bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived Racial Discrimination among Home Health Aides: Evidence from A National Survey
Authors: Lee Doohee , Muslin Ivan , Mcinerney Marjorie
Published: May 2024

Home health aides are one of our essential human resources in the U.S. long-term care industry but understanding whether home health aides experience racial discrimination in the workplace and, if so, which personal/organizational factors are associated at the national level has been unnoticed. Using a nationally representative sample (n=3,377), we attempt to investigate the association between racial discrimination and personal and organizational factors. The study found the 13.5% prevalence rate of racial discrimination. The study findings from multiple regression analysis reveal that black home care aides are more likely than white aides to experience racial discrimination in the workplace, suggesting that racial disparity may be an additional barrier to our home health care industry. National chain affiliation and low income were also found to be associated with perceived racial discrimination.
National Incidence of Medical Transfer: Patient Characteristics and Regional Variation
Authors: Reimer Andrew P. , Schiltz Nicholas , Koroukian Siran M , Madigan Elizabeth A
Published: May 2024

The aim of this descriptive study was to establish and describe the national incidence, cost, and outcomes of patients that undergo medical transfer. Using discharge data from the Nationwide Inpatient Sample 2011, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality, the dataset was analyzed using weighted frequency distribution. Approximately 1.6 million patients are transferred yearly. Transferred patients experience a mean length of stay of 9.3 days (std dv 13.5) versus 4.3 days for patients not transferred (std dv 6.0), and cost more than twice as much (mean $19,234) versus those not transferred (mean $9,469). Additionally, patients who undergo inter-facility transfer cost an additional $15.8 billion annually. Interhospital patient transfers require closer scrutiny regarding appropriateness and future policy implications.
Overcoming Community Development Challenges in Urban Slums
Authors: Appiah-Kubi Jamal
Published: May 2024

Community development has been practiced in slums to address problems such as poor housing and sanitation. However, limited information exists on how to address issues of resource constraint and ethnic conflict that have limited the efficacy of community development approaches. This study was undertaken to understand possible mechanisms to resolve such challenges. The study was conducted in Ashaiman, a municipal area bounded in the same geographical space us Accra and Tema, two key industrial cities in Ghana. A home for many rural-urban migrants, the municipality contains the Tulaku, Taboo Line and Valco Flat slums. All were sites of major community development projects on housing, footbridges and income generating activities. Interviews were conducted with key stakeholders of community development in order to obtain detailed understanding about the processes undertaken and the dynamics involved in such projects. Social capital theory was used to explore how existing networks can support community development projects. The key finding was that capacity building and community involvement were effective in resolving challenges encountered in affordable housing projects.
Productivity Growth in the Electric Power Industry: A Comparative Study of Japan, the United States, and Korea
Authors: Kobayashi Chiharu
Published: May 2024

The purpose of this paper is to provide empirical estimates of total factor productivity (TFP) growth rates in the electric power industry for the United States, Japan, and Korea. in this paper, the conventional Divisia index number approach and two cost function approaches are used to assess TFP growth rates during the 1972–1996 period. the TFP growth rates in the United States, where regulatory reform has been progressing gradually since 1978, did not show much difference from those in Japan, and were considerably lower than those achieved by Korea, where little reform has taken place. Decomposition analysis based on the total cost function shows that the major sources of TFP growth were the scale effect in Japan, the capacity utilization effect and the scale effect in Korea, and technical change in the United States. Since the mid-80s, the increases in TFP growth were due to improvements in the capacity utilization effect in all three countries.
Refocusing the Eu Budget – An Institutional View
Authors: Blankart Charles B. , Koester Gerrit B.
Published: May 2024

There is little disagreement that the EU budget should be refocused. Redistributive agricultural and structural spending should be reduced in favor of more public good spending as the Boege and Sapir reports demand. But a public choice analysis can show that the current deadlock makes a refocusing of the budget unlikely. Starting with the Treaty of Rome we demonstrate how Member States became net payers and receivers and why the underlying coalitions were fairly stable and will remain so after Lisbon. We propose an additional public good budget within an improved process of enhanced cooperation to overcome the deadlock.
Does Municipal Amalgamation Strengthen the Financial Viability of Local Government? A Canadian Example
Authors: Slack Enid , Bird Richard
Published: May 2024

The rationale for the amalgamation of Toronto, Canada in 1998 was to save costs but, as this paper shows, it did not achieve its objective. An analysis of per household expenditures in constant dollars for four services (fire, garbage, libraries, and parks and recreation) from 1988 to 2008 shows that expenditures increased after amalgamation for all services but libraries. At the same time, the amalgamation seems to have resulted in reduced access and participation by residents in local decision-making. On a positive note, the amalgamation increased the financial ability of the smaller and poorer municipalities in the newly created city by increasing their access to the tax base of the amalgamated city as a whole. It also equalized local services so that all city residents receive a similar level of services.
Collecting and Disbursing: Increasing Cash Management Efficiency through the Utilization of Bank Services
Authors: Modlin Steve
Published: May 2024

The proper management of cash transactions has proven to be a major component of county government administrative fiscal policy. Both collection and disbursement alternatives continue to be analyzed in order maximize cash flow for both the elimination of outstanding payables as well as additional investment opportunities. This study examines cash disbursement and collection practices of county governments in North and South Carolina. Initial findings indicate that professionally administered county governments do maximize efficiency through the use of multiple bank service alternatives. Additionally, the amount of time the service saved, the official responsible for service decisions, bank asset size, and the amount of cash needed on hand prior to disbursement all have significance in determining the type of services used for collections and disbursements
Debt Burden and Perceived Sovereign Default Risk: Evidence from Credit Default Swaps
Authors: Kriz Kenneth A. , Wang Qiushi , Issarachaiyos Sikarn
Published: May 2024

This research employs a relatively new type of market data, the credit default swaps (CDSs) values, to study the impact of public debt and market perceptions of default from an international perspective. Using a sample of 57 sovereign countries over five years, we find that sovereign external debt is positively associated with the implied cumulative probability of default (CPD). We further find that credit rating scores, economic growth, and cash surpluses are inversely related to CPD, while the change in the inflation rate and government size have a positive correlation with CPD. The findings clarify the relative role of the debt burden in predicting market perceived default risk.
What Factors Affect the Underfunding of Local Pensions? Evidence from Indiana
Authors: Faulk Dagney , Hicks Michael , Killian Larita
Published: May 2024

Our study focuses on the funded status of local public pension plans. We use data from Indiana to examine the determinants of unfunded local pension liabilities. We test three hypotheses considered in the literature. The first is that declining economic conditions and corresponding demographic changes decrease funds available for pension liabilities leading to greater unfunded liabilities. The second hypothesis is that conditions related to differences in local fiscal environment contribute to unfunded pension liability. The third hypothesis is that special interests create pressure to maintain higher levels of public services while deferring costs to future taxpayers. We find limited support for each hypothesis. Economic and demographic factors such as per capita income and migration, fiscal factors such as the average tax levy and state aid, and broad interest group influences such as per capita retirement income are the major determinants of pension underfunding among local governments in Indiana.
miR-133a and miR-135a Regulate All-Trans Retinoic Acid-Mediated Differentiation in Pediatric Acute Myeloid Leukemia by Inhibiting CDX2 Translation and Serve as Prognostic Biomarkers
Authors: Cheng Yu-Cai , Fan Zhong , Liang Cong , Peng Chun-Jin , Li Yu , Wang Li-Na , Luo Jie-Si , Zhang Xiao-Li , Liu Yong , Zhang Li-Dan
Published: May 2024

Background: Acute myeloid leukemia (AML) is a type of blood cancer characterized by excessive growth of immature myeloid cells. Unfortunately, the prognosis of pediatric AML remains unfavorable. It is imperative to further our understanding of the mechanisms underlying leukemogenesis and explore innovative therapeutic approaches to enhance overall disease outcomes for patients with this condition. Methods: Quantitative reverse-transcription PCR was used to quantify the expression levels of microRNA (miR)-133a and miR-135a in 68 samples from 59 pediatric patients with AML. Dual-luciferase reporter transfection assay, Cell Counting Kit-8 assay, and western blot analysis were used to investigate the functions of miR-133a and miR-135a. Results: Our study found that all-trans-retinoic acid (ATRA) promoted the expression of miR-133a and miR-135a in AML cells, inhibited caudal type homeobox 2 (CDX2) expression, and subsequently inhibited the proliferation of AML cells. Additionally, miR-133a and miR-135a were highly expressed in patients with complete remission and those with better survival. Conclusions: miR-133a and miR-135a may play an antioncogenic role in pediatric AML through the ATRA-miRNA133a/135a-CDX2 pathway. They hold promise as potentially favorable prognostic indicators and novel therapeutic targets for pediatric AML.
A Method to Reduce Tension Differences in Pull/Push Manipulation for a Robot in Fluorescence Emission-Guided Surgical Microscopy
Authors: Lee Sangyun , Yoon Kicheol , Lee Won-Suk , Kim Kwang Gi
Published: May 2024

Motivation

A fluorescence emission-guided microscope used to monitor the outcome of cancer removal surgery is highly effective when employing a manipulator to motorize and switch the observation direction. It is necessary to minimize the alignment of looper tension between the stands for pull/push to change the direction of the manipulator and reduce the error rate caused by tension differences. This paper presents a method to minimize the error rate of looper tension between the stands.

Methods

\The looper is inserted between the stands of the manipulator to minimize the difference in tension and make the stress on the pull and push of the looper constant. The constant stress allows the manipulator to move stably in left/right, up/down, and left/right movements, which will be effective for full-camera observation and close-up shots of the end effector.

Results

Reducing the tolerance for differences in the manipulator’s looper tension (angle and tension) is crucial. When the input value of the looper tension angle is 50°, the output should closely match 50°. Consequently, the measured response has a tolerance of ±49.98%, resulting in an error rate of .02% (1/50th level).

Conclusion

A method is proposed to minimize the error rate of the manipulator’s looper tension in a robot-based fluorescence emission-guided microscope used to observe the status of cancer surgery. As a result, a stable manipulator with a minimal error rate can achieve a 3.986x magnification for close-up observation by switching between high and low orientations.
Keyword-assisted topic models reveal the dynamics in the main media frames of the Grand Ethiopian Renaissance Dam (2011–2022)
Authors: Abdalbaki Salsabil M
Published: May 2024

Framing is a central concept during times of dispute because it can escalate the dispute or push it toward cooperation. Contributing to the automatic identification of frames in conflict studies, this article aims at examining the dynamics of the main media frames emphasized by Egypt, Sudan and Ethiopia over the Grand Ethiopian Renaissance Dam. These frames represent the factors of power and hydro-hegemony between the three countries, including the geographic location, military intervention, mediation, agreements and economic dimensions. Keyword-Assisted Topic Models (KeyATM) are implemented to analyse the English governmental and non-governmental newspapers that covered this dispute the most ( N = 12) over 11 years (2011–2022). While the results show the Egyptian and Sudanese media are dominated by the mediation and agreements frames, the Ethiopian media emphasizes the economic frame. They also confirm the existence of hegemony and counter-hegemony between the downstream and upstream which can be attributed to the dynamics in the adopted frames.
Longing for the “Good Old Days” or longing for a racist and sexist past?
Authors: Goidel Spencer , Goidel Kirby , Madsen Bradley
Published: May 2024

Nostalgia plays an increasingly central and polarizing role in American politics, as the Republican Party has become the primary proprietor of nostalgic rhetoric. This paper explores how feelings of collective nostalgia in a country with an unjust past are inextricably tied to racism and hostile sexism. We expect that nostalgia is strongly related to racist and sexist attitudes. We test these expectations using data from the 2022 Cooperative Election Study. Our findings reveal a standard deviation increase in nostalgia is associated with a 7–13 percentage point increase in the probability of expressing racist attitudes, and a 6–9 percentage point increase in the probability of expressing sexist attitudes, even after controlling for partisan affiliation and ideology. These results suggest that nostalgic sentiments can exacerbate prejudice and discrimination by perpetuating the belief that things were better when America was more unjust.
Anomalous Left Coronary Artery From the Pulmonary Artery With Ventricular Septal Defect and Double Aortic Arch: A Unique Case Report
Authors: Sabateen Fadi , Nosáľ Matej , Valentík Pavel , Bobík Lucia , Soják Vladimír
Published: May 2024

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is an uncommon life-threatening congenital heart defect that occurs mostly as an isolated lesion. It is very rarely associated with other cardiac abnormalities. In this report, we present a case of an infant who successfully underwent complete surgical repair of a rare triad of congenital heart defects, including ALCAPA, ventricular septal defect (VSD), and double aortic arch (DAA). To the best of our knowledge, this is only the second case of ALCAPA diagnosis associated with VSD and DAA that has been described in the literature.
Economic Importance of Hidden Child Labour among Poor Rural Families of West Bengal, India: An Investigation through Field Experiment
Authors: Das Sangita , Kundu Amit
Published: May 2024

This article investigates whether school-going children’s participation as ‘not directly paid’ family labourers in domestic chores and/or economic activities helps their families to improve their livelihood in rural West Bengal. The findings indicate that the likelihood of hidden child labour is greater when the child’s father is old, the child is not an infant, the household possesses positive operational assets and the child’s mother is part of a self-help group. Parental positive attitude towards their child’s education can also reduce the incidence of hidden child labour within the family. The evidence from the two-step treatment effect model further suggests that hidden child labour helped their family earn a higher family income than households without hidden child labour during the reference period.
Endometriosis and stigmatization: A literature review
Authors: Tragantzopoulou Panagiota
Published: May 2024

Endometriosis, a chronic condition affecting women worldwide, remains a complex and enigmatic disease. Despite its appearance and debilitating symptoms, the lack of sufficient information about endometriosis often leads to misconceptions and stigmatization of women. This literature review aims to shed light on the phenomenon of stigma surrounding endometriosis and its profound impact on the mental health of affected women. The search for relevant literature was conducted in the databases PubMed, ScienceDirect, and Scopus. Inclusion criteria for the studies were as follows: patients with endometriosis, exploration of the phenomenon of stigma in this sample, qualitative or quantitative design, publication after 2000, and written in English. Out of the total of 478 articles identified from the three databases, 6 articles met the inclusion criteria for this literature review. The review’s findings indicate that women with endometriosis encounter stigma from an early age, extending from their school years into adulthood. Employers and family members often question the severity of their pain, while menstrual pain is unjustly normalized as something women should endure. The impact of this stigma and criticism on the mental health of these women is profound, leading to feelings of despair, social exclusion, and even suicidal thoughts. In conclusion, this literature review underscores the pressing need for increased awareness and efforts to address the stigma surrounding endometriosis.
An Analysis of True Crime’s Treatment of Murder Victims
Authors: Gehrke Chloe
Published: May 2024

True crime is a non-fiction genre that focuses on real crimes and those who were involved. As one may expect, this brings attention to victims of violent crimes. With such a delicate topic, true crime needs to maintain ethical practices. Many have speculated that victims are disrespected in these retellings, but in pre-existing research, no one has measured the extent of this disrespect. As such, the following question presented itself: What is the extent of murder victim maltreatment by true crime media present on Hulu as of 2022? To answer this question, a quantitative, exploratory media analysis was completed through the use of a codebook, which assigns point values that can be combined into an overall maltreatment score. The main focus of this codebook was the narrative and imagery shown throughout an episode. Starting with all true crime series, the sample size was narrowed down to five series. These five series were coded and received an overall maltreatment score. It was found that on average, these five series displayed a substantial amount of maltreatment towards murder victims. Additionally, further analysis showed that the treatment of victims was somewhat dependent on the killers. Not only does this demonstrate an injustice to the victims themselves, but also to those that knew them.
Extraction of γ-chitosan from insects and fabrication of PVA/γ-chitosan/kaolin nanofiber wound dressings with hemostatic properties
Authors: Lee Hakyong , Kim Jinkyeong , Myung Suwan , Jung Tae-Gon , Han Dong-Wook , Kim Bongju , Lee Jae-Chang
Published: May 2024

A nanofiber-based composite nonwoven fabric was fabricated for hemostatic wound dressing, integrating polyvinyl alcohol (PVA), kaolin, and γ-chitosan extracted from three type of insects. The γ-chitosan extracted from Protaetia brevitarsis seulensis exhibited the highest yield at 21.5%, and demonstrated the highest moisture-binding capacity at 535.6%. In the fabrication process of PVA/kaolin/γ-chitosan nonwoven fabrics, an electrospinning technique with needle-less and mobile spinneret was utilized, producing nanofibers with average diameters ranging from 172 to 277 nm. The PVA/kaolin/γ-chitosan nonwoven fabrics demonstrated enhanced biocompatibility, with cell survival rates under certain compositions reaching up to 86.9% (compared to 74.2% for PVA). Furthermore, the optimized fabric compositions reduced blood coagulation time by approximately 2.5-fold compared to PVA alone, highlighting their efficacy in hemostasis. In other words, the produced PVA/kaolin/γ-chitosan nonwoven fabrics offer potential applications as hemostatic wound dressings with excellent biocompatibility and improved hemostatic performance.

Graphical abstract
Long term care facilities in England during the COVID-19 pandemic—a scoping review of guidelines, policy and recommendations
Authors: Collingridge Moore Danni , Garner Alex , Cotterell Natalie , Harding Andrew J. E. , Preston Nancy
Published: May 2024

Background

The disproportionate effect of COVID-19 on long term care facility (LTCF) residents has highlighted the need for clear, consistent guidance on the management of pandemics in such settings. As research exploring the experiences of LTCFs during the pandemic and the implications of mass hospital discharge, restricting staff movement, and limiting visitation from relatives are emerging, an in-depth review of policies, guidance and recommendations issued during this time could facilitate wider understanding in this area.

Aims

To identify policies, guidance, and recommendations related to LTCF staff and residents, in England issued by the government during the COVID-19 pandemic, developing a timeline of key events and synthesizing the policy aims, recommendations, implementation and intended outcomes.

Method

A scoping review of publicly available policy documents, guidance, and recommendations related to COVID-19 in LTCFs in England, identified using systematic searches of UK government websites. The main aims, recommendations, implementation and intended outcomes reported in included documents were extracted. Data was analysed using thematic synthesis following a three-stage approach: coding the text, grouping codes into descriptive themes, and development of analytical themes.

Results

Thirty-three key policy documents were included in the review. Six areas of recommendations were identified: infection prevention and control, hospital discharge, testing and vaccination, staffing, visitation and continuing routine care. Seven areas of implementation were identified: funding, collaborative working, monitoring and data collection, reducing workload, decision making and leadership, training and technology, and communication.

Discussion

LTCFs remain complex settings, and it is imperative that lessons are learned from the experiences during COVID-19 to ensure that future pandemics are managed appropriately. This review has synthesized the policies issued during this time, however, the extent to which such guidance was communicated to LTCFs, and subsequently implemented, in addition to being effective, requires further research. In particular, understanding the secondary effects of such policies and how they can be introduced within the existing challenges inherent to adult social care, need addressing.
Effect of postpartum depression and role of infant feeding practices on relative weight of child at 1 and 3 years of age
Authors: Shrestha Drishti , K C Bhandari Aliza , Ogawa Kohei , Tanaka Hisako , Miyayama Chiharu , Horikawa Reiko , Urayama Kevin Y. , Morisaki Naho
Published: May 2024

Background

Childhood obesity has increased and is considered one of the most serious public health challenges of the 21st century globally, and may be exacerbated by postpartum depression (PPD). The purpose of this study was to examine the association between PPD at 1st and 6th month postpartum, infant feeding practices, and body mass index (BMI) z-score of the child at one and three years of age.

Methods

This study used data from an ongoing prospective maternal-child birth cohort performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan with the period of recruitment from May 13, 2010 to November 28, 2013. Out of 2,309 total number of mothers, 1,279 mother–child dyads were assessed in the study. We performed multivariable linear regression analysis to examine the association between PPD and child’s BMI z-score stratified by the child’s age at 1 year and 3 years of age.

Results

The prevalence of PPD at 1 month postpartum (17%) was found to be higher than at 6 months (12%). In multivariable linear regression analysis we observed that children at 3 years who had mothers with PPD at 6 months had, on average, a BMI z-score 0.25 higher than children of mothers who did not have PPD at 6 months (ß coefficient 0.25, 95% CI [0.04 to 0.46], p value 0.02), holding all other covariates constant. Also, initiation of weaning food when child is at six months of age was associated with higher BMI z-score of the child at 3 years after adjusting for all covariates (ß coefficient = 0.18, 95% CI [0.03 to 0.34], p-value < 0.05).

Conclusion

The significant association between PPD at 6 months and child’s BMI z-score at 3 years of age, in conjunction with birth trends and high prevalence of PPD, can add to the body of evidence that there is need for multiple assessment across the first postpartum year to rule out PPD as early screening and early interventions may benefit both maternal health and child development outcomes. These findings can indicate the need for establishing support systems for care-giving activities for mothers with PPD.
Construction of oxidative phosphorylation-related prognostic risk score model in uveal melanoma
Authors: Zhan Zhiyun , Lin Kun , Wang Tingting
Published: May 2024

Background

Uveal melanoma (UVM) is a malignant intraocular tumor in adults. Targeting genes related to oxidative phosphorylation (OXPHOS) may play a role in anti-tumor therapy. However, the clinical significance of oxidative phosphorylation in UVM is unclear.

Method

The 134 OXPHOS-related genes were obtained from the KEGG pathway, the TCGA UVM dataset contained 80 samples, served as the training set, while GSE22138 and GSE39717 was used as the validation set. LASSO regression was carried out to identify OXPHOS-related prognostic genes. The coefficients obtained from Cox multivariate regression analysis were used to calculate a risk score, which facilitated the construction of a prognostic model. Kaplan-Meier survival analysis, logrank test and ROC curve using the time “timeROC” package were conducted. The immune cell frequency in low- and high-risk group was analyzed through Cibersort tool. The specific genomic alterations were analyzed by “maftools” R package. The differential expressed genes between low- or high-risk group were analyzed and performed Gene Ontology (GO) and GSEA. Finally, we verified the function of CYC1 in UVM by gene silencing in vitro.

Results

A total of 9 OXPHOS-related prognostic genes were identified, including NDUFB1, NDUFB8, ATP12A, NDUFA3, CYC1, COX6B1, ATP6V1G2, ATP4B and NDUFB4. The UVM prognostic risk model was constructed based on the 9 OXPHOS-related prognostic genes. The prognosis of patients in the high-risk group was poorer than low-risk group. Besides, the ROC curve demonstrated that the area under the curve of the model for predicting the 1 to 5-year survival rate of UVM patients were all more than 0.88. External validation in GSE22138 and GSE39717 dataset revealed that these 9 genes could also be utilized to evaluate and predict the overall survival of patients with UVM. The risk score levels related to immune cell frequency and specific genomic alterations. The DEGs between the low- and high- risk group were enriched in tumor OXPHOS and immune related pathway. In vitro experiments, CYC1 silencing significantly inhibited UVM cell proliferation and invasion, induced cell apoptosis.

Conclusion

In sum, a prognostic risk score model based on oxidative phosphorylation-related genes in UVM was developed to enhance understanding of the disease. This prognostic risk score model may help to find potential therapeutic targets for UVM patients. CYC1 acts as an oncogene role in UVM.
Practice variation in urine collection methods among pre-toilet trained children with suspected urinary tract infection: a systematic review
Authors: Wilson Lucy M , Tam Clara , Wai Lai Veronica Ka , Ajayi Motunrayo , Lê Mê-Linh , Oketola Banke , Klassen Terry P , Aregbesola Alex
Published: May 2024

Background

Urinary tract infections (UTIs) are a common cause of acute illness among infants and young children. There are numerous methods for collecting urine in children who are not toilet trained. This review examined practice variation in the urine collection methods for diagnosing UTI in non-toilet-trained children.

Methods

A systematic review was completed by searching MEDLINE (Ovid), Embase (Ovid), CENTRAL (Ovid), PsycInfo (Ovid), CINAHL (EBSCO), and JBI (Ovid) from January 1, 2000 until October 9, 2021 and updated on May 24, 2023. Studies were included if they were conducted in an acute care facility, examined pre-toilet trained children, and compared one urine collection method with another for relevant health care outcomes (such as length of stay in an ED, or re-visits or readmissions to the ED) or provider satisfaction. Two independent reviewers screened the identified articles independently, and those included in the final analysis were assessed for quality and bias using the Newcastle-Ottawa Scale.

Results

Overall, 2535 articles were reviewed and 8 studies with a total of 728 children were included in the final analysis. Seven studies investigated the primary outcome of interest, practice variation in urine collection methods to diagnose a UTI. The seven studies that investigated novel methods of urine collection concluded that there were improved health care outcomes compared to conventional methods. Novel methods include emerging methods that are not captured yet captured in clinical practice guidelines including the use of ultrasound guidance to aid existing techniques. Three studies which investigated healthcare provider satisfaction found preference to novel methods of urine collection.

Conclusions

There is significant practice variation in the urine collection methods within and between countries. Further research is needed to better examine practice variation among clinicians and adherence to national organizations and societies guidelines. PROSPERO registration number CRD42021267754.
Increased regional body fat is associated with depressive symptoms: a cross-sectional analysis of NHANES data obtained during 2011–2018
Authors: Zhang GuiMei , Wang Sisi , Ma Ping , Li Shuna , Sun Xizhe , Zhao Yang , Pan Jiyang
Published: May 2024

Aims

The findings from previous epidemiological studies of the association between regional body fat and depressive symptoms have been unclear. We aimed to determine the association between the body fat in different regions and depressive symptoms based on data from the National Health and Nutrition Examination Survey (NHANES).

Methods

This study included 3393 participants aged ≥ 20 years from the NHANES performed during 2011–2018. Depressive symptoms were assessed using the Patient Health Questionnaire-9. The fat mass (FM) was measured in different regions using dual-energy X-ray absorptiometry to determine the total FM, trunk FM, arm FM, and leg FM. The FM index (FMI) was obtained by dividing the FM in kilograms by the square of the body height in meters. Weighted data were calculated in accordance with analytical guidelines. Linear logistic regression models were used to quantify the association between regional FMI and depressive symptoms. Univariate and stratified analyses were also performed.

Results

The participants in this study comprised 2066 males and 1327 females. There were 404 (11.91%) participants with depressive symptoms, who were aged 40.89 ± 11.74 years and had a body mass index of 30.07 ± 7.82 kg/m². A significant association was found between total FMI and depressive symptoms. In the fully adjusted multivariate regression model, a higher total FMI (odds ratio = 2.18, 95% confidence interval [CI] = 1.08–4.39) was related to a higher risk of depressive symptoms, while increased total FMI (β = 1.55, 95% CI = 0.65–2.44, p = 0.001), trunk FMI (β = 0.57, 95% CI = 0.04–1.10, p = 0.036), and arm FMI (β = 0.96, 95% CI = 0.33–1.59, p = 0.004) were significantly associated with PHQ-9 (Patient Health Questionnaire-9) scores, whereas the leg FMI was not (p = 0.102). The weighted association between total FMI and depressive symptoms did not differ significantly between most of the subpopulations (all p values for interaction > 0.05). The risk of having depression was higher in individuals who were non-Hispanic Whites, smokers, drinkers, obese, and had diabetes and thyroid problems (p < 0.05).

Conclusion

These findings suggest that the population with a higher regional FMI is more likely to have depressive symptoms, especially in those who also have an increased total FMI. The association is more pronounced in individuals who are smokers, drinkers, obese, and have diabetes and thyroid problems.
Exclusive breastfeeding among Indonesian working mothers: does early initiation of breastfeeding matter?
Authors: Syahri Isyatun Mardhiyah , Laksono Agung Dwi , Fitria Maya , Rohmah Nikmatur , Masruroh Masruroh , Ipa Mara
Published: May 2024

Background

Early initiation of breastfeeding (EIBF) is a starting point that lays the foundation for breastfeeding and bonding between mother and baby. Meanwhile, working mothers are one of the vulnerable groups for the success of exclusive breastfeeding (EBF). The study analyzed the role of EIBF on EBF among Indonesian working mothers.

Methods

The cross-sectional study examined secondary data from the 2021 Indonesian National Nutritional Status Survey. The study analyzed 4,003 respondents. We examined EBF practice as an outcome variable and EIBF as an exposure variable. We included nine control variables (residence, maternal age, marital, education, prenatal classes, wealth, infant age, sex, and birth weight). All variables were assessed by questionnaire. The study employed a binary logistic regression test in the last stage.

Results

The result showed that the proportion of EBF among working mothers in Indonesia in 2021 was 51.9%. Based on EIBF, Indonesian working mothers with EIBF were 2.053 times more likely than those without to perform EBF (p < 0.001; AOR 2.053; 95% CI 2.028–2.077). Moreover, the study also found control variables related to EBF in Indonesia: residence, maternal age, marital, education, prenatal classes, wealth, infant age, sex, and birth weight.

Conclusion

The study concluded that EIBF was related to EBF. Indonesian working mothers with EIBF were two times more likely than those without to perform EBF. The government needs to release policies that strengthen the occurrence of EIBF in working mothers to increase EBF coverage.
Evaluation of TikTok videos on acute pancreatitis: content quality and reliability analysis
Authors: Mao Tianyang , Zhao Xin , Jiang Kangyi , Yang Jie , Xie Qingyun , Fu Jinqiang , Du Bo , Lei Zehua , Gao Fengwei
Published: May 2024

Background

Acute pancreatitis (AP) is a common acute digestive system disorder, with patients often turning to TikTok for AP-related information. However, the platform’s video quality on AP has not been thoroughly investigated.

Objective

The main purpose of this study is to evaluate the quality of videos about AP on TikTok, and the secondary purpose is to study the related factors of video quality.

Methods

This study involved retrieving AP-related videos from TikTok, determining, and analyzing them based on predefined inclusion and exclusion criteria. Relevant data were extracted and compiled for evaluation. Video quality was scored using the DISCERN instrument and the Health on the Net (HONcode) score, complemented by introducing the Acute Pancreatitis Content Score (APCS). Pearson correlation analysis was used to assess the correlation between video quality scores and user engagement metrics such as likes, comments, favorites, retweets, and video duration.

Results

A total of 111 TikTok videos were included for analysis, and video publishers were composed of physicians (89.18%), news media organizations (13.51%), individual users (5.41%), and medical institutions (0.9%). The majority of videos focused on AP-related educational content (64.87%), followed by physicians’ diagnostic and treatment records (15.32%), and personal experiences (19.81%). The mean scores for DISCERN, HONcode, and APCS were 33.05 ± 7.87, 3.09 ± 0.93, and 1.86 ± 1.30, respectively. The highest video scores were those posted by physicians (35.17 ± 7.02 for DISCERN, 3.31 ± 0.56 for HONcode, and 1.94 ± 1.34 for APCS, respectively). According to the APCS, the main contents focused on etiology (n = 55, 49.5%) and clinical presentations (n = 36, 32.4%), followed by treatment (n = 24, 21.6%), severity (n = 20, 18.0%), prevention (n = 19, 17.1%), pathophysiology (n = 17, 15.3%), definitions (n = 13, 11.7%), examinations (n = 10, 9%), and other related content. There was no correlation between the scores of the three evaluation tools and the number of followers, likes, comments, favorites, and retweets of the video. However, DISCERN (r = 0.309) and APCS (r = 0.407) showed a significant positive correlation with video duration, while HONcode showed no correlation with the duration of the video.

Conclusions

The general quality of TikTok videos related to AP is poor; however, the content posted by medical professionals shows relatively higher quality, predominantly focusing on clinical presentations and etiologies. There is a discernible correlation between video duration and quality ratings, indicating that a combined approach incorporating the guideline can comprehensively evaluate AP-related content on TikTok.
The effect of simulation of sectional human anatomy using ultrasound on students’ learning outcomes and satisfaction in echocardiography education: a pilot randomized controlled trial
Authors: Ding Kewen , Chen Mingjing , Li Ping , Xie Zichuan , Zhang Haorong , Kou Ruixing , Xu Jionghui , Zou Ting , Luo Zhen , Song Haibo
Published: May 2024

Background

Effective teaching methods are needed to improve students’ abilities in hand-eye coordination and understanding of cardiac anatomy in echocardiography education. Simulation devices have emerged as innovative teaching tools and exhibited distinctive advantages due to their ability to provide vivid and visual learning experiences. This study aimed to investigate the effect of simulation of sectional human anatomy using ultrasound on students’ learning outcomes and satisfaction in echocardiography education.

Methods

The study included 18 first-year clinical medical students with no prior echocardiography training. After randomization, they underwent a pre-test to assess basic knowledge. Following this, the students were divided into two groups: traditional teaching (traditional group) and simulation of sectional human anatomy using ultrasound (digital group). Each group received 60 min of instruction. Post-tests were assigned to students at two different time points: immediately after the lecture, and one week later (referred to as post-tests 1, and 2). In addition, anonymous questionnaires were distributed to students after class to investigate their satisfaction with teaching.

Results

Both groups showed significant improvement in their scores on post-test 1 compared to pre-test (traditional group: from 33.1 ± 8.8 to 48.1 ± 13.1, P = 0.034 vs. digital group: from 35.0 ± 6.7 to 58.0 ± 13.2, P = 0.008). However, there were no significant differences between the two groups in several post-test comparisons. Student satisfaction ratings revealed that the digital group experienced significantly greater satisfaction in areas such as subject interest, teaching style, course alignment, and interaction compared to the traditional group. Additionally, 80% of the digital group strongly endorsed the use of simulation of sectional human anatomy using ultrasound for echocardiography teaching, highlighting its effectiveness.

Conclusions

Simulation of sectional human anatomy using ultrasound may improve students’ understanding of echocardiography and satisfaction with the course. Our study provides evidence supporting the use of simulation teaching devices in medical education. Further research is needed to explore the long-term impact of this teaching method on students’ learning outcomes and its integration into the medical curriculum.

Trial registration

http://www.chictr.org.cn (registration number: ChiCTR2300074015, 27/07/2023).
Home care practice behavior and its influencing factors of primary care providers: a multicenter cross-sectional study in Sichuan Province, China
Authors: Zhou Luling , Liu Suzhen , Li Hang
Published: May 2024

Background

Primary care providers play an important role in home health care, and their practice behavior is significant for care quality and patient outcomes. This study aimed to assess the home care practice behavior of Chinese primary care providers and to explore the factors associated with the practice behavior.

Methods

A multicenter cross-sectional design with a convenience sample was used to survey 863 registered primary care providers from 62 primary health care settings in Sichuan Province, China. Descriptive statistics, t-test or ANOVA for one-way analysis, and Pearson’s correlation analyses were used to compare the differences and examine the relationships between participants’ demographics and experience of home care services and practice behavior. Multiple linear regression models were performed to identify salient variables associated with the practice behavior from among demographic and home care experience.

Results

The score of home care practice behavior questionnaire was 97.25 ± 21.05. The average scores for the dimensions of home visit preparation, assessment, medical care behavior and safety practice were 3.70 ± 0.95, 3.76 ± 1.02, 3.66 ± 1.03, and 3.20 ± 0.46, respectively. Home care practice behavior was associated with working years, working experience in general hospitals, work area, home care experience such as client types of home care, service frequency and willingness, explaining 21.5% of the total variance.

Conclusion

Chinese primary care providers had a medium to high level of home care practice behavior but poor implementation of safety practice. The results may provide clues to increased focus and implementation of safety practice, as well as providing targeted measures based on influencing factors.
Discriminating factors of body composition characteristics for academic performance in nursing college students: a cross-sectional study
Authors: Lu Andrew Ke-Ming , Tsai Shi-Yen , Lin Ching-Yi , Hsieh Jeng-Long
Published: May 2024

Background

Poor body composition may affect health status, and better body composition is often associated with better academic performance. Nursing students face heavy academic and practical pressures, and the relationship between body composition and academic performance in this group is not fully understood.

Methods

This cross-sectional observational study used de-identified student data from a university of technology in southern Taiwan to analyze the correlation between body composition characteristics and academic performance using regression models.

Results

A total of 275 nursing college students were divided into four groups according to academic performance. The group with the lowest academic performance had a lower percentage of body fat (P < 0.05) but a higher percentage of muscle mass (P < 0.05) than the other three groups. Academic performance was positively correlated with percentage of body fat (R = 0.16,P < 0.01) and body age (R = 0.41,P < 0.01), but was negatively correlated with percentage of muscle mass (R= − 0.16,P < 0.01). Percentage of body fat, visceral fat area, and body age were significant discriminators of academic performance (P < 0.05).

Conclusions

The relationship between academic performance and body composition among nursing college students is not straightforward. Contrary to our initial hypothesis, students with higher academic performance tended to have a higher percentage of body fat and a lower percentage of muscle mass. Percentage of body fat, visceral fat area, and body age were significant discriminators of academic performance, indicating that body composition should be considered an important factor in nursing education and practice.
Patient experiences and needs in cancer care– results from a nationwide cross-sectional study in Germany
Authors: Ziegler Elâ , Klein Jens , Kofahl Christopher
Published: May 2024

Background

Patient-centredness has become a central quality indicator for oncology care. Elements include shared decision-making, patient navigation and integration of psychosocial care, which impact patient-reported and clinical outcomes. Despite efforts to promote patient-centred care in Germany in recent decades, implementation remains fragmented. Further, research on patient experiences with cancer care and its determinants is limited. Therefore, this study examines which patient- and facility-specific factors are associated with patient-centred quality care delivery.

Methods

A cross-sectional study was conducted among 1,121 cancer patients in acute treatment, rehabilitation, and aftercare for different cancer entities across Germany. A participatory developed questionnaire was used. Outcome measures were the quality of physician-patient interaction and provision of psychosocial care during acute care. Predictors comprised patient-specific characteristics and treatment facility-specific factors. Multiple linear regression and multivariate binary logistic regression analyses were performed. In addition, a content analysis of open-ended comments on the patients’ overall cancer care needs was applied.

Results

Multiple linear regression analysis showed recent diagnosis (β=−0.12, p = < 0.001), being male (β=−0.11, p = 0.003), and having a preference for passive decision-making (β=−0.10, p = 0.001) to be significantly associated with higher interaction quality, but not age, education and health insurance type. An overall low impact of patient characteristics on interaction quality was revealed (adj. R2 = 0.03). Binary logistic regression analysis demonstrated the availability of central contact persons (OR = 3.10, p < 0.001) followed by recent diagnosis (p < 0.001), having breast cancer (p < 0.001) and being female (OR = 1.68, p < 0.05) to significantly predict offering psycho-oncological counselling to patients in acute care facilities. The availability of peer support visiting services (OR = 7.17, p < 0.001) and central contact persons (OR = 1.87, p < 0.001) in the care facility, breast cancer diagnosis (p < 0.001) and a higher level of education (p < 0.05) significantly increased the odds of patients receiving information about peer support in the treatment facility. Despite relatively satisfactory quality of physician-patient interactions in cancer care (M = 3.5 (± 1.1)), many patients expressed that better patient-centred communication and coordinated, comprehensive cancer care are needed.

Conclusion

The findings reflect effective developments and improvements in cancer care and suggest that patients’ social characteristics are less decisive for delivering patient-centred quality care than systemic factors surrounding the care facilities. They can serve to inform oncology care in Germany.