compared to patients in the first (SHR-L and NT-proBNP-L) group, patients in the fourth (SHR-H and NT-proBNP-H) group had the highest mortality risk (HR: 12.244; 95%CI 5.828–25.721; P < 0.001). The areas under the curve were 0.615(SHR) and 0.699(NT-proBNP) for all-cause mortality. Adding either marker to the original models significantly improved the C-statistic and integrated discrimination improvement values (all P < 0.05). Moreover, combining SHR and NT-proBNP levels into the original model provided maximal prognostic information.

Conclusions

SHR and NT-proBNP independently and jointly predicted all-cause mortality in diabetic patients with MVD, suggesting that strategies to improve risk stratification in these patients should incorporate SHR and NT-porBNP into risk algorithms.
Unraveling reproductive and maternal health challenges of women living with HIV/AIDS in Vietnam: a qualitative study
Authors: Nguyen Lynn T. , Minh Giang Le , Nguyen Diep B. , Nguyen Trang T. , Lin Chunqing
Published: March 2024

Background

Human Immunodeficiency Virus (HIV) remains a significant public health concern worldwide. Women living with HIV/AIDS (WLHA) have the additional and unique need to seek sexual and reproductive health services. WLHA’s maternal health journeys can be shaped by the cultural norms and resources that exist in their society. This study sought to understand if and how WLHA’s family planning, pregnancy, and motherhood experiences could be influenced by the patriarchal culture, gender roles, and HIV stigma in Vietnam, specifically.

Methods

Between December 2021 and March 2022, 30 WLHA with diverse socioeconomic backgrounds and childbirth experiences were interviewed in Hanoi, Vietnam. These semi-structured interviews covered topics including HIV stigma, gender norms, pregnancy experiences, and child-rearing challenges. Interviews were audio recorded, transcribed, and analysed using ATLAS.ti.

Results

Qualitative analyses of participant quotes revealed how limited information on one’s health prospects and reproductive options posed a significant challenge to family planning. Societal and familial expectations as well as economic circumstances also influenced reproductive decision-making. WLHA often encountered substandard healthcare during pregnancy, labor, and delivery. Stigma and lack of provider attentiveness resulted in cases where women were denied pain relief and other medical services. Communication breakdowns resulted in failure to administer antiretroviral therapy for newborns. Motherhood for WLHA was shadowed by concerns for not only their own health, but also the wellbeing of their children, as HIV stigma affected their children at school and in society as well. Many WLHA highlighted the constructive or destructive role that family members could play in their childbirth decision-making and care-giving experiences.

Conclusions

Overall, this study underscores the complex ways that cultural expectations, family support, and stigma in healthcare impact WLHA. Efforts to educate and engage families and healthcare providers are warranted to better understand and address the needs of WLHA, ultimately improving their reproductive and maternal health.