bluuebunny/crossref_metadata_2025 huggingface dataset:
Peningkatan Keselamatan Kapal Niaga dengan Sistem Pemuatan Berbasis Komputer
Authors: Murdjito Murdjito , Sujantoko Sujantoko , Nugroho Setyo , Djatmiko Eko Budi , Mustain Mahmud , Wardhana Wisnu , Wahyudi Wahyudi , Ardi Eka Wahyu
Published: March 2023

Peningkatan kualitas keamanan dan keselamatan pelayaran Kementerian Perhubungan telah mencanangkan zero accident dengan mengeluarkan standar yang terkait dengan teknologi kapal, kelengkapan peralatan keselamatan di kapal, dan sertifikasi awak kapal. Untuk menjamin keselamatan pelayaran, maka kapal harus dinyatakan laik laut jika ingin belayar. Walaupun demikian tingkat kecelakaan kapal di laut masih tinggi. Dalam rangka meningkatkan keselamatan pelayaran untuk mengatasi tingginya angka kecelakaan fatal maka diperlukan sarana pendidikan kepelautan yang memadai. Peningkatan mutu pendidikan formal dan sosialisasi tentang keselamatan pelayaran perlu disosialisasikan lebih luas dan lebih baik. Kecelakaan kapal sering disebabkan oleh tidak dilakukannya penataan muatan yang sistematis dan tidak dilakukannya perhitungan stabilitas secara akurat. Dengan alat perencanaan muatan berbasis komputer, maka perhitungan stabilitas kapal yang akurat dan otomatis dapat digunakan untuk meningkatkan pemahaman dan kesadaran arti pemuatan dan stabilitas kapal pada operasi muat kapal. Kegiatan yang akan dilakukan dalam program ini adalah membuat prototipe materi pelatihan dan pendidikan keselamatan kapal secara sistematis dan terstruktur dengan perangkat lunak yakni iStow. Urgensi peningkatan keselamatan kapal sangat tinggi, mengingat kecelakan kapal sering kali bersifat fatal. Sehingga dapat mengganggu kehidupan sosial dan kegiatan perekonomian. Pemanfaatan teknologi tinggi akan dapat berkontribusi dalam meningkatkan keselamatan pelayaran dan kesejahteraan awak kapal.
Pengolahan Limbah Sabut Kelapa Menggunakan Mesin Pencacah dalam Upaya Pemanfaatannya sebagai Produk Tepat Guna di Desa Candimulyo - Dolopo - Madiun
Authors: Astuti Fahmi , Pratapa Suminar , Suasmoro Suasmoro , Triwikantoro Triwikantoro , Cahyono Yoyok
Published: March 2023

Produksi buah kelapa Indonesia rata-rata 15,5 miliar butir/tahun, setara 3,02 juta ton kopra, 3,75 juta ton air, 0,75 juta ton arang tempurung, 1,8 juta ton serat sabut, dan 3,3 juta ton debu sabut. Sabut kelapa merupakan hasil samping dari buah kelapa yang berpotensi cukup besar. Saat ini pemanfaatannya masih belum optimal bahkan cenderung menjadi limbah lingkungan. Pemanfaatan mesin pencacah untuk pengolahan lebih lanjut sabut kelapa menjadi produk tepat guna misalnya: serat sabut kelapa (cocofiber) dan serbuk sabut kelapa (cocopeat) yang merupakan dua produk turunan dari sabut kelapa yang melalui beberapa penelitian dapat diolah menjadi material pendukung interior dan furnitur. Dengan demikian, maka limbah sabut kelapa dapat menjadi lebih bernilai ekonomis yang tentunya sangat berdampak positif pada masyarakat yang tinggal di sekitar lokasi penghasil kelapa. Sasaran masyarakat dalam kegiatan ini adalah masyarakat Desa Candimulyo, Dolopo, Madiun yang mana terdapat pengepul kelapa dan sentra distribusi kelapa di desa tersebut. Produk mesin pencacah yang dibuat bekerjasama dengan industri diharapkan menjadi produk dari perguruan tinggi yang dapat diimplementasikan langsung dan bermanfaat dalam jangka panjang untuk mitra.
Penerapan Literasi Bertema Teknik Kelautan dalam Proses Pembelajaran Siswa SMPIT Al Uswah Surabaya
Authors: Prastianto Rudi Walujo , Rosyid Daniel Mohammad , Sambodho Kriyo , Mulyadi Yeyes , Murdjito Murdjito , Azhim Abdul , Sumardiani Sri
Published: March 2023

Indonesia adalah negara maritim terbesar di dunia dengan potensi kelautan yang sangat besar. Dahulu, kerajaan Nusantara seperti Majapahit dan Sriwijaya telah berhasil mengelola laut untuk kejayaan dan kemakmuran rakyatnya. Ironisnya saat ini secara umum tingkat literasi masyarakat Indonesia terhadap bidang maritim atau kelautan sangat rendah. Salah satu penyebabnya ditengarai karena di dalam kurikulum pendidikan dan proses pembelajaran di sekolah-sekolah di Indonesia kurang membahas bidang kelautan. Untuk itu perlu diawali dengan membangun kembali paradigma dan pemikiran maritim/kelautan/bahari pada jiwa generasi muda sejak dini. Makalah ini menyajikan hasil kegiatan pengabdian kepada masyarakat (abdimas) yang bertujuan untuk menyediakan bahan literasi berupa buku bertema bidang teknik kelautan/maritim dan menerapkannya dalam proses pembelajaran siswa kelas VII SMPIT Al Uswah Surabaya. Metode kegiatan abdimas ini terdiri dari penyusunan buku bertema Teknik Kelautan, pembelajaran bidang kelautan melalui guru tamu di sekolah, dan kegiatan outbound di obyek wisata kelautan. Dengan cara ini diharapkan dapat menambah pengetahuan siswa terhadap bidang kelautan/maritim dan akan merangsang minat siswa pada bidang ini; sehingga akan terbentuk generasi masa depan yang berwawasan kelautan sebagai warisan jiwa bahari nenek moyang bangsa Indonesia dan siap belajar serta menekuni bidang kelautan untuk masa depannya kelak demi kemajuan bidang kelautan/maritim di Indonesia.
The importance of keeping up to date with clinical guidelines and protocols
Authors: Tingle John
Published: March 2023

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses aspects of the law on clinical guidelines and other care management tools
A survey of quality-of-life tools used in the routine care of patients with multiple myeloma
Authors: Kirkpatrick Suriya , Campbell Karen , Harding Sam
Published: March 2023

Background:

New treatment options have significantly improved the life expectancy of myeloma patients such that their cause of death is increasingly likely to be from something other than myeloma. Furthermore, the adverse effects of short- or long-term treatments as well as the disease are impacting on quality of life (QoL) for longer periods of time. Understanding people's QoL and what is important to them, is part of providing holistic care. Although QoL data has been collected for many years in myeloma studies, they have not been used to inform patient outcomes. There is growing evidence that supports the assessment of ‘fitness’ and consideration of QoL as part of routine myeloma care. A national survey was carried out to discover which QoL tools are currently being used in the routine care of myeloma patients, by whom and at which time point.

Methods:

An online survey using SurveyMonkey was adopted for flexibility and accessibility. The link to the survey was circulated via Bloodwise, Myeloma UK and Cancer Research UK contact lists. Paper questionnaires were circulated at the UK Myeloma Forum.

Results:

Data about practices in 26 centres were collected. This included sites across England and Wales. Three out of 26 centres collect QoL data as part of standard care. QoL tools used include EORTC QLQ-My20/24, MyPOS, FACT-BMT and Quality of Life Index. Questionnaires were completed by patients before, during or after a clinic appointment. Clinical nurse specialists calculate the scores and create a care plan.

Conclusion:

Despite growing evidence to support an holistic approach to management of myeloma patients, there is a lack of evidence to confirm that health-related QoL is being addressed in standard care. This is an area that needs further research.
Educational material for social marketing and behaviours linked to early detection of breast cancer
Authors: Avci Emine , Yilmaz Medine
Published: March 2023

Background:

Social marketing is an effective tool to ensure a populationbased behaviour change for a healthy lifestyle.

Aim:

The aim was to investigate the effects of breast cancer-related printed educational materials on women's behaviours related to early detection and diagnosis of breast cancer within the framework of social marketing.

Method:

This pre-post test one-group study was conducted with 80 women in a family health centre. An interview form, printed educational materials and follow-up form were used to collect the study data. The data were collected at the baseline and through phone calls at the third month.

Results:

Of the women, 36% had never performed breast self-examination (BSE), 55% had never had clinical breast examination (CBE), and 41% had never had mammography. There were no differences between the measurements made at the baseline and at the third month in terms of performing BSE, and having CBE and mammography.

Conclusion:

The importance of expanding social marketing approaches in terms of global health investments is emphasised. Adoption of positive health behaviours will lead to improvements in health status, as assessed through measures of morbidity and mortality status in cancer.
Would patient charges help to save the NHS?
Authors: Moffat Polly
Published: March 2023

A former health secretary has suggested that, to secure its future, the NHS must look at new ways to meet rising demand and move away from the free at point of use model. Is charging patients to use healthcare part of the answer?
HAVE THERE BEEN DELAYS TO THEATRE IN PATIENTS WITH UPPER LIMB TRAUMA DURING THE COVID-19 PANDEMIC? A MULTICENTRE RETROSPECTIVE COHORT STUDY
Authors: Hoban K. , Yacoub L. , Bidwai R. , Sadiq Z. , Cairns D. , Jariwala A.C.
Published: March 2023

The COVID-19 pandemic presented a significant impact on orthopaedic surgical operating. This multi-centre study aimed to ascertain what factors contributed to delays to theatre in patients with shoulder and elbow trauma.

A retrospective cohort study of 621 upper limb (shoulder and elbow) trauma patients between 16/03/2020 and 16/09/2021 (18-months) was extracted from trauma lists in NHS Tayside, Highland and Grampian and Picture Archiving and Communication Systems (PACS).

Median patient age =51 years (range 2-98), 298 (48%) were male and 323 (52%) female. The commonest operation was olecranon open reduction internal fixation (ORIF) 106/621 cases (17.1%), followed by distal humerus ORIF − 63/621 (10.1%). Median time to surgery was 2 days (range 0-263). 281/621 (45.2%) of patients underwent surgical intervention within 0-1 days and 555/621 patients (89.9%) had an operation within 14 days of sustaining their injury. 66/621 (10.6%) patients waited >14 days for surgery. There were 325/621 (52.3%) patients with documented evidence of delay to surgery; of these 55.6% (181/325) were due to amendable causes. 66/325 (20.3%) of these patients suffered complications; the most common being post-operative stiffness in 48.6% of cases (n=32/66).

To our knowledge, this is the first study to specifically explore effect of COVID-19 pandemic on upper limb trauma patients. We suggest delays to theatre may have contributed to higher rates of post-operative stiffness and require more physiotherapy during the rehabilitation phase. In future pandemic planning, we propose dedicated upper-limb trauma lists to prevent delays to theatre and optimise patients’ post-operative outcomes.
The psychedelic renaissance: a case of outlaw user innovation in the pharmaceutical industry
Authors: Söderberg Johan
Published: March 2023

Psychedelic substances are undergoing a renaissance. As they have been out-of-bounds for public research for half a century, the development process has been driven by drug user communities. With the prospect of a legalization of psychedelics, the data collected by users about toxicity, dosage, etc. have been turned into billion-dollar assets. Know-how stemming from stigmatized user communities is being transferred to companies and put under the protection of patent law. This transfer of information is predicated on psychedelics being reframed as therapeutic. The psychedelic renaissance provides an entry point for reflecting in a more critical vein about ‘user innovation’.
Pandemic as Polemic: Free Will in an Age of Restrictions?
Authors: Holmqvist Jytte
Published: March 2023

Inserting the discourse within an existentialist framework, this paper examines our existence of interrupted realities through the lens of Kierkegaardian thoughts and also draws on Simone de Beauvoir’s “Qu’est-ce que l’existentialisme?” (1947). As we navigate a surrealist time of COVID-19 (ab)normal, the lingering pandemic has left an impact on a both societal and psychosocial level. With societies across the globe facing continuous restrictions, what happens to free will? De Beauvoir defines our raison d’être as the individual having reality “only through his engagement in the world”. In this period of limited individual freedom, can we still talk of free will and how shall we engage with this all-pervasive, rule-changing pandemic ‘New Normal’?
Cause-Specific Mortality Fraction (CSMF) of adult mortality in Butajira, South Central Ethiopia
Authors: Aleme Hailelule , Mekonnen Wubegzier , Worku Alemayehu
Published: March 2023

Cause- and context-specific mortality data are imperative to understand the extent of health problems in low-income settings, where national death registration and cause of death identification systems are at a rudimentary stage. Aiming to estimate cause-specific mortality fractions, adult (15+ years) deaths between January 2008 and April 2020 were extracted from the Butajira health and demographic surveillance system electronic database. The physician review and a computerized algorithm, InterVA (Interpreting Verbal Autopsy), methods were used to assign the likely causes of death from January 2008 to April 2017 (the first) and May 2017 to April 2020 (the second) phase of the surveillance period, respectively. Initially, adult mortality rates per 1000py across sex and age were summarized. A total of 1,625 deaths were captured in 280, 461 person-years, with an overall mortality rate of 5.8 (95%CI: 5.5, 6.0) per 1000py. Principally, mortality fractions for each specific cause of death were estimated, and for 1,571 deaths, specific causes were determined. During the first phase, the leading cause of death was tuberculosis (13.6%), followed by hypertension (6.6%) and chronic liver disease (5.9%). During the second phase, digestive neoplasms (17.3%), tuberculosis (12.1%), and stroke (9.4%) were the leading causes of death, respectively. Moreover, tuberculosis was higher among persons aged 50+ (15.0%), males (13.8%), and in rural areas (14.1%) during the first phase. Hypertensive diseases were higher among females (7.9%) and in urbanities. In the second phase, digestive neoplasms were higher in the age group of 50–64 years (25.4%) and females (19.0%), and stroke was higher in older adults (65+) (10%) and marginally higher among males (9.7%). Our results showed that tuberculosis and digestive neoplasms were the most common causes of death. Hence, prevention, early detection, and management of cases at all levels of the existing healthcare system should be prioritized to avert premature mortality.
Economic evaluation of a cluster randomized, non-inferiority trial of differentiated service delivery models of HIV treatment in Zimbabwe
Authors: Benade Mariet , Nichols Brooke E. , Fatti Geoffrey , Kuchukhidze Salome , Takarinda Kudakwashe , Mabhena-Ngorima Nicoletta , Grimwood Ashraf , Rosen Sydney
Published: March 2023

About 85% of Zimbabwe’s >1.4 million people living with HIV are on antiretroviral treatment (ART). Further expansion of its treatment program will require more efficient use of existing resources. Two promising strategies for reducing resource utilization per patient are multi-month medication dispensing and community-based service delivery. We evaluated the costs to providers and patients of community-based, multi-month ART delivery models in Zimbabwe. We used resource and outcome data from a cluster-randomized non-inferiority trial of three differentiated service delivery (DSD) models targeted to patients stable on ART: 3-month facility-based care (3MF), community ART refill groups (CAGs) with 3-month dispensing (3MC), and CAGs with 6-month dispensing (6MC). Using local unit costs, we estimated the annual cost in 2020 USD of providing HIV treatment per patient from the provider and patient perspectives. In the trial, retention at 12 months was 93.0% in the 3MF, 94.8% in the 3MC, and 95.5% in the 6MC arms. The total average annual cost of HIV treatment per patient was $187 (standard deviation $39), $178 ($30), and $167 ($39) in each of the three arms, respectively. The annual cost/patient was dominated by ART medications (79% in 3MF, 87% in 3MC; 92% in 6MC), followed by facility visits (12%, 5%, 5%, respectively) and viral load (8%, 8%, 2%, respectively). When costs were stratified by district, DSD models cost slightly less, with 6MC the least expensive in all districts. Savings were driven by differences in the number of facility visits made/year, as expected, and low uptake of annual viral load tests in the 6-month arm. The total annual cost to patients to obtain HIV care was $10.03 ($2) in the 3MF arm, $5.12 ($0.41) in the 3MC arm, and $4.40 ($0.39) in the 6MF arm. For stable ART patients in Zimbabwe, 3- and 6-month community-based multi-month dispensing models cost less for both providers and patients than 3-month facility-based care and had non-inferior outcomes.
The global burden of high fasting plasma glucose associated with zinc deficiency: Results of a systematic review and meta-analysis
Authors: Wirth James P. , Zeng Wu , Petry Nicolai , Rohner Fabian , Glenn Scott , Donkor William E. S. , Wegmüller Rita , Boy Erick , Lividini Keith
Published: March 2023

Non-communicable diseases (NCDs) account for the largest share of the global disease burden, and increasing evidence shows that zinc deficiency (ZD) contributes to NCDs by inducing oxidative stress, insulin resistance, and impaired lipid metabolism. A systematic review and meta-analysis was conducted to determine whether ZD was associated with fasting plasma glucose (FPG), a key risk factor for NCDs. A random effects meta-analysis was conducted to determine the strength of the association in the form of an odds ratio (OR) and subsequently the population attributable risk (PAR) with population prevalences of high FPG. The disease burden from high FPG attributable to ZD was expressed as disability adjusted life years (DALYS). Data from seven studies were obtained as part of the systematic review. The meta-analysis shows a significant (p<0.01) inverse relationship between ZD and high FPG (OR = 2.34; 95% CI: 1.16, 4.72). Globally, the PAR of ZD’s contribution to high FPG is 6.7%, with approximately 8.2 million high FPG DALYs attributable to ZD. Cardiovascular diseases, diabetes, and chronic kidney diseases account for more than 90% of the total DALYs. Total DALYs attributable to ZD are largest in the “Southeast Asia, East Asia, and Oceania” and “High Income” Super Regions. While the disease burden is highest among populous countries (e.g., China, India, USA), the population-standardized DALYs are highest among island nations, particularly island nations in the South Pacific and Caribbean. While ZD accounts for a small share of the high FPG disease burden, the total number of DALYs far surpasses other estimates of the disease burden attributable to ZD, which focus on diarrheal diseases in childhood. Zinc interventions are urgently needed to help address the increasing disease burden from NCDs, and the double burden of malnutrition.
What influences slum residents’ choices of healthcare providers for common illnesses? Findings of a Discrete Choice Experiment in Ibadan, Nigeria
Authors: Fayehun Olufunke , Madan Jason , Oladejo Abiola , Oni Omobowale , Owoaje Eme , Ajisola Motunrayo , Lilford Richard , Omigbodun Akinyinka ,   Improving Health in Slums Collaborative
Published: March 2023

Urban slum residents have access to a broad range of facilities of varying quality. The choices they make can significantly influence their health outcomes. Discrete Choice Experiments (DCEs) are a widely-used health economic methodology for understanding how individuals make trade-offs between attributes of goods or services when choosing between them. We carried out a DCE to understand these trade-offs for residents of an urban slum in Ibadan, Nigeria. We conducted 48 in-depth interviews with slum residents to identify key attributes influencing their decision to access health care. We also developed three symptom scenarios worded to be consistent with, but not pathegonian of, malaria, cholera, and depression. This led to the design of a DCE involving eight attributes with 2–4 levels for each. A D-efficient design was created, and data was collected from 557 residents between May 2021 and July 2021. Conditional-logit models were fitted to these data initially. Mixed logit and latent class models were also fitted to explore preference heterogeneity. Conditional logit results suggested a substantial Willingness-to-pay (WTP) for attributes associated with quality. WTP estimates across scenarios 1/2/3 were N5282 / N6080 / N3715 for the government over private ownership, N2599 / N5827 / N2020 for seeing a doctor rather than an informal provider and N2196 / N5421 /N4987 for full drug availability over none. Mixed logit and latent class models indicated considerable preference heterogeneity, with the latter suggesting a substantial minority valuing private over government facilities. Higher income and educational attainment were predictive of membership of this minority. Our study suggests that slum residents value and are willing to pay for high-quality care regarding staff qualifications and drug availability. It further suggests substantial variation in the perception of private providers. Therefore, improved access to government facilities and initiatives to improve the quality of private providers are complementary strategies for improving overall care received.
Probiotic powder ameliorates colorectal cancer by regulating Bifidobacterium animalis, Clostridium cocleatum, and immune cell composition
Authors: Yang Xiaojuan , Cao Qian , Ma Bin , Xia Yuhan , Liu Miao , Tian Jinhua , Chen Jian , Su Chunxia , Duan Xiangguo
Published: March 2023

Based on the relationship between the gut microbiota and colorectal cancer, we developed a new probiotic powder for treatment of colorectal cancer. Initially, we evaluated the effect of the probiotic powder on CRC using hematoxylin and eosin staining, and evaluated mouse survival rate and tumor size. We then investigated the effects of the probiotic powder on the gut microbiota, immune cells, and apoptotic proteins using 16S rDNA sequencing, flow cytometry, and western blot, respectively. The results showed that the probiotic powder improved the intestinal barrier integrity, survival rate, and reduced tumor size in CRC mice. This effect was associated with changes in the gut microbiota. Specifically, the probiotic powder increased the abundance of Bifidobacterium animalis and reduced the abundance of Clostridium cocleatum. In addition, the probiotic powder resulted in decreased numbers of CD4+ Foxp3+ Treg cells, increased numbers of IFN-γ+ CD8+ T cells and CD4+ IL-4+ Th2 cells, decreased expression of the TIGIT in CD4+ IL-4+ Th2 cells, and increased numbers of CD19+ GL-7+ B cells. Furthermore, the expression of the pro-apoptotic protein BAX was significantly increased in tumor tissues in response to the probiotic powder. In summary, the probiotic powder ameliorated CRC by regulating the gut microbiota, reducing Treg cell abundance, promoting the number of IFN-γ+ CD8+ T cells, increasing Th2 cell abundance, inhibiting the expression of TIGIT in Th2 cells, and increasing B cell abundance in the immune microenvironment of CRC, thereby increasing the expression of BAX in CRC.
Distinctive origin and evolution of endemic thistle of Korean volcanic island: Structural organization and phylogenetic relationships with complete chloroplast genome
Authors: Kim Bongsang , Lee Yujung , Koh Bomin , Jhang So Yun , Lee Chul Hee , Kim Soonok , Chi Won-Jae , Cho Seoae , Kim Heebal , Yu Jaewoong
Published: March 2023

Unlike otherCirsiumin Korea,Cirsium nipponicum(Island thistle) is distributed only on Ulleung Island, a volcanic island off the east coast of the Korean Peninsula, and a unique thistle with none or very small thorns. Although many researchers have questioned the origin and evolution ofC.nipponicum, there is not much genomic information to estimate it. We thus assembled the complete chloroplast ofC.nipponicumand reconstructed the phylogenetic relationships within the genusCirsium. The chloroplast genome was 152,586 bp, encoding 133 genes consisting of 8 rRNA genes, 37 tRNA genes, and 88 protein-coding genes. We found 833 polymorphic sites and eight highly variable regions in chloroplast genomes of sixCirsiumspecies by calculating nucleotide diversity, as well as 18 specific variable regions distinguishedC.nipponicumfrom otherCirsium. As a result of phylogenetic analysis,C.nipponicumwas closer toC.arvenseandC.vulgarethan nativeCirsiumin Korea:C.rhinocerosandC.japonicum. These results indicate thatC.nipponicumis likely introduced through the north Eurasian root, not the mainland, and evolved independently in Ulleung Island. This study contributes to further understanding the evolutionary process and the biodiversity conservation ofC.nipponicumon Ulleung Island.
“If you miss that first step in the chain of survival, there is no second step”–Emergency ambulance call-takers’ experiences in managing out-of-hospital cardiac arrest calls
Authors: Perera Nirukshi , Birnie Tanya , Whiteside Austin , Ball Stephen , Finn Judith
Published: March 2023

When a person has an out-of-hospital cardiac arrest (OHCA), calling the ambulance for help is the first link in the chain of survival. Ambulance call-takers guide the caller to perform life-saving interventions on the patient before the paramedics arrive at the scene, therefore, their actions, decisions and communication are integral to saving the patient’s life. In 2021, we conducted open-ended interviews with 10 ambulance call-takers with the aim of understanding their experiences of managing these phone calls; and to explore their views on using a standardised call protocol and triage system for OHCA calls. We took a realist/essentialist methodological approach and applied an inductive, semantic and reflexive thematic analysis to the interview data to yield four main themes expressed by the call-takers: 1) time-critical nature of OHCA calls; 2) the call-taking process; 3) caller management; 4) protecting the self. The study found that call-takers demonstrated deep reflection on their roles in, not only helping the patient, but also the callers and bystanders to manage a potentially distressing event. Call-takers expressed their confidence in using a structured call-taking process and noted the importance of skills and traits such as active listening, probing, empathy and intuition, based on experience, in order to supplement the use of a standardised system in managing the emergency. This study highlights the often under-acknowledged yet critical role of the ambulance call-taker in being the first member of an emergency medical service that is contacted in the event of an OHCA.
Nutritional status and psychosocial stimulation associated with cognitive development in preschool children: A cross-sectional study at Western Terai, Nepal
Authors: Sharma Prakash , Budhathoki Chitra Bahadur , Maharjan Ram Krishna , Singh Jitendra Kumar
Published: March 2023

Quality education at the age of foundation to produce dynamic manpower is a public concern in developing countries including Nepal. Preschool children do not get proper care and support from their parents due to insufficient knowledge of proper feeding habits, nutrition status and methods of psychosocial stimulation, which may affect their proper cognitive development. This study aimed to identify the factors that influence cognitive development in preschool children aged 3–5 years in Rupandehi district of western Terai, Nepal. In this school based cross-sectional survey, a total of 401 preschool children were selected using a multistage random sampling technique. The study was conducted from 4th February to 12th April, 2021 in Rupandehi district of Nepal. Data on the children’s socio-economic and demographic status, level of psychosocial stimulation, nutritional status, and stage of cognitive development were collected through scheduled interviews and direct observation. Stepwise regression analysis was performed to determine the predictors of cognitive development in preschool children. A p-value less than 0.05 considered as statistical significance. Of 401 participants, 44.1% had a normal nutritional status based on height for age Z-score (HAZ). Only 1.2% of primary caregivers provided their children with high levels of psychosocial stimulation, and 49.1% of children had a medium level of cognitive development. Furthermore, cognitive development in preschoolers is positively associated with nutritional status based on the height for age z score (β = 0.280; p<0.0001), psychological stimulation from caregivers (β = 0.184; p<0.0001), and advantageous castes/ethnicity (β = 0.190; p<0.0001), but negatively associated with the child’s age (β = - 0.145; p = 0.002) and family type (β = -0.157; p = 0.001). Nutritional status and psychosocial stimulation appear to be major factors affecting cognitive development of preschoolers. Nutritional promotion strategies, as well as techniques for optimal psychosocial stimulation behavior, may play an important role in enhancing preschoolers’ cognitive development.
The volatility of beef and lamb prices in Türkiye: The role of COVID–19, livestock imports, and energy prices
Authors: Bozma Gurkan , Urak Faruk , Bilgic Abdulbaki , Florkowski Wojciech J.
Published: March 2023

This study examines the volatility of beef and lamb prices in Türkiye, as food price inflation compromises the food security of low- and middle-income households. The inflation is the result of a rise in energy (gasoline) prices leading to an increase in production costs, together with a disruption of the supply chain by the COVID-19 pandemic. This study is the first to comprehensively explore the effects of multiple price series on meat prices in Türkiye. Using price records from April 2006 through February 2022, the study applies rigorous testing and selects the VAR(1)–asymmetric BEKK bivariate GARCH model for empirical analysis. The beef and lamb returns were affected by periods of livestock imports, energy prices, and the COVID-19 pandemic, but those factors influenced the short- and long–term uncertainties differently. Uncertainty was increased by the COVID–19 pandemic, but livestock imports offset some of the negative effects on meat prices. To improve price stability and assure access to beef and lamb, it is recommended that livestock farmers be supported through tax exemptions to control production costs, government assistance through the introduction of highly productive livestock breeds, and improving processing flexibility. Additionally, conducting livestock sales through the livestock exchange will create a price information source allowing stakeholders to follow price movements in a digital format and their decision-making.
Factors affecting do-not-resuscitate decisions among patients with amyotrophic lateral sclerosis in Taiwan
Authors: Chuang Mei-Hsing , Hsu Jiunn-Rong , Hung Chia-Wei , Hwang Yu Long , Lee Chih-Ching , Shen Hsiu-Yi , Chang Fu-Kang , Kuo Li-Lin , Chen Saint Shiou-Sheng , Huang Sheng-Jean
Published: March 2023

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. Usually, patients survive for approximately 2–4 years after the onset of the disease, and they often die of respiratory failure. This study examined the factors associated with signing a “do not resuscitate” (DNR) form in patients with ALS. This cross-sectional study included patients diagnosed with ALS between January 2015 and December 2019 in a Taipei City hospital. We recorded patients’ age at disease onset; sex; presence of diabetes mellitus, hypertension, cancer, or depression; use of invasive positive pressure ventilator (IPPV) or non-IPPV (NIPPV); use of nasogastric tube (NG) or percutaneous endoscopic gastrostomy (PEG) tube; follow-up years; and number of hospitalizations. Data from 162 patients were recorded (99 men). Fifty-six (34.6%) signed a DNR. Multivariate logistic regression analyses revealed that the factors associated with DNR included NIPPV (OR = 6.95, 95% CI = 2.21–21.84), PEG tube feeding (OR = 2.86, 95% CI = 1.13–7.24), NG tube feeding (OR = 5.75, 95% CI = 1.77–18.65), follow-up years (OR = 1.13, 95% CI = 1.02–1.26), and number of hospital admissions (OR = 1.26, 95% CI = 1.02–1.57). The findings suggest that end-of-life decision making among patients with ALS may often be delayed. DNR decisions should be discussed with patients and their families during the early stages of disease progression. Physicians are advised to discuss DNR with patients when they can speak and to offer palliative care options.
Efficacy of optical coherence tomography in the triage of women with minor abnormal cervical cytology before colposcopy
Authors: Yan Lei , Xiao Xiao , He Ling , Shi Liye , Yang Xue , Zhang Jun , Zhang Yongjing , Fu Chun
Published: March 2023

Objectives

To evaluate the efficacy of Optical Coherence Tomography (OCT) for detecting cervical lesions in women with minor abnormal cytology results (atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL)).

Methods

A prospective study was conducted at gynecologic clinic from Mar 2021 to Sep 2021. The recruited women with cervical cytological findings of ASC-US or LSIL were inspected with OCT before colposcopy-directed cervical biopsy. The diagnostic performance of OCT, alone and in combination with high-risk human papillomavirus (hrHPV) testing were evaluated to detect cervical intraepithelial neoplasia of grade 2 or worse (CIN2+)/CIN3 or worse (CIN3+). The rate of colposcopy referral and the immediate risk of CIN3+ of OCT were calculated.

Results

A total of 349 women with minor abnormal cervical cytology results were enrolled. For detection of CIN2+/CIN3+, the sensitivity and NPV of OCT were lower than those of hrHPV testing (CIN2+: 71.3% vs. 95.4%, 89.0% vs. 91.1%, P < 0.001; CIN3+: 75% vs. 93.8%, 96.5% vs. 95.6%, P < 0.001), but the specificity, accuracy and PPV were higher than those of hrHPV testing (CIN2+: 77.5% vs. 15.6%, 75.9% vs. 35.5%, 51.2% vs. 27.3%, P < 0.001; CIN3+: 69.4% vs. 13.6%, 69.9% vs. 20.9%, 19.8% vs. 9.9%, P < 0.001). OCT combined with hrHPV testing (CIN2+: 80.9%; CIN3+: 72.6%) showed higher specificity than that of OCT alone (P < 0.001). The colposcopy referral rate base on OCT classification was lower than that based on hrHPV testing (34.7% vs. 87.1%, P < 0.001). Patients with hrHPV-positive ASC-US and hrHPV-negative LSIL cytology, the immediate CIN3+ risk in OCT negative cases was less than 4%.

Conclusions

OCT alone or combination with hrHPV testing shows good performance for detecting CIN2+/CIN3+ in patients with ASC-US/LSIL cytology. OCT is an effective method for colposcopy triage in women with hrHPV-positive ASC-US and hrHPV-negative LSIL cytology.
A bioelectronic route to compassion: Rationale and study protocol for combining transcutaneous vagus nerve stimulation (tVNS) with compassionate mental imagery
Authors: Kamboj Sunjeev K. , Peniket Matthew , Simeonov Louise
Published: March 2023

Background

The vagus nerve (VN) is a neural nexus between the brain and body, enabling bidirectional regulation of mental functioning and peripheral physiology. Some limited correlational findings suggest an association between VN activation and a particular form of self-regulation: compassionate responding. Interventions that are geared towards strengthening self-compassion in particular, can serve as an antidote to toxic shame and self-criticism and improve psychological health.

Objective

We describe a protocol for examining the role of VN activation on ‘state’ self-compassion, self-criticism, and related outcomes. By combining transcutaneous vagus nerve stimulation (tVNS) with a brief imagery-based self-compassion intervention, we aim to preliminarily test additivity versus synergy between these distinct bottom-up and top-down methods for putatively regulating vagal activity. We also test whether the effects of VN stimulation accumulate with daily stimulation and daily compassionate imagery practice.

Methods

Using a randomized 2 x 2 factorial (stimulation x imagery condition) design, healthy volunteers (n = 120) receive active (tragus) or sham (earlobe) tVNS plus standardized (audio-recorded) self-compassionate or sham mental imagery instructions. These interventions are delivered in a university-based psychological laboratory in two sessions, one week apart, as well as being self-administered between sessions by participants at home. Pre-stimulation, peri-stimulation and post-imagery measures of state self-compassion, self-criticism and related self-report outcomes are assessed in two lab sessions, separated by a week (Days 1 and 8). Heart rate variability is used as a physiological metric of vagal activity and an eye-tracking task assesses attentional bias to compassionate faces during the two lab sessions. On Days 2–7, participants continue their randomly assigned stimulation and imagery tasks at home, and complete state measures at the end of each remote session.

Discussion

Demonstrating modulation of compassionate responding using tVNS would support a causal link between VN activation and compassion. This would provide a basis for future studies of bioelectronic approaches to augmenting therapeutic contemplative techniques.

Clinical trials registration

ClinicalTrials.gov, Identifier: NCT05441774 (Date: July 1st 2022).

OSF registration

https://osf.io/4t9ha.
Comparative evaluation of saliva and nasopharyngeal swab for SARS-CoV-2 detection using RT-qPCR among COVID-19 suspected patients at Jigjiga, Eastern Ethiopia
Authors: Tahir Bawlah , Weldegebreal Fitsum , Ayele Firayad , Ayana Desalegn Admassu
Published: March 2023

Background

Nasopharyngeal swab (NPS) remains the recommended sample type for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) diagnosis. However, the collection procedure causes discomfort and irritation to the patients, lowering the quality of the sample and exposing healthcare workers to risk. Furthermore, there is also a shortage of flocked swabs and personnel protective equipment in low-income settings. Therefore, this necessitates an alternative diagnostic specimen. The purpose of this study was to evaluate the performance of saliva against NPS for SARS-CoV-2 detection using RT-qPCR among COVID-19 suspected patients at Jigjiga, Eastern Ethiopia.

Methods

Comparative cross-sectional study was conducted from June 28 to July 30, 2022. A total of 227 paired saliva and NPS samples were collected from 227 COVID-19 suspected patients. Saliva and NPS samples were collected and transported to the Somali Regional Molecular Laboratory. Extraction was conducted using DaAn kit (DaAn Gene Co., Ltd China). Veri-Q RT-qPCR was used for amplification and detection (Mico BioMed Co, Ltd, Republic of Korea). The data were entered into Epi-data version 4.6 and analyzed using SPSS 25. McNemar’s test was used to compare the detection rate. Agreement between NPS and saliva was performed using Cohen’s Kappa. The mean and median of cycle threshold values were compared using paired t-tests and the correlation between cycle threshold values was measured using Pearson correlation coefficient. P value < 0.05 was considered statistically significant.

Results

The overall positivity rate of SARS-CoV-2 RNA was 22.5% (95% CI 17–28%). Saliva showed higher sensitivity (83.8%, 95% CI, 73–94.5%) than NPS (68.9%, 95% CI 60.8–76.8%). The specificity of saliva was 92.6% (95% CI, 80.6% - 100%) compared to NPS (96.7%, 95% CI, 87% - 100%). The positive, negative, and overall percent agreement between NPS and saliva was 83.8%, 92.6%, and 91.2% respectively (κ = 0.703, 95% CI 0.58–0.825, P = 0.00). The concordance rate between the two samples was 60.8%. NPS showed a higher viral load than saliva. There was low positive correlation between the cycle threshold values of the two samples (r = 0.41, 95% CI -1.69 to -0.98, P >0.05).

Conclusion

Saliva showed a higher detection rate for SARS-CoV-2 molecular diagnosis than NPS and there was significant agreement between the two specimens. Therefore, saliva could be suitable and easily obtainable alternative diagnostic specimen for SARS-CoV-2 molecular diagnosis.
Validity of ICD codes to identify do-not-resuscitate orders among older adults with heart failure: A single center study
Authors: Callahan Katherine , Acharya Yubraj , Hollenbeak Christopher S.
Published: March 2023

Background

Observational research on the advance care planning (ACP) process is limited by a lack of easily accessible ACP variables in many large datasets. The objective of this study was to determine whether International Classification of Disease (ICD) codes for do-not-resuscitate (DNR) orders are valid proxies for the presence of a DNR recorded in the electronic medical record (EMR).

Methods

We studied 5,016 patients over the age of 65 who were admitted to a large, mid-Atlantic medical center with a primary diagnosis of heart failure. DNR orders were identified in billing records from ICD-9 and ICD-10 codes. DNR orders were also identified in the EMR by a manual search of physician notes. Sensitivity, specificity, positive predictive value and negative predictive value were calculated as well as measures of agreement and disagreement. In addition, estimates of associations with mortality and costs were calculated using the DNR documented in EMR and the DNR proxy identified in ICD codes.

Results

Relative to the gold standard of the EMR, DNR orders identified in ICD codes had an estimated sensitivity of 84.6%, specificity of 96.6%, positive predictive value of 90.5%, and negative predictive value of 94.3%. The estimated kappa statistic was 0.83, although McNemar’s test suggested there was some systematic disagreement between the DNR from ICD codes and the EMR.

Conclusions

ICD codes appear to provide a reasonable proxy for DNR orders among hospitalized older adults with heart failure. Further research is necessary to determine if billing codes can identify DNR orders in other populations.
Sustainability of rural tourism in poverty reduction: Evidence from panel data of 15 underdeveloped counties in Anhui Province, China
Authors: Wang Fuwei , Du Lei , Tian Minghua , Liu Yi , Zhang Yichi
Published: March 2023

Based on the characteristics of underdeveloped areas, this paper selects the panel data of 15 underdeveloped counties in Anhui Province from 2013 to 2019 and uses the panel threshold model to empirically analyze the sustainability of rural tourism development. The results show that: (1) Rural tourism development has a non-linear positive impact on poverty alleviation in underdeveloped areas and has a double threshold effect. (2) When the poverty rate is used to express the poverty level, it can be found that the development of rural tourism at a high level can significantly promote poverty alleviation. (3) When the number of poor people is used to express the poverty level, it can be found that the poverty reduction effect shows a marginal decreasing trend with the phased improvement of the development level of rural tourism. (4) The degree of government intervention, industrial structure, economic development, and fixed asset investment play a more significant role in poverty alleviation. Therefore, we believe that we need to actively promote rural tourism in underdeveloped areas, establish a mechanism for the distribution and sharing of rural tourism benefits, and form a long-term mechanism for rural tourism poverty reduction.
Imágenes de un futuro demasiado cercano: la inscripción de lo distópico en la España actual
Authors: Martinez Mesa Francisco José
Published: March 2023

El estudio de las distopías, como en general el del conjunto de los fenómenos utópicos, constituye una fuente histórica indispensable para cualquier análisis de nuestras sociedades tanto presentes como pasadas. Tras la ficción de sus propuestas y la idealización positiva o negativa de escenarios inexistentes e irrealizables se manifiestan expectativas concretas que configuran y vertebran el espíritu de la humanidad en cada momento presente. El presente artículo busca analizar el potencial sentido y valor histórico de una serie de títulos pertenecientes a la actual producción distópica española, desarrollada en torno a una serie de patrones estilísticos y narrativos comunes con las normas del género, aunque con una serie de atributos y especificidades que la hacen definitorias de una realidad histórica particular y propia. A partir de su inscripción en un marco temporal concreto, el planteamiento del trabajo se organiza en torno a dos ámbitos en torno a los cuales se encuadra el diferente orden de conflictos y amenazas sobre los cuales sus autores centran el foco de sus miedos y ansiedades: de un lado, la conversión de la ciudad en un espacio opresivo y angustioso que amenaza con ver disueltos definitivamente sus vínculos comunitarios; de otro, la conversión de lo urbano en el campo de aplicación de un régimen totalitario fundado en el control y sometimiento de los individuos.
STATE SUPPORT FOR FOREIGN TRADE DIVERSIFICATION OF AZERBAIJAN
Authors: Akhundova A.G.
Published: March 2023

Global trade, already since the end of 2019, has fallen sharply due to the coronavirus pandemic and the restrictions adopted in connection with it. Then, due to the fall in prices on the world oil market, which is the main source of formation of the state budget of the country, there was a sharp drop in revenues, difficulties arose in financing the development of more important areas of the Azerbaijani economy. Problems were especially manifected in improving the socio-economic well-being of the population, indeveloping the infrastructure of the regions, in the industrial sector of the country in the context of improving the technologies used in production activities of domestic enterprises. In fact, the decline in oil prices forced all oil states and enterprises of various vocational orientations to a sharp transition from active economic activity to passive. New mechanisms and reforms are needed to diversify the national economy, since there are a number of problems that impede the implementation of this process and the expansion of the country's foreign economic activity. The article discusses the priority areas of diversification of Azerbaijan's foreign trade, studies the problems, analyzes the volume of exports and imports of the republic by years.
REGIONAL FOOD SECURITY: PROBLEMS OF FORMATION AND IMPLEMENTATION (ON THE EXAMPLE OF THE IRKUTSK REGION)
Authors: Belousova S.V.
Published: March 2023

The purpose of the work is to analyze regional food security on the example of the Irkutsk region, both in conceptual and practical aspects. The objectives are to specify the basic components of this concept and to establish conditions for monitoring regional food security. The article analyzes the concept of food security, which offers criteria for its provision, including accessibility, reliability, sustainability, independence. Of these four criteria, only two are fixed in the Doctrine of Food Security of Russia with an emphasis on the level of self-sufficiency for 11 types of food without specifying the state of production, resource and other potential providing it and prospects for its development: The importance of creating analytical and information systems for monitoring food security is indisputable, while it is necessary to take into account the regional aspect of assessing this problem. Currently, there is a wide set of indicators for assessing food security, although without methodological support for monitoring and interpreting its results. Using the proposed composition of indicators grouped by four criteria: accessibility, reliability, sustainability, independence, an analysis of the food security of the Irkutsk region was carried out, which showed the criticality of the region in this area. The results of the work are very relevant for the formation of regional economic policy in the field of food security management.