bluuebunny/crossref_metadata_2025 huggingface dataset:
Sự hài lòng về môi trường thực hành lâm sàng và hứng thú nghề nghiệp của sinh viên Điều dưỡng
Authors: Nguyễn Văn Chinh , Bùi Kiến Trúc , Trần Thụy Khánh Linh
Published: February 2025

Đặt vấn đề: Giáo dục điều dưỡng đóng một vai trò quan trọng trong việc định hình lực lượng lao động tương lai của các chuyên gia chăm sóc sức khỏe. Thực hành lâm sàng (THLS) tạo cơ hội cho sinh viên tiếp xúc với môi trường chăm sóc sức khỏe và trải nghiệm thực tế. Xác định sự hài lòng về môi trường THLS và hứng thú nghề nghiệp của sinh viên có thể hỗ trợ nhà giáo dục nhằm cải tiến chương trình và thiết kế những hoạt động thu hút nguồn lao động thiết yếu này.

Mục tiêu: Xác định điểm trung bình hài lòng với môi trường THLS và hứng thú nghề nghiệp của sinh viên Điều dưỡng.

Đối tượng và phương pháp nghiên cứu: Nghiên cứu cắt ngang mô tả lấy mẫu thuận tiện 410 sinh viên Cử nhân Điều dưỡng (CNĐD), CNĐD chuyên ngành Gây mê hồi sức, Cử nhân Hộ sinh năm 3 và năm 4 của một trường đại học ngành sức khỏe Thành phố Hồ Chí Minh vào đầu năm 2024. Thang điểm Clinical Learing Environment, supervision and Nurse Teacher Scale (CLES+T) và bộ câu hỏi về sự hứng thú nghề nghiệp được sử dụng để khảo sát.

Kết quả: Sinh viên có sự hài lòng về môi trường THLS ở mức khá cao với điểm trung bình chung (ĐTBC) là 4,01 ± 0,49, tuy nhiên sự hứng thú nghề nghiệp của sinh viên chỉ ở mức trung bình với ĐTBC là 2,83 ± 0,31. Hầu hết sinh viên có nhận thức tích cực về nghề điều dưỡng với điểm trung bình (ĐTB) là 3,17± 0,3. Cảm xúc về nghề nghiệp ở mức trung bình với ĐTB là 2,51 ± 0,5.

Kết luận: Môi trường THLS hiện tại đang hỗ trợ hiệu quả cho sinh viên điều dưỡng. Tuy nhiên, để nâng cao hứng thú nghề nghiệp và gắn bó với nghề, các chương trình giáo dục cần được xem xét cải tiến hoạt động nhằm thu hút, duy trì nguồn nhân lực điều dưỡng chất lượng trong tương lai.

Từ khóa: hứng thú nghề nghiệp, thực hành lâm sàng, điều dưỡng
Chất lượng cuộc sống ở người bệnh nhiễm HIV trước và sau can thiệp truyền thông giáo dục sức khỏe tại bệnh viện Bệnh Nhiệt Đới năm 2023
Authors: Võ Ngọc Thạnh
Published: February 2025

Đặt vấn đề: Hiện nay tình hình nhiễm HIV trên thế giới ngày càng gia tăng. Người bệnh HIV đối mặt với nhiều vấn đề dẫn đến giảm sút chất lượng cuộc sống (CLCS).

Mục tiêu: Đánh giá hiệu quả truyền thông giáo dục sức khỏe đến chất lượng cuộc sống và kết quả điều trị của người bệnh nhiễm HIV.

Đối tượng và phương pháp nghiên cứu: Nghiên cứu dọc và phương pháp chọn mẫu thuận tiện được sử dụng để chọn 100 người bệnh HIV được chọn vào theo phương pháp thuận tiện đang điều trị ngoại trú tại bệnh viện Bệnh Nhiệt Đới Thành phố Hồ Chí Minh từ tháng 09 đến tháng 12 năm 2023. Thang đo MOS – HIV, WHOQOL-HIV BREF được sử dụng để đánh giá hiệu quả điều trị và chất lượng cuộc sống của người bệnh HIV.

Kết quả: Nam giới chiếm đa số với 76% và độ tuổi trung bình của đối tượng tham gia nghiên cứu là 36,6 tuổi. Nghiên cứu ghi nhận sự cải thiện về chất lượng cuộc sống với điểm trung bình CLCS trước khi can thiệp truyền thông giáo dục sức khỏe là 45,25 và sau can thiệp là 48,66. Bên cạnh đó, nghiên cứu cũng ghi nhận sự cải thiện hiệu quả điều trị trên sức khỏe thể chất và tinh thần với điểm số trung bình lần lượt trước – sau can thiệp là 57,67; 62,56 và 49,05; 56,65. Sự cải thiện về chất lượng cuộc sống và kết quả điệu trị trong nghiên cứu có ý nghĩa thống kê với p <0,05.

Kết luận: Truyền thông giáo dục sức khỏe giúp cải thiện chất lượng cuộc sống của người bệnh HIV cũng như nâng cao hiệu quả điều trị cho người bệnh.

Từ khóa: truyền thông-giáo dục sức khỏe; chất lượng cuộc sống; người bệnh HIV; thang đo MOS – HIV; thang đo WHOQOL-HIV BREF
Thực trạng sử dụng thuốc kháng đông và các biến cố liên quan ở bệnh nhân cao tuổi mắc rung nhĩ không do bệnh van tim
Authors: Trần Ngọc Mạnh , Phan Quang Nghĩa , Nguyễn Hồng Quốc , Bùi Minh Trạng
Published: February 2025

Đặt vấn đề: Rung nhĩ không do bệnh van tim là một tình trạng thường gặp ở người cao tuổi, với tỷ lệ mắc gia tăng theo độ tuổi. Người từ 75 tuổi trở lên có nhiều vấn đề về sức khoẻ hơn, việc sử dụng thuốc kháng đông cần thận trọng hơn. Do vậy, việc tìm hiểu thực trạng và các biến cố liên quan sử dụng thuốc kháng đông ở nhóm tuổi này giúp có thêm cơ sở cho việc chỉ định thuốc kháng đông an toàn và hiệu quả.

Mục tiêu: Khảo sát biến cố và các yếu tố liên quan sử dụng thuốc kháng đông.

Đối tượng và phương pháp nghiên cứu: Nghiên cứu đoàn hệ. Thông tin được thu thập từ hồ sơ điện tử và gọi điện thoại phỏng vấn tất cả bệnh nhân từ 75 tuổi trở lên đang khám tại Viện Tim Thành phố Hồ Chí Minh (TPHCM) từ 01/01/2022 đến 31/7/2023 được chẩn đoán rung nhĩ không do bệnh van tim, thời điểm kết thúc nghiên cứu 31/7/2024.

Kết quả: Trong 98 bệnh nhân được chọn, tỷ lệ bỏ khám chiếm 30%. Nam bỏ khám nhiều hơn nữ có ý nghĩa (p <0,001). Nhóm bệnh nhân sử dụng NOAC có tỷ lệ dùng liều thuốc thấp hơn liều khuyến cáo chiếm 45%. Nhóm dùng thuốc kháng vitamin K có tỷ lệ INR trong khoảng điều trị chỉ đạt 22%. Biến cố nặng giữa nhóm dùng NOAC so với nhóm dùng thuốc kháng vitamin K không có sự khác biệt (4,8% so với 4,2%. p= 0,83).

Kết luận: Hầu hết bệnh nhân trong nghiên cứu được chỉ định dùng thuốc kháng đông đúng theo khuyến cáo. Tuy nhiên, INR trong khoảng điều trị thấp, liều NOAC thấp hơn liều khuyến cáo chiếm tỉ lệ cao. Tỷ lệ bỏ khám cao, đặc biệt là nam giới.

Từ khóa: kháng đông, NOAC, thuốc kháng vitamin K, rung nhĩ, người cao tuổi
Kísérlet a hitelezői érdekek védelmét szolgálójogi eszközök összefoglalására
Authors: Páhi Barbara
Published: February 2025

A hitelek igénybevétele szerves része a gazdasági életnek, éppen ezért kardinális kérdés a piaci szereplők szempontjából a bizalom, hiszen csak annak birtokában működik megfelelően a gazdaság, s apellálhat a hitelező arra, hogy az általa megelőlegezett pénzügyi eszközöket az adós vissza fogja részére téríteni. Aki előnyök szerzése végett megszegi a gazdaság megfelelő működését biztosító jogszabályokat, annak különböző – a jogsértés súlyához igazodó – hátrányos jogkövetkezményekkel kell számolnia. Ennek biztosítása érdekében vált szükségessé a hitelezők érdekeinek védelme a polgári jogon túl a  büntetőjog, azon belül a gazdasági büntetőjog eszközrendszerével is.
Severe, uncontrolled epilepsy in pregnancy: A population-based case-control study
Authors: Kemp Bryn , Kelso Andrew , Williams David , Knight Marian
Published: February 2025

Background Epilepsy affects one percent of the UK population and is the most common serious neurological condition experienced during pregnancy. We compared the characteristics, clinical management, and pregnancy outcomes in women with severe, uncontrolled epilepsy to those of women with well controlled disease. Methods We conducted a population-based case-control study in all UK consultant-led maternity units. Cases of severe uncontrolled epilepsy during pregnancy were identified prospectively and reported via the UK Obstetric Surveillance System (UKOSS). Severe epilepsy was defined a-priori as ≥1 of the following: admission to hospital during pregnancy to manage seizures; prescribed ≥3 antiepileptic medications; or died from epilepsy. Controls comprised women with epilepsy not meeting the case definition, identified within the same centres as cases. Pre-pregnancy epilepsy control and pregnancy outcomes were compared between groups using multivariable logistic regression. Results We identified 94 cases between 1 October 2015 and 31 March 2017 and compared these with 186 controls. Cases were significantly more likely to be admitted to manage seizures in the year preceding pregnancy (42/94 cases vs 10/186 controls, adjusted odds ratio [aOR]=7.38 [95% CI 2.70-20.2]), and to report their most recent seizure within 3 months of pregnancy (51/94 cases vs 18/186 controls, aOR=5.86 [95% CI 2.30-15.0]). Cases were significantly more likely to deliver before 37 weeks (20/94 cases vs 8/186 controls, aOR=7.61 [95% CI 2.87-20.2]). Conclusions Women admitted for seizure management in the year before pregnancy are at higher risk of severe epilepsy during pregnancy and of preterm birth. These women should be prioritised for discussion about pregnancy and contraception. When pregnant, they should be reviewed as early as possible by specialists in the management of epilepsy during pregnancy. Delivering messages about the importance of pregnancy planning and contraception to all women with epilepsy should be viewed as the responsibility of all clinicians involved their care.
A Concise Proof of Goldbach Conjecture
Authors:   Nanjing Institute of Geology and Palaeontology, Chinese Academy of Sciences., Wang Xin
Published: February 2025

The Goldbach Conjecture, frequently abbreviated as “2 = 1 + 1”, has been a fascinating goal for many mathematicians
over centuries. In spite of numberless painstaking attempts by various mathematicians, this question remains unconquerable
until recently. Among them, a Chinese mathematician, Dr. Jingrun Chen, proved “1 + 2”, which is the best result the human
beings had achieved previously. The complexity of this question is hinged with the notoriously random occurrence of prime
numbers in natural numbers. Taking advantage of the periodicity of prime numbers revealed recently, here the author provides
a concise, straight-forward, rigorous proof for the conjecture using mathematical induction.
¿Se deben abrir los yacimientos arqueológicos subacuáticos para su visita?
Authors: Castro Filipe
Published: February 2025

Texto de presentación para el debate de revista PH 115 (junio 2025) en torno a la apertura de los los yacimientos arqueológicos subacuáticos para su visita, de la persona que lo coordina, el investigador Filipe Castro, del Centro de Ecología Funcional de la Universidad de Coimbra (Portugal).
Advancing Therapeutic Drug Monitoring of oral targeted anticancer drugs: analytical and clinical studies
Authors:   , Meertens Marinda
Published: February 2025

Oral targeted therapies have significantly improved cancer treatment, but variability in drug exposure and narrow therapeutic windows can lead to suboptimal efficacy or increased toxicity. Therapeutic Drug Monitoring (TDM) enables dose optimization by adjusting drug levels based on pharmacokinetic (PK) measurements. This thesis investigates the utility, feasibility of TDM of oral targeted anticancer therapies, and how this could be advanced by the use of home-sampling, contributing to the optimization of patient treatments.

In Part 1, the role of TDM was explored through prospective and retrospective studies. The clinical applicability of TDM was assessed for multiple drugs, including lenvatinib, pazopanib, and abiraterone. Real-world data showed that treatment outcomes often differed from clinical trial results, highlighting the need for individualized dosing strategies. In prospective studies it was confirmed that PK-guided dosing successfully reduced subtherapeutic drug exposure in several cohorts. However, for certain drug cohorts routine TDM was deemed unfeasible, due to consistently adequate exposure, too much toxicity or impractical study protocols.

Part 2 focused on improving TDM through home-sampling methods. Volumetric absorptive microsampling (VAMS) was analytically and clinically validated as a viable alternative to venous blood collection, with promising results for drugs like imatinib. Patient acceptability was high, and adequate samples were obtained in most cases. However, further validation is required before implementing home-sampling for abiraterone and alectinib.

This thesis demonstrated that TDM can optimize treatment outcomes for specific oral targeted anticancer drugs. Home-sampling offers a patient-friendly approach to TDM and could facilitate broader implementation in clinical practice. Future research should focus on refining home-based TDM and expanding its application to additional targeted therapies.
Fodder production in peasant-farmers farms of the forest zone
Authors: Shpakov Anatoly
Published: February 2025

In terms of resource potential, the forest zone of Russia is the main one for the commercial production of dairy and meat products of cattle. The need for such products is high. The population of the zone is 62 million people, including 51.3 million or 82.7% of the urban population. In the future, in order to fully provide the population, it is necessary to produce more than 20 million tons of milk, 1.6 million tons of cattle meat, or double production. Currently, milk production is concentrated on large and medium-sized agricultural enterprises (85%). In peasant farms, milk production does not exceed 6% with a marketability of 61–66%.
Seawater carbonate chemistry based carbon dioxide removal: towards commonly agreed principles for carbon monitoring, reporting, and verification
Authors: Halloran Paul R. , Bell Thomas G. , Burt William J. , Chu Sophie N. , Gill Sophie , Henderson Cameron , Ho David T. , Kitidis Vassilis , La Plante Erika , Larrazabal Monica , Loucaides Socratis , Pearce Christopher R. , Redding Theresa , Renforth Phil , Taylor Fran , Toome Katherine , Torres Riccardo , Watson Andrew
Published: February 2025

Carbon Dioxide Removal (CDR) from the atmosphere is unavoidable if we are to meet the Paris Agreement’s goal of limiting global warming to 1.5°C, and almost certainly required to limit warming to 2°C. The ocean exchanges carbon dioxide (CO2) with the atmosphere and is a large repository of carbon that could either be partially emptied to allow more CO2 absorption or have its carbon storage capacity enhanced to allow it to remove additional CO2 from the atmosphere. Early-stage techniques exist to utilise the ocean in atmospheric CO2 removal, but typically, the atmospheric CO2 removal these techniques stimulate happens downstream of their activity. Verifying the carbon removal associated with these techniques, while critical when evaluating the approaches and pricing the removal, is challenging. This study briefly reviews the challenges associated with verifying the carbon removal associated with non-biological (abiotic) engineered marine CDR approaches, specifically Ocean Alkalinity Enhancement and Direct Ocean Carbon Capture and Storage, and presents the findings from a workshop held with interested parties spanning industry to government, focused on their collective requirements for the Monitoring, Reporting, and Verification (MRV) of carbon removal. We find that it is possible to agree on a common set of principles for abiotic marine MRV, but identify that delivering this MRV with today’s understanding and technology could be prohibitively expensive. We discuss focal areas to drive down marine MRV costs and highlight the importance of specification of MRV criteria by an ultimate regulator to stimulate investment into the required work. High-quality MRV is important to correctly price any CO2 removal, but we identify that accessibility and transparency in MRV approaches are also key in realising the broader benefits of MRV to society.
Predictors of smartphone addiction and its effect on quality of life: a cross-sectional study among the young adults in Bangladesh
Authors: Ratan Zubair Ahmed , Parrish Anne-Maree , Alotaibi Mohammad Saud , Hosseinzadeh Hassan
Published: February 2025

The enigma of smartphone addiction (SA) has plagued academics for the last decade, now scholars believed this behaviour might affect physical and mental wellbeing. SA has become a complex problem, yet to date, there is limited research investigating the predictors of SA and its effect on “health-related quality of life (HRQoL)”. This study aimed to address this gap. The data was gathered from a convenience sample of 440 young adults completed between July 2021 and February 2022 through online survey in Bangladesh. On Logistic regression, after controlling for socio-demographic variables; friend support, process, social and compulsive usage were determined as significant predictors of SA. Those who were smartphone addicted were more presumably to have a lower quality of life. This study has significant implications for designing prevention pro-grams and policy development in relation to predictors of SA and its effect on HRQoL.
Life’s Simple 7 and its impact on chronic bowel disorders: a study on constipation and diarrhea in the U.S. adult population
Authors: Sun Hongzhi , Qi Lei , Ming Yiwei , Wang Weichen , Hu Maoneng
Published: February 2025

Background

Chronic gastrointestinal disorders, such as chronic constipation and diarrhea, pose significant public health challenges, affecting quality of life and healthcare costs. Life’s Simple 7 (LS7), established by the American Heart Association, encompasses essential health behaviors that may influence bowel health.

Methods

We utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2010, focusing on adults aged 20 years and older. A total of 12,912 participants were included in the analysis. Bowel health was assessed through self-reported questionnaires, while LS7 was evaluated based on seven components: smoking status, physical activity, dietary quality, BMI, blood pressure, blood glucose, and blood cholesterol. Survey-weighted logistic regression models were employed to assess the associations between LS7 and chronic constipation and diarrhea, adjusting for various demographic and health-related covariates.

Results

Our findings revealed a significant inverse association between LS7 adherence and the prevalence of chronic constipation (OR: 0.914, 95% CI: 0.864–0.966, p = 0.003) and chronic diarrhea (OR: 0.883, 95% CI: 0.856–0.912, p < 0.0001). The protective effect of LS7 was more pronounced among males and individuals with a BMI under 30 kg/m2 for chronic constipation, and among younger adults and those without hypertension for chronic diarrhea. Restricted cubic spline analyses indicated a dose–response relationship, particularly for chronic diarrhea.

Conclusion

This study highlights the protective role of LS7 in promoting bowel health and preventing chronic constipation and diarrhea. Tailoring public health interventions based on demographic and health characteristics may enhance the effectiveness of strategies aimed at improving gastrointestinal health outcomes.
Recent advances of nanovaccines on cancer theranostics
Authors: Yuan Xiaobing , Xu Tianyou , Hussain Mubashir , Liu Bin , Zhu Jianwei
Published: February 2025

Cancer is a leading cause of death worldwide, with an estimated 20 million new cancer cases and 9.7 million cancer deaths worldwide in 2022. Immunotherapy provides innovative strategies among the most groundbreaking developments in cancer treatment. Cancer vaccines, as a form of immunotherapy, have a great prospect to help patients resistant to other standard-of-care immunotherapies. On the other hand, the various properties of nanomaterials play an essential role in the collecting, maturation, and activation of the immune system. Cancer vaccines based on nanomaterials (also called nanovaccines) can be specifically delivered to target tissues and cells through nanocarriers and nanoplatforms, thereby improving efficacy, extending the duration of antitumor immunity, and minimizing side effects. This paper reviewed the research progress of some nanovaccines in cancer immunotherapy, including polymer nanoparticle vaccine, liposome nanoparticle vaccine, cell-based nanoparticle vaccine, inorganic nanoparticle vaccine, adjuvant and auxiliary work. We believe that polymer nanoparticle-based nanovaccines have the most widespread applications currently, while liposome nanovaccines using mRNA are expected to see greater development in the future. We also think that nanovaccines can play a great role in cancer prevention and treatment, especially in prolonging the life span of patients.
Brain local structural connectomes and the subtypes of the medial temporal lobe parcellations
Authors: Li Zhensheng , Ma Jie , Bai Hongmin , Deng Bingmei , Lin Jian , Wang Weimin
Published: February 2025

Objective

To investigate the quantitative characteristics and major subtypes of local structural connectomes for medial temporal lobe (MTL) parcellations.

Methods

The Q-Space Diffeomorphic Reconstruction (QSDR) method was used to track white matter fibers for the ROIs within MTL based on the integrating high-resolution T1 structural MR imaging and diffusion MR imaging of 100 adult Chinese individuals. Graph theoretical analysis was employed to construct the local structural connectome models for ROIs within MTL and acquire the network parameters. These connectivity matrices of these connectomes were classified into major subtypes undergoing hierarchical clustering.

Results

(1) In the local brain connectomes, the overall network features exhibited a low characteristic path length paired with moderate to high global efficiency, suggesting the effectiveness of the local brain connectome construction. The amygdala connectomes exhibited longer characteristic path length and weaker global efficiency than the ipsilateral hippocampus and parahippocampal connectomes. (2) The hubs of the amygdala connectomes were dispersed across the ventral frontal, olfactory area, limbic, parietal regions and subcortical nuclei, and the hubs the hippocampal connectomes were mainly situated within the limbic, parietal, and subcortical regions. The hubs distribution of the parahippocampal connectomes resembled the hippocampal structural connectomes, but lacking interhemispheric connections and connectivity with subcortical nuclei. (3) The subtypes of the brain local structural connectomes for each ROI were classified by hierarchical clustering, The subtypes of the bilateral amygdala connectomes were the amygdala-prefrontal connectome; the amygdala-ipsilateral or contralateral limbic connectome and the amygdala-posterior connectome. The subtypes of the bilateral hippocampal connectomes primarily included the hippocampus-ipsilateral or contralateral limbic connectome and the anterior temporal-hippocampus-ventral temporal-occipital connectome in the domain hemisphere. The subtypes of the parahippocampal connectomes exhibited resemblances to those of the hippocampus.

Conclusion

We have constructed the brain local connectomes of the MTL parcellations and acquired the network parameters to delineate the hubs distribution through graph theory analysis. The connectomes can be classified into different major subtypes, which were closely related to the functional connectivity.
The impact of radiotherapy on disease control in vulvar extramammary Paget’s disease: a retrospective study from a single institution
Authors: Seol Aeran , Kim Se Ik , Song Yong Sang
Published: February 2025

Objective

Vulvar extramammary Paget’s disease (EMPD) is a rare intraepithelial carcinoma that affects apocrine gland-bearing skin, predominantly in postmenopausal women. Due to its rarity, optimal treatment strategies, including the role of radiotherapy (RT), remain poorly established. This study aimed to evaluate the role of radiation therapy in vulvar EMPD, focusing on preserving functional and aesthetic vulvar tissue without compromising survival rates.

Materials and methods

We conducted a retrospective cohort study of 32 patients diagnosed with vulvar EMPD at Seoul National University Hospital between 2000 and 2024. Clinicopathologic data, including demographics characteristics, clinical presentations, histopathological findings, treatment modalities, and outcomes, were collected. Patients were divided into two groups: those who received neoadjuvant or adjuvant RT (n = 9) and those who did not (n = 21). Univariate and multivariate analyses were performed to assess factors related to recurrence and progression-free survival (PFS).

Result

The median age at diagnosis was 63.8 years (range: 38.0–87.8), with 84.4% of patients being postmenopausal. Among the 32 patients, 30 (93.8%) underwent surgery, and nine (28.1%) received adjuvant RT. Recurrence rates were similar between the RT (66.7%) and non-RT (66.7%) groups. The median PFS was longer in the RT group (28.1 months) compared to the non-RT group (23.4 months), although this difference was not statistically significant (p = 0.395). Univariate and multivariate analyses identified age ≥ 60 years as a borderline predictor of poorer PFS (p = 0.053), while no significant associations were found between RT and postoperative complications or recurrence risk.

Conclusion

In conclusion, although RT did not show a statistically significant survival benefit, both our data and previous studies strongly suggest that RT holds potential for disease control. It may be the primary treatment before and after surgery in patients with extensive vulvar EMPD.
Clinical characteristics and risk factors of Clostridioides difficile infection in children with diarrhoea
Authors: Wang Ning , Jiang Kun , Huang Jinyue , Hou Mengzhu , Wang Lu , Wang Wei , Fang Yulian
Published: February 2025

Objective

To investigate the clinical characteristics and risk factors of Clostridioides difficile infection (CDI) in children with diarrhea, and to provide evidence for the clinical prevention and treatment of CDI.

Methods

The clinical data of 192 children with diarrhoea suspected of CDI admitted from August 2020 to March 2023 were retrospectively analysed and divided into two groups according to whether CDI occurred, and the clinical characteristics and risk factors of the two groups were analysed statistically.

Results

There were 85 cases of CDI in children with diarrhoea, 60 males (70.6%) and 25 females (29.4%), with a male to female ratio of 2.4:1; clinical manifestations were mostly fever, diarrhoea, abdominal pain, vomiting and blood in stool, with no statistically significant differences compared to the non-infected group. Interleukin - 6 (IL - 6) levels were lower in the CDI group than in the non - CDI group, and the difference was statistically significant (P < 0.05). Multi-factor logistic regression analysis was used to show that a history of hospitalisation within the last three months, a history of antibiotic treatment for ≥7 days, non-breastfeeding, and a history of antibiotic combined with probiotic treatment were risk factors for CDI in children with diarrhoea (P < 0.05).

Conclusions

A history of hospitalisation within the last three months, previous antibiotic treatment for ≥7 days or combined with probiotic treatment, and non-breastfeeding are risk factors for CDI in children with diarrhoea, so children with diarrhoea who present as described above need to be alerted to CDI and are advised to have active investigations to facilitate rapid and effective control of the disease and improve prognosis.
Identification of maize kernel varieties based on interpretable ensemble algorithms
Authors: Bi Chunguang , Bi Xinhua , Liu Jinjing , Xie Hao , Zhang Shuo , Chen He , Wang Mohan , Shi Lei , Song Shaozhong
Published: February 2025

Introduction

Maize kernel variety identification is crucial for reducing storage losses and ensuring food security. Traditional single models show limitations in processing large-scale multimodal data.

Methods

This study constructed an interpretable ensemble learning model for maize seed variety identification through improved differential evolutionary algorithm and multimodal data fusion. Morphological and hyperspectral data of maize samples were extracted and preprocessed, and three methods were used to screen features, respectively. The base learner of the Stacking integration model was selected using diversity and performance indices, with parameters optimized through a differential evolution algorithm incorporating multiple mutation strategies and dynamic adjustment of mutation factors and recombination rates. Shapley Additive exPlanation was applied for interpretable ensemble learning.

Results

The HDE-Stacking identification model achieved 97.78% accuracy. The spectral bands at 784 nm, 910 nm, 732 nm, 962 nm, and 666 nm showed positive impacts on identification results.

Discussion

This research provides a scientific basis for efficient identification of different corn kernel varieties, enhancing accuracy and traceability in germplasm resource management. The findings have significant practical value in agricultural production, improving quality management efficiency and contributing to food security assurance.
Beyond borders: investigating the impact of the 2023 conflict in Gaza on generalized anxiety disorders and associated somatic symptoms and wellbeing among the Kuwait population: a global call for public intervention programs
Authors: Alnaser Musaed Z. , Alhamad Hamad , Alotaibi Naser , Alhamdan Nadia , Manee Fahad
Published: February 2025

Purpose

Armed conflicts can lead to devastating psychological health issues within and around conflict zones. Generalized anxiety disorder, associated somatic symptoms, and wellbeing were examined among the Kuwait population during the Gaza Conflict in 2023, in addition to exploring the provoking factors.

Methods

A descriptive, correlational cross-sectional design was used in this study. An online survey was conducted to collect information from people living in Kuwait during the Gaza Conflict. Data were collected between November 20 and November 27, 2023. The generalized anxiety disorder scale (GAD-7), a modified patient health questionnaire (mPHQ-15), and the World Health Organization – Five (WHO-5) were used to examine self-reported anxiety, somatic symptoms, and wellbeing among the study participants. Spearman’s correlation and chi-squared tests were used to determine the relationships between anxiety, somatic symptoms, and wellbeing, and to capture the instigating factors.

Results

This study included 1979 participants living in Kuwait during the Gaza conflict period. GAD-7 and mPHQ-5 final scores were moderate (μ = 10.20 ± 4.48; μ = 11.12 ± 6.39), and WHO-5 final score was fair (μ = 53.35 ± 21.82). Spearman’s correlation showed a large positive correlation between the GAD-7 and mPHQ-15, r(1977) = 0.52, p < 0.0001, a medium negative correlation between the GAD-7 and WHO-5, r(1977) = −0.36, p < 0.0001, and a medium negative correlation between the mPHQ-15 and WHO-5, r(1977) = −0.27, p < 0.0001. Spearman’s correlation showed a small positive correlation between the GAD-7 and current feelings of insecurity, r(1977) = 0.246, p < 0.0001, and medium positive correlation with future fears, r(1979) = 0.292, p < 0.0001.

Conclusion

The Gaza conflict impacted the psychological health of the Kuwait population, who shared geographical, geocultural, and geopolitical factors with those in the conflict zone. A global call to address mental health intervention programs for the public in and around conflict zones is a priority.
Relationship between dietary intake and growth and development in Chinese pupils
Authors: Fang Wen , Fu Ye , Li Qin , Cheng Menghan , Zhang Miao , Lu Yu
Published: February 2025

Background

A nutritional diet is essential for children’s growth and development. This study aimed to investigate the relationship between dietary intake and growth and development of pupils to provide more specific nutritional recommendations for their healthy growth.

Methods

This cross-sectional study included 592 pupils, and standardized questionnaires were used to collect information on students’ sociodemographic characteristics, lifestyle habits and dietary intake. Growth and development assessment indicators were measured according to standard protocols. The multivariate generalized linear regression models adjusted for covariates were used to investigate the association between dietary intake and growth and development of pupils.

Results

The generalized linear regression model showed that standing long jump of all pupils (β = −6.735, 95% CI: −12.064, −1.406) and body fat rate (β = −2.650, 95% CI: −4.794, −0.507), fat weight (β = −1.283, 95% CI: −2.286, −0.280) and chest circumference (β = −1.456, 95% CI: −2.789, −0.123) of boys were negatively correlated with dietary diversity score. Among all pupils, meat intake was positively correlated with chest circumference (β = 0.420, 95% CI: 0.119, 0.721) and negatively correlated with standing long jump(β = −1.991, 95% CI: −3.902, −0.080); milk intake was positively correlated with waist circumference (β = 0.470, 95% CI: 0.007, 0.932); soybean intake was negatively correlated with body fat rate (β = −0.583, 95% CI: −1.125, −0.042), fat weight (β = −0.262, 95% CI: −0.517, −0.006), and waist circumference (β = −0.607, 95% CI: −1.050, −0.164); and vegetable intake was negatively correlated with height (β = −0.290, 95% CI: −0.496, −0.084), and positively correlated with stature-sitting height index and waist circumference (p < 0.05). Certain associations retained significance even after stratified analysis based on gender and frequency of dietary intake.

Conclusion

Dietary diversity score and their respective food groups such as meat, milk, coarse grain, soybean and vegetable will impact growth and development indicators, requiring purposefully controlled dietary intake.
Perceived sexual harassment and gender differences in anesthesiology: a cross-sectional survey
Authors: Shenoy Renuka , Harter Ronald , Uribe Alberto , Abdel-Rasoul Mahmoud , Tishko Jillian , Weaver Tristan , Stein Erica
Published: February 2025

Background

In 2017, the hashtags #MeToo and #MeTooMedicine went viral and raised awareness of sexual harassment (SH) and sexual violence affecting all ages, genders, races, sexualities, and careers. Most studies investigating SH have found that women report higher rates of SH experiences compared to men, with documented incidences reaching as high as 81%. Notably, 47% of these incidents go unreported. A study from the Association of Anesthesiologists found that female victims of sexual assault often do not speak up due to the myth that harassment is rare, which further silences women and stigmatizes this issue, leading them to be discouraged from participating in academic anesthesia. Due to the outdated data examining the incidence of SH in the field of anesthesiology, an anonymous 20 item survey was administered to physician attendings and trainees to assess the incidence of SH perceiving SH within the field.

Methods

An anonymous questionnaire-based cross-sectional study, adapted from a validated survey tool on SH and burnout, was administered to a sample of registered members of the American Society of Anesthesiologists (ASA) to evaluate physicians’ perceptions related to SH and burnout in their workplace.

Results

The email survey was sent to 30,765 registered ASA members; a total of 2,830 (9.2%) members responded to the 20-item survey for this quantitative analysis. 53.4% (n = 1,511) and 44.2% (n = 1,251) identified themselves as men and women, respectively. Among all the respondents, 57.6% perceived some form of SH (75.5% women and 44.2% men, p-value:<0.0001). Around 40.1% of respondents indicated that they did not react to or report SH events, with a significantly higher incidence among women when compared to men (46.3% vs. 35.5%; p-value:<0.0001). Respondents who perceived SH were more likely to agree with the 5-point Likert-scale questions related to experiencing burnout, facing declining job opportunities or leaving a job, and becoming more emotionally detached from others.

Conclusion

SH has been reported by both male and female anesthesiologists, with female physicians perceiving significantly higher rates of SH compared to their male counterparts. Most respondents who experienced SH in their workplaces expressed agreement with statements related to “burnout feelings” and/or “declining a job opportunity or leaving the workplace.” This study contributes to the current literature that SH is prevalent within the field of anesthesiology. Furthermore, our study demonstrates that SH has a positive correlation to feelings of burnout. This study demonstrates the critical importance of instituting policies regarding reporting SH events. Additionally, implementing bystander training can empower individuals to report witnessed SH events. Lastly, safeguards should be implemented to protect those who report witnessing or experiencing SH events.
How efficient are specialized public health services in China? A data envelopment analysis and geographically weighted regression approach
Authors: Bai Qian , Huang Lieyu , Guo Yan , Xu Xin , Zhang Zhouyixin , Wang Yuan , Chen Hao , Bian Ying
Published: February 2025

Background

The Chinese public health system is grappling with escalating demands, which stemmed from the challenges of preventing chronic and infectious diseases, as well as the aging population. Meanwhile, in the context of restricted public health resources, how to efficiently utilize these resources becomes a paramount concern.

Objective

This study aimed to evaluate the technical efficiency of specialized public health facilities, the major providers of public health services in China, then discuss its temporal and spatial distribution characteristics and finally investigate its influencing factors.

Methods

The super slacks-based measure data envelopment model was constructed to calculate the efficiency of specialized public health facilities of 31 provinces from 2017 to 2019. Stepwise regression was applied to sort out significant independent variables. Then, geographically weighted regression was used to analyze the spatially varying associations between efficiency and independent variables.

Results

On average, the average technical, pure technical and scale efficiencies were 0.6569, 0.7336 and 0.9206, respectively. Notably, a subtle downward trend was observed in the technical efficiency, which declined from 0.6889 in 2017 to 0.6238 in 2019. From the efficiency decomposition, this reduction was mainly caused by the decreasing of scale efficiency. Besides, substantial geographic variations were observed, with the eastern region exhibiting greater levels of technical and pure technical efficiency. Contrarily, the western region appeared to perform better in terms of scale efficiency. Based on the geographically weighted regression, the proportion of public health expenditure had a noticeable negative impact on the technical efficiency, especially in partial central and eastern coastal provinces. On the other side, the ratio of older population, the sex ratio and the Nitrogen Oxides emission volume had positive impacts on technical efficiency with variations in coefficient magnitude across different geographic areas.

Conclusion

The efficiency of specialized public health facilities has not achieved the optimal status, particularly in terms of the pure technical efficiency. Moreover, the geographic variation was a significant issue affecting the sustainable and balanced performance of public health delivery system in China. The spatially heterogeneous associations between macro-regional factors and efficiency provide in-depth insights in assisting local governments to formulate more targeted and effective interventions, thereby contributing to reduce regional disparities.
Effectiveness of a short-term oxygen therapy training program in Liberia during and after COVID-19
Authors: Luke Mark B. , Ziah Moses , Lu Lily Zhi Ning , Davis Michael D. , Arzoaquoi Samson , Drucker Eva , Kanneh Foday , Logan Gorbee G. , Massaquoi Moses
Published: February 2025

Background

Access to high-quality medical oxygen has been a long-standing challenge in Liberia due to barriers that span across the health system, which were amplified during the COVID-19 pandemic. The surge in cases requiring oxygen therapy necessitated rapid capacity-building for healthcare workers. In response, an emergency oxygen training package was adapted and implemented by the Liberia Ministry of Health and the National Incidence Management System. This manuscript evaluates the implementation of a short-term respiratory care training package to rapidly build healthcare worker capacity during the COVID-19 response and its adaptation for routine in-service training post-response.

Methods

The emergency training used the “hot and cold” simulation approach from the 2014 Ebola response, consisting of a cold phase (3-days) with didactic lectures and practical sessions, and mock COVID treatment unit simulations (2-days); and a hot phase within an active CTU. Participants were doctors, physician assistants, nurses, or midwives, deployed to COVID treatment units at major health centers and hospitals across all counties in Liberia. Training assessments consisted of a paper-based knowledge test pre- and post-training, and Objective Structured Clinical Examinations post-training.

Results

The emergency training as part of COVID response included 123 health care workers from 43 health facilities and saw a significant increase in knowledge (median score of 46% pre-training vs. 84% post-training, p < 0.001). Adaptation and piloting of the package for routine in-service training was also effective at increasing knowledge amongst 81 health care workers (median score of 41% pre-training vs. 78% post-training, p < 0.001). High post-training Objective Structured Clinical Examination scores demonstrated clinical competency achievement in both cohorts. For emergency training, median scores were 92% (pulse oximetry), 81% (oxygen cylinders), and 83% (oxygen concentrators). For routine in-service training, scores were 88, 82, and 84%, respectively.

Conclusion

We demonstrate that the implementation of a healthcare worker training package in oxygen therapy during the COVID response in Liberia and its eventual integration into a routine in-service training program was able to achieve significant improvements in health care worker knowledge and skills. This highlights the feasibility of using rapid and short-term training to enhance clinical capacity within both emergency and post-response settings in a resource-limited country.
Experiences of gender-based violence among women in sub-Saharan Africa: identifying evidence for intervention and public health priorities
Authors: Katende-Kyenda Lucky Norah , Ani Judith I.
Published: February 2025

Background

Gender-based violence (GBV) poses a significant global threat to human rights, public health and attaining the Sustainable Development Goals. There is a growing emphasis on researching to identify issues and understand the experiences of women relative to GBV. The increasing demand for policymakers and public health practitioners to adopt evidence-based approaches in addressing GBV highlights the need for research prioritization on experiences of GBV among women in resource-limited settings such as sub-Saharan Africa. This paper explored GBV among women in 25 sub-Saharan African (SSA) countries to identify and present key intervention priority areas for addressing GBV in these settings.

Methods

The study involved a cross-sectional analysis of a nationally representative dataset from the Demographic and Health Survey of 25 SSA African countries. Data was analyzed descriptively and inferentially using the Pearson chi-square (X2) at a p < 0.05.

Results

Findings revealed that women aged 25–29, living in rural areas and with primary education were at a significant risk of experiencing GBV across 25 SSA countries. A notable 44.94% of women reported experiencing at least one form of GBV, with the prevalence varying by country. Women in Comoros had the lowest reported prevalence (10.76%), while Sierra Leone women had the highest (60.27%), followed by Uganda (56.92%). Emotional and physical violence were most prevalent in Sierra Leone, while sexual violence was most common in Burundi and the Democratic Republic of Congo.

Discussion

This study highlights the urgent need for targeted interventions for younger women in rural areas and those with limited education. By prioritizing evidence-based approaches, stakeholders can develop more effective, sustainable, and impactful programs to reduce GBV and improve the well-being of women across the SSA region.
Towards SDG 14: Protecting and Restoring Our Oceans Using Underwater Labs
Authors: Raimundo Inês , Peixoto Raquel S.
Published: February 2025

The oceans that cover much of our planet are important for billions of people. But some human activities, like polluting the environment and catching too many fish, harm our oceans. Because of this, the United Nations created a big goal called Sustainable Development Goal (SDG) 14, Life Below Water, to help us make the oceans healthy again. Scientists have been observing and studying the oceans to come up with new ideas to save these waters and all the creatures that live there. Since all living things are connected, when the oceans are healthy, we can be healthy, too. One group of scientists has created a special place called the Coral Probiotics Village. There, they are working together to test new technologies and treatments to protect coral reefs and the organisms that depend on them. With this research, scientists can help people make better choices and help countries work together to take care of our big, blue planet!
Climate adaptation plans and “green jobs”: challenges for implementing a responsive, multi-skilled workforce in Worcester, Massachusetts
Authors: Bhat Varun , Strauss Sarah
Published: February 2025

Cities across the United States are affected by climate change impacts, and several cities have adopted climate adaptation plans to respond to this growing threat. These plans outline interventions that require a multi-skilled workforce working towards “green” or sustainable goals. However, the “green jobs” linked to these goals are ill-defined and misunderstood among employers and job seekers and can cause gaps in implementing the interventions outlined in the climate adaptation plans. Therefore, it is important to analyze the current state of green jobs in US cities and understand what employers, job seekers, and others think of the green jobs market. We conduct this analysis with the help of natural language processing and qualitative coding in the City of Worcester, Massachusetts, USA using job data from Indeed and semi-structured interviews. We find that the current green job market in Worcester is siloed around green jobs requiring degrees and that non-degree green jobs are significantly less present. Moreover, most green jobs are located far away from Worcester, making them unattractive to job seekers, influencing the overall image of green jobs among job seekers. Finally, both policymakers and employers are unclear about the definition of a “green job” impacting a job seeker’s search behaviors. All this points to a vague description of green jobs and green workforce, that can significantly impact Worcester’s ability to achieve a climate-ready workforce and to achieve its climate adaptation goals.