bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Baseline Vitamin D Level in Patients Receiving Gefitinib-Directed Therapy for EGFR-Mutant Non–Small-Cell Lung Cancer
Authors: Noronha Vanita , Kolkur Manali , ArunKumar R , Adak Supriya , Patil Vijay , Menon Nandini , Shah Minit , Prabhash Kumar
Published: May 2024

Background:

There is contradicting evidence on vitamin D levels and cancer mortality rates. In this study, we aimed to evaluate the impact of baseline vitamin D level on the outcome in patients with epidermal growth factor receptor (EGFR)-mutant advanced non–small-cell lung cancer (NSCLC) who received either gefitinib or gefitinib with chemotherapy (pemetrexed and carboplatin) as first-line therapy in a prospective randomized study.

Methods:

This was a post hoc analysis of a phase III randomized trial comparing gefitinib with gefitinib with carboplatin and pemetrexed in patients with advanced NSCLC with activating EGFR mutations in the first-line setting. As a part of regular practice, baseline vitamin D levels were measured using circulating 25(OH) levels in blood. We included 334 patients who had baseline vitamin D levels in the study and evaluated the effect of the vitamin D level on oncologic outcomes.

Results:

There were 136 (40.7%) patients with a sufficient (>20 ng/mL) baseline vitamin D level, and 198 (59.3%) patients who were deficient in vitamin D (<20 ng/mL). The median progression-free survival (PFS) in patients with normal vitamin D levels was 17 months, whereas that in patients with deficient vitamin D levels was 15 months, with a hazard ratio of 1.45 (95% confidence interval [CI] = 1.03-2.06). The median overall survival (OS) in patients with normal vitamin D levels was 28.6 months, whereas that in patients with deficient vitamin D levels was 28.5 months, with a hazard ratio of 1.17 (95% CI = 0.81-1.68). On multivariate analysis, only 2 factors impacted the PFS, the baseline vitamin D level, and the treatment regimen; other factors like age, sex, disease stage, and performance status did not.

Conclusions:

Baseline vitamin D levels have a significant impact on PFS, whereas OS is not affected by the baseline vitamin D levels on patients receiving targeted therapy for EGFR-mutant lung cancer.

Trial registration:

The trial was prospectively registered with the Clinical Trial Registry of India, registration number CTRI/2016/08/007149. The date of the registration was 5 August 2016.
Mothers, terrorists, or victims? The framing of Dutch and Belgian women in the Syrian camps and the question of repatriation in news media
Authors: Bossen Ronja , Badran Yazan
Published: May 2024

Following the fall of ISIS in March 2019, thousands of women affiliated with the movement, along with their children, were brought to Kurdish-controlled camps in north-eastern Syria. Since then, an international, political, and juridical debate raged on regarding the repatriation of Western female detainees in the camps and their children. This paper aims to evaluate how Dutch and Belgian women in the Syrian camps have been framed by their national news media in the context of political discussions on their repatriation. Our qualitative framing analysis identifies six distinct framing packages: the criminal, terrorist, victim, regret, mother, and bad parent frames. Moreover, our analysis highlights how the frames, and their intersection with different modes of othering, shifted as the debate moved to the question of their repatriation. Finally, we also discuss differences in the framing, argumentation, and frame advocates between the two contexts.
Strategic planning for degrowth: What, who, how
Authors: Savini Federico
Published: May 2024

Degrowth is gaining traction as a viable alternative to mainstream approaches to sustainability. However, translating degrowth insights into concrete strategies of collective action remains a challenge. To address this challenge, this paper develops a degrowth perspective for strategic spatial planning as well as a strategic approach for degrowth. I argue that a degrowth transition needs to address three strategic issues: depth, agency, and trajectory. Degrowth strategies aim for satiation, the satisfaction of all essential needs in a particular society. To do so, they rely on diffused societal power, raising from existing practices of reduction. Strategies also follow a nonlinear trajectory that seeks to prefigure satiation, popularize it among the masses, and then pressure existing institutions. Strategic spatial planning offers important insights for dealing with these challenges but needs to embrace satiation as a strategic goal. It can do so by creating complementarities between prefigurative practices that perform satiation. The article defines and illustrates these processes by looking at the making of Amsterdam’s ‘doughnut’ strategy.
Durability and sustainability of polyethylene terephthalate water bottles using computer aided design/computer aided engineering elements
Authors: Ikhries Ibrahim I. , Al-Shawabkeh Ali F. , Al-Adwan Ibrahim M. , Al-Najdawi Nijad A.
Published: May 2024

Disposing of plastic water bottles contributes to environmental pollution and waste buildup. Choosing recycling options helps mitigate these adverse impacts and supports a more sustainable approach to waste management. Polyethylene terephthalate constitutes the primary component in water bottles. This study focuses on a water bottle design model, subjecting it to simulations that replicate stresses encountered during storage, transportation, and usage. Polyethylene terephthalate bottles successfully underwent stress analysis, surpassing all stipulated requirements, the results indicate stress values below the yield point and safety factors exceeding one. This affirms the product’s superior quality and its ability to withstand even the most rigorous conditions. The analysis further identified peak stress values (59.819, 65.124, and 34.330 MPa) in distinct scenarios, noting that the bottle may incur damage beyond the critical vertical load of 88.4 N. These findings underscore the efficacy of the proposed process in validating stresses in water bottles pre-manufacture. Consequently, this approach aids in waste reduction and addresses environmental challenges associated with recycling, including resource and energy consumption, contamination, and inefficiencies in recycling systems. In essence, this study constitutes a substantial contribution to the realm of sustainable bottle design. It stands out as one of the few comprehensive investigations into the structural impact on the durability and sustainability of water bottles. This research has the potential to emerge as a significant advancement in the development of more environmentally friendly bottle designs.
Systematic Screening and Assessment of Hospital-Based Youth Violence Prevention Programs
Authors: Piervil Esther , Wong Leslyn , Marshall Khiya J. , Earl Tara , Leonard Scotti , Waajid Malikah , Jones Tiffany , Katapodis Nicole , Marbach Alexis , Schneiderman Stephanie , Bartholow Brad
Published: May 2024

Youth violence is a preventable public health issue. Few hospital-based programs intentionally focus on youth violence prevention. This project aimed to describe the Systematic Screening and Assessment (SSA) methodology used to identify existing hospital-based youth violence prevention (HBYVP) programs ready for future rigorous evaluation. To identify promising HBYVP programs currently in use and assess readiness for evaluation, data from the 2017 American Hospital Association (AHA) Annual Survey of Hospitals was used to identify hospitals with Level I-III trauma centers with reported HBYVP programs. Information for each program was gathered via environmental scan and key informant interviews. A total of 383 hospital-based violence prevention programs were identified. Two review panels were conducted with violence prevention experts to identify characteristics of programs suitable for an evaluability assessment (EA). Fifteen programs focused on youth (10–24 years old) and were identified to be promising and evaluable. Three of the 15 programs were determined to have the infrastructure and readiness necessary for rigorous evaluation. Lessons learned and best practices for SSA project success included use of streamlined outreach efforts that provide program staff with informative and culturally tailored project materials outlining information about the problem, project goals, proposed SSA activities, and altruistic benefit to the community at the initial point of contact. In addition, success of review panels was attributed to use of software to streamline panelist review processes and use of evaluation and data analysis subject matter experts to serve as panel facilitators. Communities experiencing high youth violence burden and hospitals serving these communities can improve health outcomes among youth by implementing and evaluating tailored HBYVP programs.
Six Years’ Experience With a Novel Dissection-Specific Stent-Graft to Prevent Distal Stent-Graft-Induced New Entry
Authors: Shehab Maysam , Wanhainen Anders , Tegler Gustaf , Lindstrom David , Yoon William , Mani Kevin
Published: May 2024

Introduction:

Thoracic endovascular aortic repair (TEVAR) in chronic dissection is associated with a risk for distal stent-graft-induced new entry (dSINE) in up to a quarter of cases. We assess the mid-term outcome of a novel dissection-specific stent-graft (DSSG), which is a custom-made device based on the Cook Alpha platform, with a modified graft design and a distal endovascular elephant trunk without any supporting stent to reduce the radial force on the dissection membrane at the distal landing zone.

Methods:

A retrospective single-center study of chronic dissection patients at high risk of dSINE who received an elective endovascular repair with DSSG from January 2017 to June 2023. The primary outcome is Kaplan-Meier (KM) estimated freedom from dSINE during follow-up. Secondary outcomes included technical success, aortic remodeling, and anatomical evaluation of the distal landing zone in cases with dSINE during follow-up versus those without.

Results:

Thirty patients (24 males) with a median age of 66 years [range=31-78] underwent elective TEVAR with the DSSG. The majority, n=27 (90%), had previous aortic repair; 7 (23%) had established connective tissue disease, and 6 (20%) had established dSINE after previous stent-graft implantation as an indication for TEVAR. Technical success was achieved in n=29 (97%). Median follow-up was 38.5 months (4.3-76.4), and KM estimated freedom from dSINE at 1 and 3 years was 95.6% (SE 0.043) and 89% (SE 0.081), respectively Four cases developed dSINE during follow-up. The median distance from the distal stent-graft to the coeliac trunk was 74mm (range=18-123) in the dSINE group versus 26mm (range=0-74) in the non-dSINE group (p=0.049). Median proximal tangential aortic angulation in the distal landing zone was 38.5° (range=26°-50°) in the dSINE group compared to 21° (range=3-61°) in the non-dSINE group (p=0.052).

Conclusions:

The Use of a novel DSSG with low radial force for TEVAR in the setting of chronic dissection is safe and feasible, with remodeling outcomes comparable with standard TEVAR. The reduced distal radial force in the DSSG does not eliminate the risk for dSINE over time, with new entries occurring, particularly in cases where the distal landing zone is in a tortuous aortic segment and not close to the coeliac trunk.

Clinical Impact

Using the novel dissection-specific stent-graft with reduced radial force is safe and feasible but does not completely eliminate the risk of dSINE occurring over time. The exact positioning of the distal stent-graft in a straight aortic segment, close to the coeliac trunk, may be of importance to further mitigate the risk.
Harnessing Hyperthermia: Molecular, Cellular, and Immunological Insights for Enhanced Anticancer Therapies
Authors: Lukácsi Szilvia , Munkácsy Gyöngyi , Győrffy Balázs
Published: May 2024

Hyperthermia, the raising of tumor temperature (≥39°C), holds great promise as an adjuvant treatment for cancer therapy. This review focuses on 2 key aspects of hyperthermia: its molecular and cellular effects and its impact on the immune system. Hyperthermia has profound effects on critical biological processes. Increased temperatures inhibit DNA repair enzymes, making cancer cells more sensitive to chemotherapy and radiation. Elevated temperatures also induce cell cycle arrest and trigger apoptotic pathways. Furthermore, hyperthermia modifies the expression of heat shock proteins, which play vital roles in cancer therapy, including enhancing immune responses. Hyperthermic treatments also have a significant impact on the body’s immune response against tumors, potentially improving the efficacy of immune checkpoint inhibitors. Mild systemic hyperthermia (39°C-41°C) mimics fever, activating immune cells and raising metabolic rates. Intense heat above 50°C can release tumor antigens, enhancing immune reactions. Using photothermal nanoparticles for targeted heating and drug delivery can also modulate the immune response. Hyperthermia emerges as a cost-effective and well-tolerated adjuvant therapy when integrated with immunotherapy. This comprehensive review serves as a valuable resource for the selection of patient-specific treatments and the guidance of future experimental studies.
In-vitro Cytotoxicity Investigations for Phytoconstituents of Saudi Medicinal Plants With Putative Ocular Effects
Authors: Alghamdi Ali Hendi , Ahmed Aimun A.E. , Abdalgadir Haidar , Bashir Mahadi , Khalid Asaad , Abdalla Ashraf N. , Elzubier Mohamed E. , Adnan Almaimani Riyad , Refaat Bassem , Alzahrani Khalid , Alghamdi Saleh M.S. , Gul Sheraz
Published: May 2024

Background:

Metastatic secondary ocular tumors spread from systemic malignancies, including breast cancer. This study aimed to evaluate the cytotoxicity of extracts from 5 medicinal plants native to Saudi Arabia.

Methods:

For preliminary activity screening, cytotoxicity using the MTT assay and selectivity index determinations were made for medicinal plant extracts against various cancer cell-lines. The most promising extract was subjected to GC-MS analysis to determine the phytochemical composition. Clonogenic assays were performed using the most promising extract to confirm the initial results. Finally, western blot analysis was used to determine the modulation in expression of survivin and P27 suppressor genes in the human breast adenocarcinoma (MCF7) cell-line to understand the potential mechanistic properties of the active plant extract.

Results:

The 5 plant extracts showed various cytotoxic activity levels using IC50. The most active extract was found to be the leaves of Capparis spinosa L. (BEP-07 extract) against the MCF7 breast cancer cell-line (IC50 = 3.61 ± 0.99 μg/ml) and selectivity index of 1.17 compared to the normal human fetal lung fibroblast (MRC5) cells. BEP-07 extract showed a dose dependent clonogenic effect against the MCF7 colonies which was comparable with the effect of doxorubicin. BEP-07 extract caused a significant decrease of survivin and increase in P27 expression compared to control GAPDH at its highest dose (14 µg/ml). The GC-MS chromatogram of Capparis spinosa L. (BEP-07 extract) revealed the existence of 145 compounds, belonging to the diverse classes of phytoconstituents. Fatty acids and their derivatives represent 15.4%, whilst octadecanoic acid, 2,3-dihydroxypropyl ester was the principal component (7.9%) detected.

Conclusion:

Leaves of Capparis spinosa L. (BEP-07 extract) exhibited a significant cytotoxic effect particularly against breast cancer cells. It exhibited this effect through survivin inhibition and via P27 upregulation. The detected phytoconstituents in the plant extract might be involved in tested cytotoxic activity, while further investigations are required to complete the drug candidate profile.
From Poison Books to “Bibliotoxicology”: Highlighting Hazards in Paper-Based Library Collections
Authors: Grayburn Rosie , Tedone Melissa
Published: May 2024

The Bibliotoxicology Working Group (“BibTox”) was formed in 2022 as an ad-hoc, international cohort of conservators, cultural heritage scientists, librarians, collection managers, book historians, and health and safety professionals. Sixty members across more than 30 institutions and eight countries in North America, Europe, and Australasia explore reliable identification methodologies for toxic materials in library and archives collections and develop safer practices for managing such collections. This note will discuss the working group’s past activities and future outputs, as well as sharing information about getting involved in the working group.
Attachment, Mental Health, and Alcohol Use by Men: The Mediating Role of Cumulative Lifetime Violence Severity
Authors: Taylor Petrea , DiTommaso Enrico , Scott-Storey Kelly , O’Donnell Sue , Busolo David , Vincent Charlene D. , Malcolm Jeannie
Published: May 2024

Cumulative lifetime violence (CLV) encompasses many different types and contexts of violence that occur across the lifespan and is associated with negative mental health outcomes in men; however, little attention has been paid to other factors that can influence these relationships such as attachment style. In this analysis, our focus is to understand how attachment styles directly and indirectly through CLV affect men’s mental health, specifically depression, anxiety, posttraumatic stress disorder (PTSD), and alcohol use. Data from 597 Canadian men with lifetime experiences of violence who participated in our national online survey focusing on violence and health were used for mediation analysis. Results indicated that CLV severity mediated the relationship between attachment anxiety (but not attachment avoidance) and depression, anxiety, PTSD, and alcohol use. Although attachment anxiety and attachment avoidance each directly affected depression, anxiety, and PTSD, neither directly affected alcohol use. Importantly, these findings provide the first evidence that the mechanism by which anxious attachment affects alcohol use is through CLV severity. These findings highlight the importance of anxious attachment on mental health outcomes for men who have experienced CLV.
Toward a Framework for Appraising the Quality of Integration in Mixed Methods Research
Authors: Fàbregues Sergi , Younas Ahtisham , Escalante-Barrios Elsa Lucia , Molina-Azorin José F. , Vázquez-Miraz Pedro
Published: May 2024

Although integration is a crucial element of mixed methods research (MMR), most MMR quality frameworks have not comprehensively addressed integration in their criteria. These frameworks tend to focus on whether integration is present, without considering important aspects such as the rigor of the integration processes used or their consistency with the other components of the MMR study. This paper presents the Mixed Methods Integration Quality Framework (MMIQF), which was developed based on a methodological review of the literature on integration in MMR. The proposed framework is intended to be useful to authors and readers of MMR studies who wish to ensure and appraise the appropriate implementation of integration in the design, conduct, and reporting of MMR studies.
An interpretable decision-making model for autonomous driving
Authors: Li Yanfeng , Guan Hsin , Jia Xin
Published: May 2024

Modeling the interactive behavior of human drivers is essential for achieving safe and fully autonomous vehicles. Unfortunately, most decision-making systems employed in current autonomous vehicles rely on complex deep neural network models that function as black boxes with opaque reasoning that hampers human interpretation. Drawing upon the needs theories endorsed by psychologists and driving-related psychological research, we summarize five fundamental driving needs underlying the driver’s behavior: safety, dominance, achievement, order, and relatedness. Leveraging the behavior selection module from general cognitive architectures, we propose a decision-making model explicitly tailored for autonomous vehicles, comprising three distinct modules: needs assessment, motivation generation, and behavior selection. We conducted experiments to evaluate the proposed model using a self-developed 2D simulator based on Unity. The results intuitively visualized the motivation and behavior of self-driving vehicles. This model demonstrates remarkable proficiency in handling routine tasks, such as independent and complete driving tasks, intersection navigation, and maneuvering among multiple vehicles.
Role of ERK in gender difference of fibromyalgia pain
Authors: Chang Ju-Hsin , Chen Ke-Wei , Tsai Shih-Ying , Zeng Yen-Jing , Li Chi-Yuan , Chen Kuen-Bao , Wen Yeong-Ray
Published: May 2024

This study investigated the ERK pathway of the peripheral nervous system and discovered a gender-specific pattern of ERK activation in the dorsal root ganglion of an acid-induced chronic widespread muscular pain model. We employed a twice acid-induced chronic musculoskeletal pain model in rats to evaluate mechanical pain behavior in both male and female groups. We further conducted protein analysis of dissected dorsal root ganglions from both genders. Both male and female rats exhibited a similar pain behavior trend, with females demonstrating a lower pain threshold. Protein analysis of the dorsal root ganglion (DRG) showed a significant increase in phosphorylated ERK after the second acid injection in all groups. However, phosphorylation of ERK was observed in the dorsal root ganglion, with higher levels in the male ipsilateral group compared to the female group. Moreover, there was a no difference between the left and right sides in males, whereas the significant difference was observed in females. In conclusions, the administration of acid injections induced painful behavior in rats, and concurrent with this, a significant upregulation of pERK was observed in the dorsal root ganglia, with a greater magnitude of increase in males than females, and in the contralateral side compared to the ipsilateral side. Our findings shed light on the peripheral mechanisms underlying chronic pain disorders and offer potential avenues for therapeutic intervention.
Factors influencing researchers’ scientific integrity in scholarly publishing: a path analysis approach
Authors: Nguyen Lan Thi , Tuamsuk Kulthida
Published: May 2024

Scientific integrity is defined as the condition that occurs when individuals adhere to accepted standards, professional values, and practices of the relevant scientific community. This study aims to investigate the influential factors on the scientific integrity in scholarly publishing of researchers in Thailand. The questionnaire was delivered to a sample size of 398 top researchers who had high citations and h-index recorded in the Scopus database during the past 5 years, 316 responses were returned. The findings confirm that there are five factors that affect scientific integrity in scholarly publishing: university/faculty requirements/policies, university support, aspects of publishing, publisher aspects, and researcher-related factors. It is evident that establishing a process and criteria for authorship agreement and verification, as well as dedicating offices or units within the university to address research integrity concerns and provide support to researchers, exhibit the highest factor loading values. The findings ensure that scientific integrity stands out as a top priority for researchers linked with prominent research universities in Thailand. To tackle this challenge, it is recommended for the universities to prioritize initiatives aimed at enhancing researchers’ ethical awareness and nurturing scientific integrity.
Impact of line probe assay-based molecular testing on individualized treatment in patients with rifampicin-resistant tuberculosis: data from the prospective INNOVA4TB cohort study in Ukraine
Authors: Dudnyk Andrii , Hempel Matthias , Lytvyniuk Oksana , Liudkevych Halyna , Matsera Volodymyr , Nikitchenko Tetiana , Blyzniuk Svitlana , Molina-Moya Barbara , Preyer Rosemarie , Domínguez José
Published: May 2024

Background:

Ukraine remains a high World Health Organization priority country for drug-resistant tuberculosis (TB). Rifampicin-resistant TB (RR-TB) has a more protracted, more complicated, and more expensive treatment. In 2021, Ukraine reported 4025 RR-TB cases – 5.4 times more (751) than all 30 European Union/ European Economic Area countries together.

Objectives:

The objective of the study was to determine the diagnostic accuracy of line probe assay (LPA), AID Autoimmun Diagnostika GmbH, for detecting resistance to anti-TB drugs and its clinical application for selecting treatment regimens.

Design:

A prospective observational cohort study.

Methods:

From May 2019 to June 2020, we consecutively enrolled patients with active TB hospitalized at the Regional Phthisiopulmonology Center (Vinnytsia, Ukraine), aged between 18 and 82 years. The LPA was performed in the Genetic Research Laboratory at National Pirogov Memorial Medical University, Vinnytsia, Ukraine.

Results:

A total of 84 clinical specimens and 97 culture isolates from 126 TB patients were tested during the study. Accuracy (95% confidence interval) of LPA for clinical samples in comparison with phenotypic drug susceptibility test (DST) was 80.1 (68.5–89.0) for isoniazid (H), 74.7 (62.4–84.6) for rifampicin (R), 74.4 (62.5–84.1) for ethambutol, 71.4 (41.9–91.6) for streptomycin, 84.6 (62.4–96.5) for prothionamide/ethionamide, and 84.6 (73.6–92.3) for levofloxacin (Lfx), respectively. We found a significantly higher sensitivity of LPA for H, R, and Lfx for the culture isolates compared to clinical specimens ( p < 0.05). LPA detected different mutations in 6 out of 17 (35.5%) patients susceptible to R by Xpert. A shorter treatment regimen with an injectable agent demonstrated a low suitability rate of 5% (8/156) in a cohort of RR-TB patients from Ukraine.

Conclusion:

Initial LPA testing accurately identifies resistance to anti-TB drugs and facilitates the selection of an appropriate treatment regimen, minimizing exposure to empirical therapy.
Enhancing nasogastric tube insertion skill performance by using updated checklist among nursing students
Authors: Kebede Ebissa Bayana , Biratu Terfa Yonas , Tiruneh Abebaw , Sehumehone Enatfanta , Fekecha Bekana
Published: May 2024

Background:

Nasogastric tube (NGT) insertion is one of the most commonly performed procedures for critically ill patients through the nostril or mouth into the stomach, which is indicated for multiple reasons.

Objective:

This study is, therefore, aimed to enhance the NGT insertion skill performance of third-year nursing students using the updated checklist, 2021.

Method:

A facility-based pre-post intervention study was conducted among third-year nursing students of the School of Nursing, Jimma University. An updated checklist and intervention package were used among 26 randomly selected nursing students. The collected data was entered into EpiData version 3.1, EpiData Association, Denmark and exported to SPSS version 23, IBM Corp, Armonk, NewYork for analysis. Descriptive statistics were made for each item and Paired T-test analysis was conducted to summarize the findings.

Result:

The highest NGT skill insertion performance score from 40% before the intervention was 35; however, after the intervention, the score increased to 40.3. Their mean score in NGT skill performance was increased by 11 after the intervention of implementing the intervention package using the updated checklist from 26.5 ±5 0.3 the pre-intervention to 37.8 ±5 1.7 post-intervention. The finding indicated that the improvement was statistically significant at p < 0.001.

Conclusion:

Implementing an intervention package and employing an updated NGT insertion checklist improved the performance of third-year nursing students’ NGT insertion skills by an average of 11 points compared to their pre-test scores. A large-scale control randomized trial study was recommended to control for the effects of confounding factors on the implementation of intervention packages.
The practice of key messages for optimal breastfeeding and associated factors among lactating mothers in the Boset District, Oromia, Ethiopia
Authors: Deybasso Haji Aman , Kalu Begi Sultan , Deme Lenjiso Birhanu , Bekele Nardos Tilahun , Getahun Mihiret Shawel , Negussie Yohannes Mekuria
Published: May 2024

Background:

Inadequate breastfeeding can lead to significant morbidity, mortality, and long-term adverse health outcomes. Key messages promoting optimal breastfeeding are integral to Essential Nutritional Action, aimed at improving children’s nutritional status, especially those under the age of two. However, there is a dearth of data regarding the extent to which lactating mothers adhere to these key messages and the associated factors. Therefore, this study aimed to assess the level of practice of key messages for optimal breastfeeding and identify associated factors among lactating mothers living in the Boset District, Oromia, Ethiopia.

Methods:

A community-based cross-sectional study was conducted among 418 lactating mothers from January 1st to February 28th, 2022. The participants were selected using a systematic random sampling technique, and data were collected through interviewer-administered questionnaires. The collected data were entered into Epi Info version 7 and exported to SPSS version 25 for analysis. Binary logistic regressions were performed to examine the association between independent and dependent variables. Adjusted Odds Ratios with a 95% confidence interval were used to estimate the strength of the associations and statistical significance was declared at a p-value < 0.05.

Result:

The overall level of practice of key messages for optimal breastfeeding was 63.9% (95% CI: 59.1–68.2). The odds of practicing key messages for optimal breastfeeding were higher for mothers who attended antenatal care four times or more (AOR = 2.7, 95% CI: 1.4–5.3), received counseling on breastfeeding during postnatal care (AOR = 3.7, 95% CI: 2.2–6.4), had a good knowledge of breastfeeding (AOR = 6.2, 95% CI: 3.6–10.7), and had a favorable attitude toward breastfeeding (AOR = 6.1, 95% CI: 3.5–10.6).

Conclusion:

Breastfeeding key message practices among lactating mothers in the study area fell below the recommended universal coverage of 90%. Factors identified included the number of antenatal care visits, counseling on breastfeeding, level of knowledge, and attitude toward breastfeeding. Promoting regular antenatal visits, providing thorough postnatal counseling, and enhancing knowledge and attitudes are crucial for improving optimal breastfeeding practices.
Fecal microbiota transplantation and next-generation therapies: A review on targeting dysbiosis in metabolic disorders and beyond
Authors: Sahle Zenawork , Engidaye Getabalew , Shenkute Gebreyes Demissew , Adenew Behailu , Abebe Tsegahun Asfaw
Published: May 2024

The human microbiome, particularly the gut microbiome, has emerged as a central determinant of health and disease. Dysbiosis, an imbalance in the microbial composition of the gut, is associated with a variety of metabolic and other diseases, highlighting the potential for microbiota-targeted treatments. Fecal microbiota transplantation has received considerable attention as a promising therapy to modulate the gut microbiome and restore microbial homeostasis. However, challenges remain, including standardization, safety, and long-term efficacy. This review summarizes current knowledge on fecal microbiota transplantation and describes the next generation therapies targeting microbiome. This review looked at the mechanistic understanding of fecal microbiota transplantation and alternative strategies, elucidating their potential role in improving dysbiosis-associated metabolic disorders, such as obesity, and type 2 diabetes and others. Additionally, this review discussed the growing application of therapies targeting the gut microbiome. Insights from clinical trials, preclinical studies, and emerging technologies provide a comprehensive overview of the evolving landscape of microbiome-based interventions. Through a critical assessment of current advances and prospects, this review aims to highlight the therapeutic potential of targeting gut microbiome and pave the way for innovative approaches in precision medicine and personalized treatments.
Does the aerosol box accommodate the double-lumen tube intubation?
Authors: Cavanaugh Nicholas B , Deng Zhen , Sivamurugan Aravinthasamy , Subramani Sudhakar , Agarwal Deepak , Arshava Evgeny V , Hanada Satoshi
Published: May 2024

The aerosol box was widely used to shield healthcare providers from exposure to COVID-19 during single-lumen intubation procedures. However, it has not previously been evaluated for its use in double-lumen tube intubations. This report presents the case of a 25-year-old COVID-19-positive male with a fever who required an emergency thoracotomy for a mediastinal abscess. During the rapid-sequence induction of general anesthesia, an attempt to use the aerosol box for double-lumen tube intubation was made. The attempt faced unique challenges due to the aerosol box’s restrictive dimensions and the double-lumen tube’s physical characteristics, such as length and flexibility, resulting in an unsuccessful first attempt. Consequently, the aerosol box was removed, and a successful intubation was achieved without it. Postoperatively, the patient remained intubated, was transferred to the intensive care unit, and was extubated on the second postoperative day, followed by intensive care unit discharge. This experience suggests that the standard aerosol box size (50 cm wide, 40 cm deep, and 50 cm tall) may not be suitable for double-lumen tube intubations. This highlights the importance of assessing the feasibility of each aerosol box before its clinical use in such procedures.
The colonial effect: Language, trust and attitudes to science as predictors of vaccine hesitancy across Africa
Authors: Falade Bankole
Published: May 2024

Perceptions of vaccine safety, importance and effectiveness are at the core of vaccine hesitancy around the world, and Africa has had its own share of vaccine revolts. This study uses the 2018 Wellcome Global Monitor on public perceptions of vaccines in 40 African countries to examine the predictors of vaccine hesitancy. It examines levels of hesitancy from a language perspective, comparing French speakers with others, mostly English speakers. Results show that French speakers were significantly more hesitant about importance and safety, while English speakers and others were more hesitant about effectiveness. This reflects the continuing influence of colonial ties on African countries. Respondents with high levels of trust in social actors (such as national government, journalists, people neighborhood, doctors and nurses) were also more hesitant about the safety and effectiveness of vaccines, indicating the importance of non-scientists in influencing vaccine hesitancy. Those with high levels of education were more likely to be hesitant about vaccines in general, indicating that having more education may have an opposite effect. Perception of science as progress was significant for all three hesitancy types, indicating that Africans with more progressive attitudes were less likely to worry about the importance, safety and effectiveness of vaccines. At the country level, there was no overarching predictor, indicating the strong role of local social and cultural factors. These findings improve our understanding of the drivers of vaccine hesitancy in Africa and provide valuable input for future vaccine policy and health-awareness campaigns.
K–12 Experiences of LGBTQ+ Students of Color: Findings From the First Focus Group Interview
Authors: Yoon Eunhui , Sherman Lyds , Jean-Baptiste Kiana E.
Published: May 2024

Having an affirming and inclusive school environment is pertinent to the well-being of LGBTQ+ students of color. However, research indicates that existing school policies and protections are insufficient to support this population. The present study investigates how LGBTQ+ individuals of color perceived their K–12 experiences related to their intersectional identity and their interactions with school counselors. In a focus group of three LGBTQ+ college students of color, participants recounted how they navigated their identities during their K–12 schooling. The analysis yielded five themes related to the participants’ identities: (a) isolation, (b) delayed identity development, (c) peer pressure and aggression, (d) teachers’ bias and (micro)aggressions, and (e) heteronormative curriculum and extracurricular activities. Regarding the students’ experiences with school counselors, three themes emerged: (a) school counselors were too busy to talk, (b) uncertainty about who was an ally, and (c) unsureness of confidentiality. Findings underscored the unique challenges LGBTQ+ students of color encounter related to receiving support and engaging in identity development. We discuss implications and recommendations for school counselors and school systems.
Supporting Students Who Are Grieving: Interventions and Practices for School Counselors
Authors: Wood Katherine M. , McMahon H. George
Published: May 2024

This conceptual article focuses on interventions and practices for school counselors to utilize when working with students who are grieving due to parental death, ambiguous loss, or suffocated grief. We review the three-stage model of evidence-based school counseling (assessing student needs, accessing quality interventions, and evaluating outcomes) and provide practical strategies for school counselors to engage with students experiencing grief and support them through the grieving process.
Student Change Agent Model: How School Counselors Can Operationalize the Advocating Student-Within-Environment Framework to Promote Student Empowerment
Authors: Leopold Morgan , Hargrove Julia , Marrone Sarah , Jennings Gillian , Max Ryan
Published: May 2024

Feelings of empowerment among students are crucial prerequisites to their participation in change agency in both educational and non-educational settings. Educators notice a compelling correlation between student empowerment and academic achievement and other positive outcomes in K–12 educational environments. School counselors are optimally positioned to influence positive changes in power dynamics and student outcomes by creating space for students, especially those who have been historically marginalized, to become change agents within their environments. The Student Change Agent Model operationalized through the Advocating Student-within-Environment theoretical framework and delivered through the evidence-based school counseling approach is one proposed way for school counselors to achieve and evaluate the extent of their impacts on student empowerment.
How Can Fund Leaders Utilize Organizational Networks to Enhance Organizational Sustainable Performance Using the Funds’ Co-Holding Network as a Tool
Authors: Guo Xiaoping , An Gang , Han Jiao , Wang Zhenjia
Published: May 2024

With the intensification of economic uncertainty and the increasingly fierce competition in the fund industry, how to use the organizational network to improve the sustainable performance of the fund has become a very urgent issue. However, most of the existing research focuses on the impact of the microstructure of a single social or business network before fund leaders make decisions on the performance of fund organizations, which has the defects of incomplete information sets and the inability of leaders to identify all information and then affect organizational learning and performance. This paper constructs two kinds of fund co-holding networks as two kinds of inter-fund organization networks based on the indirect relationship between the co-holding of large and small funds and the co-holding of large funds. The study not only overcomes the above defects, but also finds that: (a) the status and power of different organizations in the two networks are unbalanced in terms of the macro overall network, the meso community and the micro individual structure, and the “super excellent community” and “benchmark fund” group occupy the core position in the network. (b) With the fund co-holding network as a tool, fund leaders can reduce risks and improve the sustainable performance of funds by observing and learning the behaviors of excellent associations and benchmark funds in the network. We provides a reference for further understanding the characteristics of inter-fund organizational networks and the rational use of organizational networks by leaders of financial organizations for organizational learning and sustainable performance improvement.
The Effect of Gamification with Web 2.0 Tools on EFL Learners’ Motivation and Academic Achievement in Online Learning Environments
Authors: Temel Tuba , Cesur Kürşat
Published: May 2024

New teaching and learning practices related to gamified tools in online learning environments have become even more important during the pandemic and will continue to reshape educational processes, including higher education institutions, in the post-pandemic period. In line with this, the present study aimed to investigate the effects of gamification with Web 2.0 tools including Kahoot!, Socrative, Quizizz, and Mentimeter on EFL learners’ motivation and academic achievement levels in online learning environments through a quasi-experimental research method and was based on a mixed-method sequential explanatory research design. The participants of the study are 60 freshman learners studying at a state university in Türkiye. The data were obtained through a scale, an Achievement Test, and a semi-structured interview. The quantitative data were analyzed via statistical measures, and the qualitative data were analyzed through content analysis. The findings indicated that the treatment via gamified Web 2.0 tools had a statistically significant difference in favor of the experimental group in terms of the participants’ motivation/course interest levels and the experimental group scored higher on the Achievement Test compared to the control group.
The Impact of Perceived Effectiveness of Non-Pharmaceutical Interventions (NPIs) on Attitude Toward Usage, Behavioral Intentions, and Actual Usage
Authors: Haverila Matti J. , Haverila Kai , McLauglin Caitlin
Published: May 2024

The purpose is to examine the impact of the perceived effectiveness of NPIs (e.g., hand hygiene, respiratory etiquette, face masks) on behavioral intentions, attitudes toward usage, and actual use against the backdrop of the Technology Acceptance Model (TAM). Responses were gathered with a survey instrument from Canadian respondents ( N = 278). PLS-SEM and exploratory factor analysis (EFA) were used as analytical methods. The hypotheses between the key constructs were accepted consistently with TAM. Also, the results show a positive relationship between perceived effectiveness and attitude toward the usage of NPIs. However, the perceived effectiveness did not significantly impact behavioral intentions and actual use of NPIs. A significant indirect relationship was discovered between perceived effectiveness via attitudes on behavioral intentions and the actual use of NPIs. The perceptions of the respondents who perceived the NPIs to be effective and those who did not were quite similar. The current research provides a framework for effectively promoting the relevant behaviors while utilizing the Technology Acceptance Model (TAM) framework. The critical role of attitude toward the use of NPIs is highlighted through the direct impact of perceived effectiveness and the indirect effect of perceived effectiveness on behavioral intentions and actual usage toward the use of NPIs.
Tourists’ Adoption of Context-Aware Applications: A Case Study, Using Personal Locator Beacons at the Mole National Park, Ghana
Authors: Tiika Bernard John , Tang Zhiwei , Dagadu Joshua Caleb , Azaare Jacob , Otoo Samuel Nii-Ayi
Published: May 2024

The use of technology to provide contextual information for decision-making has been a long-standing practice. The study aims to identify the antecedents influencing tourists’ use of context-aware applications. It employs the Unified Model of Electronic Government Adoption (UMEGA) and the Expectation Confirmation Model (ECM) to investigate tourists’ behaviors in the use of Personal Locator Beacons (PLBs) during the pre-adoption and post-adoption stages at the Mole National Park in Ghana. Data was analyzed using Smart PLS 3.0 software. The findings suggest that pre-adoption performance expectancy, motivational needs, and personal situation significantly affect tourists’ pre-adoption intentions to continue using context-aware applications. In addition, information recommendation, service quality, confirmation expectation, and satisfaction influenced continued use and recommendation. However, social influence and enjoyment experience did not significantly impact tourists’ behavioral intentions. The findings contribute to theory by integrating components of the two models (UMEGA & ECM) and delving into the antecedents of users’ decision-making processes.
Environmental Foe or Friend: The Impact of Intellectual Capital and Ambidextrous Innovation on Environmental Performance
Authors: Huynh Mai Tram Nguyen , Hoang Ngoc Bui
Published: May 2024

This study was conducted to address the question of whether the existence of green intellectual capital, ambidextrous green innovation, and pro-environmental behaviors promotes environmental performance in 320 enterprises in Vietnam. Evidence obtained from the partial least squares structural equation model (PLS-SEM) shows that: (i) Employees’ pro-environmental behavior positively contributes to improving enterprises’ environmental performance; (ii) The more extensive the green intellectual capital, the more efficient the environmental improvement through measures such as reducing hazardous waste and increasing the use of renewable inputs. As a result, environmental quality can be improved. In addition, as a moderator, green intellectual capital positively affects the relationship between ambidextrous green innovation and environmental performance. Based on the study’s findings, the authors suggest some governance implications for promoting sustainable environmental development in some Vietnamese enterprises.
Enhancing Disaster Resilience: Insights from the Cianjur Earthquake to Improve Indonesia’s Risk Financing Strategies
Authors: Handoyo Felix Wisnu , Dalimunthe Syarifah Aini , Purwanto Purwanto , Suardi Ikval , Yuliana Chitra Indah , Mychelisda Erla , Wardhana Irwanda Wisnu , Nugroho Agus Eko
Published: May 2024

Earthquakes pose a growing threat to Indonesia, and the country’s limited resources for risk mitigation propagate its vulnerability. The heavy reliance on ad-hoc government relief for risk transfer is not sustainable. This study aims to provide scientific evidence for formulating disaster risk financing strategies in Indonesia, focusing on active fault areas with high population density. By analyzing people’s responses to risk financing after the November 21, 2022, earthquake in Cianjur Regency, the study examines emotional reactions, risk perceptions, and willingness to participate in risk insurance. The findings highlight three major issues: low participation in insurance programs due to limited insurance literacy and enrollment, the significant financial burden on the government from material losses, and the critical need for disaster insurance schemes for homes and fixed assets. The study emphasizes the urgency of implementing disaster risk financing in Indonesia, with a focus on the vulnerability of poor and low-income households. It also stresses the importance of enhancing disaster risk governance and promoting public-private partnerships on small-scale insurance schemes.