bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-abortion care services in Zambian health facilities: a qualitative study of users’ experiences and perceptions
Authors: Lubeya Mwansa Ketty , Munakampe Margarate Nzala , Mwila Meek , Makasa Musonda , Mukosha Moses , Jacobs Choolwe , Phiri Christabel Chigwe , Vwalika Bellington , Sichone Victor , Mangala Benedictus , Haketa Melissa Mukalumamba , Kumwenda Andrew , Kaonga Patrick
Published: July 2024

Background

Despite attempts to increase Universal Health Coverage, availability, accessibility, acceptability, and quality-related challenges remain barriers to receiving essential services by women who need them. We aimed to explore the experiences and perceptions of women receiving post-abortal care services in Zambia, within a human-rights framework.

Methods

A qualitative case study was conducted between August and September 2021 in Lusaka and Copperbelt provinces of Zambia. Fifteen (15) women seeking post-abortion care services were` interviewed using audio recorders; transcribed data was analyzed using thematic analysis. We report women’s experiences and perceptions of the healthcare system, their experiences of abortion, and healthcare-seeking behaviour. We used the availability, accessibility, acceptability, and quality (AAAQ) framework to understand how women claimed their right to healthcare as they sought and utilized post-abortion care services.

Results

Women who experienced spontaneous abortions delayed seeking health care by viewing symptoms as ‘normal pregnancy symptoms’ and not dangerous. Women also delayed seeking care because they feared the negative attitudes from their communities and the health care providers towards abortion in general, despite it being legal in Zambia. Some services were considered costly, impeding their right to access quality care.

Conclusions

Women delayed seeking care compounded by fear of negative attitudes from the community and healthcare providers. To ensure the provision and utilization of quality all abortion-related healthcare services, there is a need to increase awareness of the availability and legality of safe abortion services, the importance of seeking healthcare early for any abortion-related discomfort, and the provision and availability of free services at all levels of care should be emphasized.
Deregulation of MicroRNA-146a and 155 expression levels might underlie complicated pregnancy in Toxoplasma Gondii seronegative women
Authors: Naguib Marwa M. , Zaher Youssef Abdel , Ali Hemat Salah M. , Elnoury Hamasat Abdelhafiz , Mohammed Lina Abdelhady , Habashy Omnia Youssef , Mohammed Dina Abdelhady
Published: July 2024

Background

To evaluate the ability of the estimated plasma expression levels of genes of microRNA (MiR-) 146a and 155 to differentiate between samples of pregnant women suspected to be infected by T. gondii. 50 newly pregnant women who had at least one of the criteria of high risk for toxoplasma infection and 50 newly primigravida women free of these criteria gave blood samples for qualitative determination of serum toxoplasma antibodies and estimation of plasma expression levels of MiR-146a and 155 using the qRT-PCR. During the pregnancy course, the incidence of pregnancy complications was recorded.

Results

Twenty-six women were IgM−/IgG−, 17 women were IgM+/IgG− and 7 women were IgM+/IgG+. Thirty-two women had pregnancy complications with significantly lower incidence in IgM−/IgG− women. Plasma expression levels of MiR-146a and 155 were significantly higher in total patients compared to control levels and were significantly higher in samples of IgM+/IgG+ patients than in other samples. Statistical analyses defined a high plasma level of MiR-155 as the highly significant predictor for oncoming pregnancy complications and high levels of both microRNAs as predictors for the presence of toxoplasmosis despite seronegativity. Kaplan-Meier regression analysis defined increasing cumulative risk of having toxoplasmosis despite seronegativity with plasma levels of MiR-146a and MiR-155 of 1.2 and 3, respectively.

Conclusion

The incidence of pregnancy complications is high, irrespective of the seronegativity of women at high risk of toxoplasmosis. Estimated plasma levels of MiR-155 might identify women liable to develop complications and differentiate seronegative women vulnerable to having T. gondii infection.

Trial registration

The study protocol was approved preliminarily by the Local Ethical Committee at Benha Faculty of Medicine. Before enrollment, the study protocol was discussed in detail with the study participants, and those accepted to participate in the study signed written fully informed consents. The final approval of the study protocol was obtained after the end of case collection and registered by RC: 5-11-2022.
Cancer nurses’ experience during the COVID-19 pandemic: Multicenter mixed-methods study on coping and resilience strategies
Authors: Cadorin Lucia , Mazzega-Fabbro Cristina , Cedrone Sonja
Published: July 2024

Background

In early 2020, the COVID-19 pandemic created severe difficulties in clinical and organizational fields. Healthcare workers needed to protect their health and avoid infecting their family members, but also limit the virus’s spread among vulnerable oncology patients undergoing hospital treatment.

Objective

To evaluate the resilience and coping strategies of nurses working in the oncology setting.

Methods

A mixed-methods study was conducted. First, two questionnaires (CD-RISK and COPE- NVI-25) were used to assess nurses’ resilience strategies and coping mechanisms quantitatively. Second, qualitative semi-structured interviews were conducted to explore the personal experiences of nurses who cared for patients during the pandemic, and Colaizzi’s framework was used for content analysis.

Results

The 164 participants, the majority of whom were women (88.4%), reported high resilience. The CD-RISK score varied according to education. With respect to COPE-NIV-25, transcendent orientation and avoidance strategies had the lowest mean scores, while problem orientation was higher in nurses aged ≥ 40. Five themes emerged: (1) changes in work and personal areas; (2) feelings/emotions, such as fear of infection of themselves or their loved ones, difficulty in using the face mask, relational repercussions with patients or their families; (3) personal and working group strategies used to counteract the suffering attributable to COVID-19; (4) professionalism/nursing responsibilities in developing new rules and protocols, and (5) metaphors to describe their experiences.

Conclusions

The COVID-19 pandemic led to major changes in the nurses’ roles, but they showed resilience and generated a positive working climate.

Implication for practice

Even in emergency situations, nursing administrations and policymakers ought to ensure that nurses receive adequate training and support to develop resilience and coping strategies.
NANO.PTML model for read-across prediction of nanosystems in neurosciences. computational model and experimental case of study
Authors: He Shan , Nader Karam , Abarrategi Julen Segura , Bediaga Harbil , Nocedo-Mena Deyani , Ascencio Estefania , Casanola-Martin Gerardo M. , Castellanos-Rubio Idoia , Insausti Maite , Rasulev Bakhtiyor , Arrasate Sonia , González-Díaz Humberto
Published: July 2024

Neurodegenerative diseases involve progressive neuronal death. Traditional treatments often struggle due to solubility, bioavailability, and crossing the Blood-Brain Barrier (BBB). Nanoparticles (NPs) in biomedical field are garnering growing attention as neurodegenerative disease drugs (NDDs) carrier to the central nervous system. Here, we introduced computational and experimental analysis. In the computational study, a specific IFPTML technique was used, which combined Information Fusion (IF) + Perturbation Theory (PT) + Machine Learning (ML) to select the most promising Nanoparticle Neuronal Disease Drug Delivery (N2D3) systems. For the application of IFPTML model in the nanoscience, NANO.PTML is used. IF-process was carried out between 4403 NDDs assays and 260 cytotoxicity NP assays conducting a dataset of 500,000 cases. The optimal IFPTML was the Decision Tree (DT) algorithm which shown satisfactory performance with specificity values of 96.4% and 96.2%, and sensitivity values of 79.3% and 75.7% in the training (375k/75%) and validation (125k/25%) set. Moreover, the DT model obtained Area Under Receiver Operating Characteristic (AUROC) scores of 0.97 and 0.96 in the training and validation series, highlighting its effectiveness in classification tasks. In the experimental part, two samples of NPs (Fe3O4_A and Fe3O4_B) were synthesized by thermal decomposition of an iron(III) oleate (FeOl) precursor and structurally characterized by different methods. Additionally, in order to make the as-synthesized hydrophobic NPs (Fe3O4_A and Fe3O4_B) soluble in water the amphiphilic CTAB (Cetyl Trimethyl Ammonium Bromide) molecule was employed. Therefore, to conduct a study with a wider range of NP system variants, an experimental illustrative simulation experiment was performed using the IFPTML-DT model. For this, a set of 500,000 prediction dataset was created. The outcome of this experiment highlighted certain NANO.PTML systems as promising candidates for further investigation. The NANO.PTML approach holds potential to accelerate experimental investigations and offer initial insights into various NP and NDDs compounds, serving as an efficient alternative to time-consuming trial-and-error procedures.
Associations of dietary inflammatory index scores and serum inflammatory factors with the risk of osteoporosis: a cross-sectional study from Xinjiang, China
Authors: Tong Min , Zhang Huanwen , Li Yuanyuan , Fu Wenhui , Luo Tao , Dai Jianghong , Huang Yifei
Published: July 2024

Background

Previous studies have shown that the inflammatory potential of the diet is associated with a variety of chronic noncommunicable diseases characterized by a chronic low-grade inflammatory response. However, the relationships between dietary inflammatory potential and organismal inflammatory status and osteoporosis have been less studied. This study aimed to investigate the relationships among inflammatory diet, inflammatory state and osteoporosis in the Xinjiang multiethnic population.

Methods

The participants consisted of 4452 adults aged 35 to 74 years from Xinjiang, China. The dietary inflammatory index (DII) was calculated using dietary data collected with a semiquantitative food frequency questionnaire, and information about osteoporosis was derived from quantitative ultrasound measurements. The relationships of the DII score and inflammatory factors with the risk of osteoporosis were analysed using multivariate logistic regression, and the nonlinear associations between DII and osteoporosis were further analysed using restricted cubic splines.

Results

The results showed that proinflammatory diets were associated with a greater risk of osteoporosis (T3 vs. T1: OR = 1.87; 95% CI = 1.44, 2.45) and that there was no nonlinear relationship between the DII and the risk of osteoporosis. Increased concentrations of the inflammatory factors IL-6, IL-10, IL-12p70, IL-17, and IL-23 were associated with a greater risk of osteoporosis.

Conclusions

The risk of osteoporosis can be reduced by increasing the consumption of an appropriate anti-inflammatory diet.
Probiotic potential of lactic acid bacteria isolated from Ethiopian traditional fermented Cheka beverage
Authors: Albene Dawit , Lema Niguse Kelile , Tesfaye Getaneh , Andeta Addisu Fekadu , Ali Kidist , Guadie Awoke
Published: July 2024

Introduction

: Lactic acid bacteria (LAB) are a cluster of microbes distributed in a variety of environments and have potential probiotic activity to improve human well-being. This study was aimed at assessing the probiotic potential of LAB isolated from Cheka, an Ethiopian traditionally fermented beverage.

Method

Pure isolates obtained from 16 Cheka samples from Konso (n = 8) and Derashe (n = 8) were characterized morphologically, biochemically, and physiologically by considering basic criteria to identify the LAB. The probiotics properties of the LAB were evaluated in vitro at low pH values (2.0 and 3.0), and two bile salt concentrations (0.3 and 0.5%) for 3 and 6 h. The 16 S rRNA gene sequencing was done using an ABI 3730xl sequencer, and the gene sequences were aligned.

Results

Of the 27 pure isolates, 11 isolates were proven to be LAB with non-motile, negative for catalase, and non-spore former characteristics. Based on cultural characteristics and sugar fermentation ability, the 11 isolates were assembled into the genera Lactobacillus (55%), Lactococcus (18%), Pediococcus (18%), and Leuconostoc (9%). At pH 3.0 and a bile salt concentration of 0.3%, isolate ChK-11 showed a better survival rate (97 and 94%) than other isolates [ChK-7 (93 and 80%) > ChD-5 (84 and 76%) > ChD-8 (46 and 36%) > ChK-4 (41 and 34%)] for 6 and 3 h, respectively. According to 16 S rRNA sequencing results, isolates ChK-11 and ChK-7 were found to be Weissella paramesenteroides and Leuconostoc pseudomesenteroides with sequence similarity of 99 and 91%, respectively.

Conclusions

In the present study, probiotic LAB (Weissella paramesenteroides and Leuconostoc pseudomesenteroides) was successfully isolated and sequenced from Cheka samples. The findings of this in vitro study indicated that fermented beverages like Cheka are a source of the LAB with probiotic functional properties. Overall, Weissella paramesenteroides and Leuconostoc pseudomesenteroides isolates, which showed promising probiotic properties under in vitro conditions, can be used for starter culture development for the Cheka fermentation process.
Modeling behavioral patterns of family violence aggressors
Authors: Jolliffe Simpson Apriel D. , Joshi Chaitanya , Polaschek Devon L. L.
Published: July 2024

Background setting

The presumption that family violence will repeat and escalate is embedded in practices including risk assessment and case management. However, there is limited evidence that further episodes are inevitable, or that subsequent episodes will increase in severity. Therefore, we need to better understand temporal patterns in aggressor behavior to inform how risk is conceptualized in practice.

Methods

For a sample of 2115 family violence aggressors who came to police attention in Integrated Safety Response catchment areas in Aotearoa New Zealand, we collected information New Zealand Police routinely recorded about reported harm between 2018 and 2020. We used a hidden Markov model to estimate the latent (i.e., unmeasurable) states behind the information reported to police, and modeled aggressors’ movement between those states over time.

Results

We identified three latent states. The first contained low or no reported harm, the second contained low probabilities of reported harm, and the third involved a high probability of reported verbal abuse and a moderate probability of reported physical violence. We identified four pathways through the latent states over the two-year follow-up period, which we called No reported harm, High reported harm, Low reported harm, and De-escalation.

Conclusions

The findings add to the body of research indicating that family violence aggressors do not inevitably repeat or escalate their harmful behavior, and that a small subset of cases account for a large proportion of reported harm. This study demonstrates how information that police routinely collect can be used to estimate aggressors’ latent behavioral states and model pathways communicating the probability that they will continue to come to police attention for family violence, contributing to improved risk assessment and practice.
An efficient PGD solver for structural dynamics applications
Authors: Vella Clément , Gosselet Pierre , Prudhomme Serge
Published: July 2024

We propose in this paper a Proper Generalized Decomposition (PGD) solver for reduced-order modeling of linear elastodynamic problems. It primarily focuses on enhancing the computational efficiency of a previously introduced PGD solver based on the Hamiltonian formalism. The novelty of this work lies in the implementation of a solver that is halfway between Modal Decomposition and the conventional PGD framework, so as to accelerate the fixed-point iteration algorithm. Additional procedures such that Aitken’s delta-squared process and mode-orthogonalization are incorporated to ensure convergence and stability of the algorithm. Numerical results regarding the ROM accuracy, time complexity, and scalability are provided to demonstrate the performance of the new solver when applied to dynamic simulation of a three-dimensional structure.
Intelligent assessment system of material deterioration in masonry tower based on improved image segmentation model
Authors: Zou Jianshen , Deng Yi
Published: July 2024

Accurate and timely data collection of material deterioration on the surfaces of architectural heritage is crucial for effective conservation and restoration. Traditional methods rely heavily on extensive field surveys and manual feature identification, which are significantly affected by objective conditions and subjective factors. While machine vision-based methods can help address these issues, the accuracy, intelligence, and systematic nature of material deterioration assessment for large-scale masonry towers with complex geometries still require significant improvement. This research focuses on the architectural heritage of masonry towers and proposes an intelligent assessment system that integrates an improved YOLOv8-seg machine vision image segmentation model with refined 3D reconstruction technology. By optimizing the YOLOv8-seg model, the system enhances the extraction capabilities of both detailed and global features of material deterioration in masonry towers. Furthermore, by complementing it with image processing methods for the global visualization of large-scale objects, this research constructs a comprehensive intelligent assessment process that includes "deterioration feature extraction—global visualization—quantitative and qualitative comprehensive assessment." Experimental results demonstrate that the intelligent assessment system significantly improves the performance of target feature extraction for material deterioration in masonry towers compared to existing methods. The improved model shows improvements of 3.39% and 4.55% in the key performance metrics of mAP50 and mAP50-95, respectively, over the baseline model. Additionally, the efficiency of global feature extraction and visualization of material deterioration increased by 66.36%, with an average recognition accuracy of 95.78%. Consequently, this system effectively overcomes the limitations and subjective influences of field surveys, enhancing the objectivity and efficiency of identifying and analyzing material deterioration in masonry towers, and providing invaluable data support for the subsequent preservation and restoration efforts.
Hate speech detection in the Bengali language: a comprehensive survey
Authors: Al Maruf Abdullah , Abidin Ahmad Jainul , Haque Md. Mahmudul , Jiyad Zakaria Masud , Golder Aditi , Alubady Raaid , Aung Zeyar
Published: July 2024

The detection of hate speech (HS) in online platforms has become extremely important for maintaining a safe and inclusive environment. While significant progress has been made in English-language HS detection, methods for detecting HS in other languages, such as Bengali, have not been explored much like English. In this survey, we outlined the key challenges specific to HS detection in Bengali, including the scarcity of labeled datasets, linguistic nuances, and contextual variations. We also examined different approaches and methodologies employed by researchers to address these challenges, including classical machine learning techniques, ensemble approaches, and more recent deep learning advancements. Furthermore, we explored the performance metrics used for evaluation, including the accuracy, precision, recall, receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), sensitivity, specificity, and F1 score, providing insights into the effectiveness of the proposed models. Additionally, we identified the limitations and future directions of research in Bengali HS detection, highlighting the need for larger annotated datasets, cross-lingual transfer learning techniques, and the incorporation of contextual information to improve the detection accuracy. This survey provides a comprehensive overview of the current state-of-the-art HS detection methods used in Bengali text and serves as a valuable resource for researchers and practitioners interested in understanding the advancements, challenges, and opportunities in addressing HS in the Bengali language, ultimately assisting in the creation of reliable and effective online platform detection systems.
A qualitative comparison of parents’ experiences of early childhood expulsion following a legislative ban
Authors: Zinsser Katherine M. , Coba-Rodriguez Sarai , Lowe-Fotos Allison
Published: July 2024

Over the past decade, numerous reports have indicated pervasively high rates of early childhood expulsion nationwide. In response, state and federal policymakers have enacted various measures to ban or reduce reliance on such exclusionary discipline. Prior evaluations of the implementation of one such legislative ban on expulsion enacted in Illinois in 2018 showed partial reductions but relied only on program administrator-reported data. Parents (N = 16) of children (43.75% children of color) expelled from Illinois early childhood programs before and in the years since the 2018 legislative ban were interviewed about their experiences. Parents in both groups reported similar incidents regarding how and why children are excluded, how programs communicated with parents about children’s behavioral concerns, and how programs assisted (or did not) with accessing resources and supports that may enable a child to be retained. Findings indicate that expulsions continue to happen despite the ban and families’ experiences were essentially unchanged and negative. Findings hold implications for the implementation of similar policy efforts across the country.
Eggshell membrane and green seaweed (Ulva lactuca) micronized powders for in vivo diabetic wound healing in albino rats: a comparative study
Authors: Moustafa Moustafa H. , Turkey Mohamed S. , Mohamedin Noha S. , Darwish Amira A. , Elshal Amira A. M. , Yehia Mona A. H. , El Safwany Mohamed M. , Mohamed Ehab I.
Published: July 2024

Background

Nonhealing diabetic wounds are a serious complication associated with extremely lethargic wound closure and a high risk of infection, leading to amputation or limb loss, as well as substantial health care costs and a poor quality of life for the patient. The effects of either eggshell membrane (ESM) and green seaweed (Ulva lactuca) extracts alone or in combination were evaluated for in vivo skin wound healing in a rat model of induced diabetes.

Methods

Micronized powders of waste hen ESM, Ulva lactuca, and their 1:1 mixture were prepared using regular procedures. The mechanical, electrical, and surface morphology characteristics of powders were examined using direct compression, LCR-impedancemetry, and scanning electron microscopy. The effect of ESM, Ulva lactuca, and their mixture as compared to standard Dermazin treatments were evaluated on wounds inflicted on male Wistar Albino rats with induced diabetes. Quantitative wound healing rates at baseline and at 3, 7, 14, and 21 days of treatments among all rat groups were conducted using ANOVA. Qualitative histological analysis of epidermal re-epithelization, keratinocytes, basement membrane, infiltrating lymphocytes, collagen fibrines, and blood vessels at day 21 were performed using Image J processing program.

Results

Compressive strength measurements of tablets showed a Young’s modulus of 44.14 and 27.17 MPa for the ESM and ESM + Ulva lactuca mixture, respectively. Moreover, both samples exhibited relatively low relative permittivity values of 6.62 and 6.95 at 1 MHz, respectively, due to the porous surface morphology of ESM shown by scanning electron microscopy. On day 21, rats treated with ESM had a complete diabetic wound closure, hair regrowth, and a healing rate of 99.49%, compared to 96.79% for Dermazin, 87.05% for Ulva lactuca, 90.23% for the mixture, and only 36.44% for the negative controls. A well-formed basement membrane, well-differentiated epithelial cells, and regular thick keratinocytes lining the surface of the epidermal cells accompanied wound healing in rats treated with ESM, which was significantly better than in control rats.

Conclusion

Ground hen ESM powder, a low-cost effective biomaterial, is better than Ulva lactuca or their mixture for preventing tissue damage and promoting diabetic wound healing, in addition to various biomedical applications.
An auto-ethnographic study of co-produced health research in a patient organisation: unpacking the good, the bad, and the unspoken
Authors: Janssens Astrid , Drachmann Danielle , Barnes-Cullen Kristy , Carrigg Austin , Christesen Henrik Thybo , Futers Becky , Lavery Yvette Ollada , Palms Tiffany , Petersen Jacob Sten , Shah Pratik , Thornton Paul , Wolfsdorf Joseph
Published: July 2024

Background

In rare diseases, limited access to services and rare disease experts may force families to act as medical advocates for their child; they can volunteer to support clinician-initiated research or initiate and lead research themselves. Ketotic Hypoglycemia International (KHI) is a new, global organization for families affected by idiopathic ketotic hypoglycemia (IKH) and is run solely by volunteers. Doing research together, families and international experts in a collaborative process such as at KHI, also referred to as patient and public involvement and engagement (PPIE) or extreme citizen science, is often praised for its positive effects on the research and the stakeholders involved.

Methods

We used auto-ethnographic narratives from parents and medical professionals in KHI to report on their experiences with co-produced health research. All co-authors wrote down their experiences in relation to three topics: time invested, work invested and power dynamics.

Results

Whilst the parents and health care professionals felt a new hope for (their) children with IKH, they also felt pressure to contribute time or to be flexible in how and when they dedicated time towards the organization. The power dynamics were characterised by a change in the relationship between the parents and medical experts; the parent being taught by the expert shifted to the expert learning from the lived experience of the parent. Both parents and medical experts struggled with maintaining boundaries and safeguarding their mental health.

Conclusion

Our findings call for the need to secure and prioritize funding for patient organizations, to enable them to create the sustainable architecture required for meaningful PPIE within these organizations. The morals and often deeply personal reasons for engaging with voluntary work in health research, can lead to overstepping of boundaries. As a result of our research, we call for the development of ethics of care guidelines within collaborative health research.
Comparison between open and closed systems for vitrification of individual sperm: assessing morphometric measurements and chromatin integrity
Authors: Khalili Mohammad Ali , Vatanparast Mahboubeh , Mangoli Esmat , Ghasmi-Esmaeilabad Saeed , Moshrefi Mojgan , Hosseini Akram
Published: July 2024

Background

Classic vitrification methods are not appropriate when there are minimal numbers of viable sperm, and the new methods emphasize the low semen volumes in these cases. The aim was to assess the efficacy of the cryotech as a device for freezing low sperm volume, through the two methods of open (OVS) and closed (CVS) vitrification systems.

Methods

Testicular biopsy samples from 30 men with obstructive azoospermia (OA) were assigned to three groups fresh control (FC), OVS, and CVS. Testicular sperms were selected using an ICSI injection pipette and vitrified on the cryotech straws, containing one droplet of freezing medium. After warming, sperm head morphometric characterizations were evaluated with the MSOME technique. Sperm motility, membrane integrity, chromatin quality assessment including DNA fragmentation, Chromomycine A3 staining (CMA3), and Aniline Blue (AB) were assessed. Fluorescein isothiocyanate-conjugated Pisum sativum agglutinin (FITC-PSA) was done to examine sperm acrosome integrity.

Results

The mean sperm motility, viability, and sperm with intact acrosome reduced after vitrification, in both methods of CVS, and OVS, but the results were more promising in the closed method (p < 0.05). However, the variations were not significant between the two methods of cryopreservation, the OVS undergoes significant head dimensions changes compared to the control group (p < 0.05). The results also showed higher membrane, and chromatin abnormality after OVS (p < 0.05).

Conclusions

The overall post-thaw recovery of human testicular sperm proposes that CVS is more efficient for single sperm cryopreservation, while higher sperm viability, and lower alterations in chromatin, acrosome, and sperm head morphometry were seen compared to OVS.
Implementation fidelity of intravenous ferric carboxymaltose administration for iron deficiency anaemia in pregnancy: a mixed-methods study nested in a clinical trial in Nigeria
Authors: Akinajo Opeyemi R. , Annerstedt Kristi Sidney , Banke-Thomas Aduragbemi , Obi‑Jeff Chisom , Sam-Agudu Nadia A. , Babah Ochuwa A. , Balogun Mobolanle R. , Beňová Lenka , Afolabi Bosede Bukola
Published: July 2024

Background

Iron deficiency anaemia is common among pregnant women in Nigeria. The standard treatment is oral iron therapy, which can be sub-optimal due to side effects. Intravenous ferric carboxymaltose (FCM) is an evidenced-based alternative treatment with a more favourable side effect profile requiring administration according to a standardized protocol. In this study, we assessed the fidelity of administering a single dose of FCM according to protocol and identified factors influencing implementation fidelity.

Methods

We used a mixed-method approach with a sequential explanatory design nested in a clinical trial across 11 facilities in Lagos and Kano States, Nigeria. Guided by a conceptual framework of implementation fidelity, we quantitatively assessed adherence to protocol by directly observing every alternate FCM administration, using an intervention procedure checklist, and compared median adherence by facility and state. Qualitative fidelity assessment was conducted via in-depth interviews with 14 skilled health personnel (SHP) from nine purposively selected health facilities, using a semi-structured interview guide. We analyzed quantitative data using descriptive and inferential statistics in Stata and used thematic analysis to analyze the transcribed interviews in NVivo.

Results

A total of 254 FCM administrations were observed across the 11 study sites, with the majority in secondary (63%), followed by primary healthcare facilities (PHCs) (30%). Overall, adherence to FCM administration as per protocol was moderate (63%) and varied depending on facility level. The lowest level of adherence was observed in PHCs (36%). Median, adherence level showed significant differences by facility level (p = 0.001) but not by state (p = 0.889). Teamwork and availability of protocols are facilitation strategies that contributed to high fidelity. However, institutional/ logistical barriers are contextual factors that influenced the varied fidelity levels observed in some facilities.

Conclusions

Collaborative teams and access to operating protocols resulted in high fidelity in some facilities. However, in some PHCs, fidelity to FCM was low due to contextual factors and intervention complexities, thereby influencing the quality of delivery. In Nigeria, scale-up of FCM will require attention to staff strength, teamwork and availability of administration protocols, in order to optimize its impact on anaemia in pregnancy.
The palace of Charles V in the Alhambra: graphic analysis of the ‘large plan’ (circa 1532)
Authors: Gámiz-Gordo Antonio , García-Ortega Antonio-Jesús
Published: July 2024

Around 1526, Emperor Charles V decided to build a new Renaissance palace in addition to the Nasrid palaces in the Alhambra of Granada, a monumental site currently included in the United Nations Educational, Scientific and Cultural Organisation (UNESCO) World Heritage List. In that period, a large floor plan, which is preserved today at the Library of the Royal Palace of Madrid, was drawn to represent the building and its surroundings. Although this anonymous drawing has attracted considerable historiographic interest, a study of the graphical aspects analysed here, namely, paper assemblage, drawing technique, representation system, metrology, graphical scale, dimensioning, and labelling, is lacking. To accomplish this analysis, the original document was carefully examined and digitalised with high definition. This process allowed a comprehensive graphic analysis, utilising other drawings from the same period as a comparative reference and studying for the first time the major characteristics of one of the most relevant architectural drawings of the 16th century.
Mind the diversity: defining intervention concepts of built heritage in international doctrinal documents
Authors: Lin Mi , Roders Ana Pereira , Nevzgodin Ivan , de Jonge Wessel
Published: July 2024

Purpose

Interventions are essential for the management of built heritage because they extend the lifespan of buildings and enable them to be enjoyed by multiple generations. International organisations and institutions, such as UNESCO and ICOMOS, have adopted doctrinal documents over time, stimulating best practices in built heritage management worldwide. Although these documents are often referenced in academic work, they are seldom systematically researched. Which interventions are referenced or omitted? Are they defined? What trends are noted in the understanding of best practices as interventions?

Design/methodology/approach

This research consists of a systematic content analysis of nine international doctrinal documents, which were selected from nearly seventy international doctrinal documents—mainly adopted by UNESCO and ICOMOS. The main aim is to reveal and compare the concepts used for reference interventions and further use the definitions to reveal and discuss the relationships between them. The trends of these interventions being used were determined based on the frequency of mentions per intervention term in the selected documents.

Findings

Regarding the definition of the intervention concepts, there are three main findings. First, instead of being treated as a single concept, ‘conservation’ has been presented as an umbrella concept for other interventions and thus has been the most popular concept since the first version (1992) of the New Zealand Charter was implemented. In contrast, ‘preservation’ remains a single concept, among the highest scales, to maintain the integrity of built heritage, including use. Second, ‘repair’ was found to play a paradoxical role between ‘restoration’ and ‘reconstruction’, which created divergent opinions in the documents. Third, since the notions of ‘use’ have expanded from the functions of monuments (International Charter for the Conservation and Restoration of Monuments and Sites: The Venice Charter, 1964) to the ‘associations of places’ (The Burra Charter: The Australia ICOMOS Charter for Places of Cultural Significance, with associated Guidelines and Code on the Ethics of Co-existence, 1999; The Burra Charter: The Australia ICOMOS Charter for Places of Cultural Significance, 2013), which include activities, traditional habits, accessibility, etc., the complexity of mentioning different forms of ‘use’ has led to some (re)interventions, such as ‘adaptation’, ‘adaptive reuse’, and ‘rehabilitation’, being put into grey areas and used interchangeably.

Originality

This research advances the current understanding of intervention concepts and their relationships, as well as differences and similarities in definitions.
De-escalation treatment of patients with HPV-positive oropharyngeal squamous cell carcinoma.
Authors: Golubev Pavel , Bolotina Larisa , Gevorkov Artem , Deshkina Tatiana , Kuzmina Evgenia , Pokataev Ilya , Galkin Vsevolod
Published: July 2024

e18052

Background: According to Globocan in 2020 were identified 98 412 new cases of oropharyngeal squamous cell carcinoma in the world. It was proved that the human papillomavirus (HPV) is a favorable prognostic factor. Patients with HPV-positive oropharynx cancer have higher indicators of progression-free survival (PFS) and overall survival (OS). As induction chemotherapy, the only TPF regimen (cisplatin/ docetaxel/ 5-fluorouracil) has been approved which has high toxic profile. Published results of randomized trials demonstrate the possibility of de-escalation CRT without reduction OS and PFS, but there is no data about safety of de-escalated IC regimen. Given the high toxicity of the standard regimen, as well as the presence of a favorable prognostic factor (HPV infection), since 2021 has started a prospective trial, investigating the possibility of use the dual-component IC regimen according to the TP scheme (cisplatin/ docetaxel). Objective: Improve the results of treatment of patients with locally advanced HPV- positive squamous cell carcinoma of the oropharynx by optimizing the scheme IC. Methods: In the prospective trial included 68 patients with p16-positive oropharyngeal squamous cell carcinoma (T3-4N0-1M0, or T1-4N2-3M0), who were divided into 2 equal groups. The research group received 3 cycles of IC to the de-escalated TP regimen and the control group according to the standard three-component TPF regimen. After completion IC patients of both groups had a standard CRT 70 Gy with carboplatin AUC 2.0 weekly. The primary endpoints were the assessment of objective response rate after the IC and toxicity. The Secondary endpoints: 1-year OS and PFS. Results: Complete response (CR) was achieved in 3 patients (8,8%), a partial response (PR) in 22 (64,7%), stable disease (SD) in 8 (23,5%) patients in the research arm. In the control arm: CR 4 patients (11,8%), PR 24 (70,6%), SD 6 (17,6%) patients. Both IC regimens demonstrated high efficacy rates, and there was no statistically significant ORR in the group (p=0,2133).Toxic manifestations were often observed in the arm of standard IC. The higher incidence of mucositis in the control group was statistically significant (p=0,025). The effect of IC regimen on subsequent CRT was also assessed. In the research arm, the time before the start of CRT was statistically significantly less than in the control arm (30 days vs 63 days, p=0,0035.). And the period of development mucositis of CRT in the TP group was longer than in the TPF group (34G vs 32G, p=0,0298). 1 year - PFS 94%, 1 year - OS 100% in the research group and 92% and 100% in the control arm. There was no statistically significant 1 year – PFS and 1 year - OS in the group (р=0,6547). Conclusions: The research scheme of IC demonstrated high results of an objective response, 1-year OS and 1 year - PFS, comparable to the standard TPF scheme, against the background of better tolerance.
Induction chemotherapy with nab-paclitaxel plus nedaplatin plus concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma: A retrospective real-world study.
Authors: Fengqin Yan
Published: July 2024

e18056

Background: Although induction chemotherapy (IC) plus concurrent chemoradiotherapy (CCRT) is recommended as standard treatment option of locally advanced nasopharyngeal carcinoma (NPC), the IC regimens conduct further study. Therefore, this study was evaluated the efficacy and safety of IC with nab-paclitaxel and nedaplatin followed by CCRT in locally advanced NPC. Methods: In this retrospective real-world study, 295 patients was enrolled, and all received nab-paclitaxel (260mg/m2/d) and nedaplatin (80mg/m2/d) –based IC every 3 weeks. Results: All patients completed the treatment plans. The ORR were 95.3% in the NP and 96.9% in the neck after IC, respectively. At the end of CCRT, the ORR were 97.3% in the NP and 97.3% in the neck nodes, respectively. 3 years survival outcomes were 96.4% of OS, 95.7% of LRRFS, 93.7% of DMFS, and 89.8% of PFS, respectively. During IC, all treatment-related adverse events occurred in 43.2%. The most frequent grade 3 toxicities were neutropenia (7.8%), leucopenia (4.4%), anaemia (0.3%), thrombopenia (2.4%) and hepatic injury (3.1%), respectively. Conclusions: IC with nab-paclitaxel and nedaplatin showed promising efficacy and safety profile in locally advanced NPC.
Laryngeal squamous cell carcinoma (LSCC) prognosis and machine learning insights.
Authors: Alshwayyat Sakhr Abdulsalam , Alenezy Abdalwahab , Alshwayyat Mustafa , Alshwayyat Tala Abdulsalam
Published: July 2024

e18058

Background: LSCC has seen a rise in cases and deaths over the past 30 years. Considering the evolving therapeutic options available in the treatment landscape, we evaluated treatment approaches and developed a machine learning (ML) model for patients with LSCC without distant metastasis. Methods: Data from 2000 to 2020 were obtained from the National Cancer Institute Surveillance, Epidemiology, and End Results database with localized/regional stages only, including the glottis (GC), supraglottic (SuGC), and subglottic (SGC). Patients who were not diagnosed based on histology, previous history of cancer or other concurrent malignancies, or unknown data were excluded. T-tests and chi-square tests were used to compare variables, while the Kaplan-Meier estimator, log-rank tests, and Cox regression analysis identified prognostic factors for overall survival (OS) and cancer-specific survival (CSS). We constructed prognostic models using ML algorithms to predict the 5-year survival. Patient records were randomly divided into training (70 %) and validation (30 %) sets. A validation method incorporating the area under the curve (AUC) of the receiver operating characteristic curve was used to validate the accuracy and reliability of the ML models. Results: A total of 68,282 patients were included (43,434 with GC, 24,010 with SuGC, and 838 with SGC). Of the patients, 80.8% were males and 63.5% were over 60 years old and white (n=56,171). The tumors were >2 cm in size (85.1%). The median patient age was 64 years, and the median tumor size was 3.2 cm. Of these patients, 36.5% underwent surgery with local tumor excision in 23.9 % and total laryngectomy in 5.7% of patients. White race, regional stage, large tumor size, and chemotherapy were poor prognostic factors for GC. Asian ethnicity, white race, and total laryngectomy were good prognostic factors for SuGC, whereas male sex and older age were poor prognostic factors. In terms of SCG "Surgery + adjuvant radiotherapy" was associated with better prognosis while regional and white race were associated with poor prognosis. Performance metrics for all ML algorithms are summarized in the Table. The factors that contributed the most to GC were the surgery type, stage, and age. Stage, surgery type, and race for SuGC and age, stage, and surgery type for SGC. Conclusions: ML models showed promising accuracy in predicting prognosis, highlighting the valuable contributions of factors such as surgery type, stage, age, and race. These findings offer insights into personalized treatment decisions and future research directions. [Table: see text]
Local differences in robustness to ocean acidification
Authors: Padilla Dianna K. , Milke Lisa , Akin-Fajiye Morodoluwa , Rosa Maria , Redman Dylan , Liguori Alyssa , Rugila Allison , Veilleux David , Dixon Mark , Charifson David , Meseck Shannon L.
Published: July 2024

Ocean acidification (OA) caused by increased atmospheric carbon dioxide is affecting marine systems globally and is more extreme in coastal waters. A wealth of research to determine how species will be affected by OA, now and in the future, is emerging. Most studies are discrete and generally do not include the full life cycle of animals. Studies that include the potential for adaptation responses of animals from areas with different environmental conditions and the most vulnerable life stages are needed. Therefore, we conducted experiments with the widely distributed blue mussel, Mytilus edulis, from populations regularly exposed to different OA conditions. Mussels experienced experimental conditions prior to spawning, through embryonic and larval development, both highly vulnerable stages. Survivorship to metamorphosis of larvae from all populations was negatively affected by extreme OA conditions (pH 7.3, Ωar, 0.39, pCO2 2479.74), but, surprisingly, responses to mid OA (pH 7.6, Ωar 0.77, pCO21167.13) and low OA (pH 7.9, Ωar 1.53, pCO2 514.50) varied among populations. Two populations were robust and showed no effect of OA on survivorship in this range. One population displayed the expected negative effect on survivorship with increased OA. Unexpectedly, survivorship in the fourth population was highest under mid OA conditions. There were also significant differences in development time among populations that were unaffected by OA. These results suggest that adaptation to OA may already be present in some populations and emphasizes the importance of testing animals from different populations to see the potential for adaptation to OA.
Randomized Clinical Trial to Increase Self-Monitoring of Physical Activity and Eating Behaviors in Youth: A Feasibility Study
Authors: Ajja Rahma , Skelton Joseph A. , Peluso Alexandra G. , Singletary Camelia R. , Cohen Gail M. , Turner-Mcgrievy Gabrielle , Ip Edward , Miller David , Moore Justin B.
Published: July 2024

Introduction

Mobile health (mHealth) has the potential to reduce reliance on in-person healthcare visits, making monitoring of health, eating, and physical activity less burdensome. There is a great need to develop and test mHealth tools for pediatric weight loss programs to enhance clinical practice. This study aimed to test the feasibility of utilizing a tailored suite of mHealth components to augment an existing evidence-based in-person pediatric weight management program.

Method

Using a two-group randomized superiority trial design, participants who completed baseline measurement were randomized to Brenner Families in Training (Brenner FIT) or Brenner FIT + mHealth (Brenner mFIT), and follow-up measures were completed at 3 and 6 months. Feasibility was assessed in terms of screening, recruitment, randomization, retention, and the assessment process. Acceptability was assessed in terms of program completion, and implementation fidelity was assessed in terms of logging activity, frequency of self-monitoring, goal setting, and retention rate.

Results

Overall, 173 dyads were eligible for enrollment based on inclusion criteria. Twenty-five dyads consented to participate. Sixteen dyads completed baseline psychosocial questionnaires, eight dyads completed at least two 24-h dietary recalls, and 20 (youth) participants returned accelerometers. Of the 14 dyads who completed enrollment, seven dyads were each randomized into the intervention and control groups, with ten and five dyads retained at three and six months, respectively. A total of four caregivers and two youth who utilized the website for goal setting set at least one goal, all seven youth linked their activity tracker, and most downloaded at least one video (two youth) or podcast (six caregivers).

Conclusions

Our results suggest that the assessment protocol was overly burdensome, the intervention had low acceptability, and the study as designed was not feasible to complete. Future studies should evaluate barriers and facilitators to the uptake of mHealth.