bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnitude of sexual and reproductive health communication between parents and their adolescents: Evidence from Osun State, Nigeria
Authors: Bamidele Olayinka Oluwabusola , Oyeniran Agnes Aderinola , Sabageh Olukemi Adedayo , Asekun-Olarinmoye Esther Olufunmilayo
Published: February 2025

This study evaluated sexual and reproductive health communication (SRHC) between dyads of parents and their in-school adolescents in urban and rural areas of Osun State, Nigeria. A descriptive cross-sectional design was used to determine and compare the prevalence, pattern, level, triggers, and methods of SRHC between 625 parents and their in-school adolescents. Respondents were recruited using the multistage sampling technique, and data was collected using the mixed-method approach. Quantitative data was collected using a semi-structured questionnaire and analysed using chi-square and logistic regression tests, while the qualitative data was collected using a focus group discussion guide and analysed thematically. About 56% of parents (53% rural, 58% urban) and 69% of adolescents (68% rural, 71% urban) reported ever having SRHC. The level of SRHC was 31% for adolescents, with no significant difference by type of residence (36% rural, 33% urban, p=0.324) while for parents it was 59%, with a statistically significant difference by the type of residence (52% rural, 66% urban; p<0.01). A two times higher odds of having a good level of SRHC with their parents was observed among rural female vs. rural male adolescents (OR = 1.9, 95% CI: 1.053 - 3.471, p = 0.033) and among urban early vs. urban late adolescents (OR = 2.2, 95% CI: 1.215 - 4.048, p = 0.009). The odds of having a good level of SRHC were three times higher among mothers (OR: 3.4, 95% CI: 1.409 – 8.422, P < 0.007) in urban areas compared to fathers in the same area. SRHC occurred between parents and adolescents in Osun State but with inherent disparities by location and gender. Interventions are required to improve the depth, frequency, and clarity of SRHC, particularly with topics related to experiencing sex. Parents, especially fathers, should be educated about the significance of SRHC and be provided with the skills to engage in early, effective, and sustained discussion with both male and female adolescents.
A pragmatic pipeline for drug resistance and lineage identification in Mycobacterium tuberculosis using whole genome sequencing
Authors: Elton Linzy , Aydin Alp , Stoker Neil , Rofael Sylvia , Wildner Letícia Muraro , Abdul Jabar Babatunde Pacome Agbo Achimi , Tembo John , Hamid Muzamil Abdel , Claujens Chastel Mfoutou Mapanguy , Canseco Julio Ortiz , Doyle Ronan , Satta Giovanni , O’Grady Justin , Witney Adam , Ntoumi Francine , Zumla Alimuddin , McHugh Timothy D.
Published: February 2025

Delays in accurate diagnosis of drug resistant tuberculosis (DR-TB) can hinder treatment. Whole genome sequencing (WGS) provides more information than standard molecular and phenotypic testing, but commonly used platforms are expensive to implement, and data interpretation requires significant expertise. We aimed to optimise a TB WGS diagnostic pipeline balancing user-friendliness, cost-effectiveness and time to results, whilst ensuring accuracy. Growth conditions, DNA extraction protocols and Oxford Nanopore Technologies (ONT) library preparation kits were compared. ONT was compared with Illumina protocols. Software for basecalling and analysis were evaluated to find the most accurate resistance SNP and lineage predictor. Optimally, a spin-column CTAB DNA extraction method was combined with the RBK110.96 library preparation kit, high accuracy (HAC) basecalling and data analysis using TB-Profiler. Compared with Illumina, the pipeline was concordant for 16/17 (94%) isolates (lineage) and for 17/17 (100%) isolates (resistance SNPs). Our pipeline was 71% (12/17) concordant with phenotypic drug susceptibility test (DST) results. Time-to-diagnosis was around four weeks. This optimised TB sequencing pipeline requires less time and expertise to run and analyse than Illumina, takes less time than phenotypic DSTs and the results are comparable with Illumina. The cost per sample is comparable with other methods. These features make it an important tool for incorporating into routine DR-TB diagnostic pipelines and larger scale drug resistance surveillance in all settings.
Peripheral extremity surgery performed during the Syrian conflict – A scoping review
Authors: Khan Anas , Ammar Usman , Abbara Aula , Hariri Mahmoud , Darwish Ammar , Alawa Jude
Published: February 2025

The protracted Syrian conflict has devastated healthcare infrastructure across Syria with impacts on both the conflict and non-conflict related surgical needs of patients. This review summarises the literature related to peripheral limb surgery performed in Syria between March 2011 to January 2024 to determine the influence of the conflict on surgical capacity and provision. A systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines was performed using six academic and one grey literature database. Studies that included clinical-epidemiological descriptions of procedures in orthopaedic, vascular and plastic surgery were included for quantitative and narrative analysis. The search resulted in 3951 papers, of which 7 met inclusion criteria. Studies varied widely in sample size (range: 25–3835; total: 7749), design, and outcomes. Procedures spanned orthopaedic (1285, 31%), vascular (741, 18%), and plastic surgery (2145, 51%), totalling 4171 cases. Common procedures included wound management (51%), external fixation (26%), and lower limb amputation (15%). There was prevalence of emergency over elective surgery, performed in rudimentary, secret field hospitals by practitioners lacking formal specialist training or aid-workers. Inadequate documentation and incomplete data capture, due to the conflict, hindered the availability of high-quality, comprehensive surgical datasets within Syria. The focus on emergency surgery is a natural consequence of the prioritisation required with conflict-related pathology, however poor resource availability resulted in challenges in providing basic surgical care. Further research is needed to address gaps in evidence regarding the current state of surgery, training needs, and the quality of care provided.
Sustainability of zinc coverage for acute childhood diarrhea in Bangladesh and other low- and middle-income countries: one decade following the SUZY project
Authors: Beam Keith , Hsu Nicole , Kanagaratnam Amandari , Larson Charles , Koehlmoos Tracey
Published: February 2025

Oral zinc is a proven effective treatment for diarrheal illness, and long-term monitoring is key to evaluating the success of efforts to scale up zinc treatment. We examine zinc coverage for diarrheal illness in Bangladesh since the conclusion of the Scaling Up Zinc for Young Children (SUZY) project in 2008 and provide an overview of other countries’ zinc scale-up programs to compare the long-term effectiveness of SUZY. We used data from the Bangladesh Demographic and Health Surveys from 2005–2022 to examine the proportion of children under five receiving zinc treatment for diarrheal illness and evaluate disparities in zinc coverage by urbanicity and wealth quintile. We used a qualitative framework synthesis to compare the SUZY project with national or large-scale zinc scale-up programs in other low- and middle-income countries (Ghana, India, Kenya, Nepal, Nigeria, Uganda). This method for synthesizing qualitative and quantitative data was used to break down components of the SUZY project and other national or large-scale zinc scale-up programs. In Bangladesh, zinc coverage has continued to increase since the conclusion of the SUZY project, disparities in coverage between urban and rural areas and across wealth quintiles have been resolved, and the prevalence of diarrheal illness has decreased from 10·8% in 2007 to 4·8% in 2022. The countries with the highest zinc coverage (Bangladesh, Kenya, Uganda) had national rather than regional scale-up campaigns. Our findings demonstrate the long-term success of the SUZY project and provide insights into best practices for impactful zinc scale-up programs including significant pre-launch implementation research addressing key knowledge gaps and partnering with research organizations. Long-term monitoring of scale-up campaigns is important to determine if these interventions can become socially embedded and self-sustaining, improving health outcomes in the long run.
Investigating the impact of Premolis semirufa caterpillar bristle toxins on human chondrocyte activation and inflammation
Authors: de Lima Cinthya Lais , Pohl Paula C. , Villas-Boas Isadora M. , Pidde Giselle , Tambourgi Denise V.
Published: February 2025

Background

The caterpillar of Premolis semirufa, known as Pararama, is found in the Brazilian Amazon, primarily on rubber trees of the genus Hevea. Pararamosis is an inflammatory disease resulting from accidental contact with the caterpillar’s bristles, leading to acute and chronic symptoms. Chronic exposure can cause significant osteoarticular deformities, similar to those seen in osteoarthritis and rheumatoid arthritis, due to cartilage degradation and synovial inflammation. Currently, there are no specific treatments for Pararamosis, and research on the molecular mechanisms of the caterpillar’s venom and its role in disease pathogenesis is limited. The chronic changes in Pararamosis are thought to be linked to chondrocyte activation and the NF-κB signaling pathway, influenced by the toxic components in the bristles. Understanding these interactions is crucial for developing preventive measures and therapeutic strategies, especially for rubber tappers at risk in the Amazon region.

Methodology/principal findings

This study investigated the effects of P. semirufa bristle extracts on human chondrocytes, focusing on the activation mechanism of the NF-κB transcription factor and the expression of osteoarthritis markers. Cell viability tests indicated that the extracts did not significantly affect chondrocyte survival. However, supernatant analysis revealed a time- and dose-dependent increase in IL-6 and IL-8 levels. Additionally, the expression of NF-κB and its inhibitor, IκB, was assessed, showing higher levels of phosphorylated IκB, which induces its proteosomal degradation, compared to the negative control, while native IκB expression was greater in the control group. Furthermore, the gene expression profile of treated chondrocytes demonstrated modulation in matrix metalloproteinases (MMPs), aggrecan (ACAN), collagen type II (COL2A1), interleukins (IL6 and IL8), and complement system molecules.

Conclusions/significance

These findings highlight the significant impact of P. semirufa bristle extracts on human chondrocyte activation and the inflammatory processes associated with pararamosis.
Prevalence and determinants of poor glycemic control among diabetic chronic kidney disease patients on maintenance hemodialysis in Tanzania
Authors: Mfundo Emmanuel Arthur , Marealle Alphonce Ignace , Nyondo Goodluck G. , Manguzu Martine A. , Buma Deus , Kunambi Peter , Mutagonda Ritah F.
Published: February 2025

Background

Poor glycemic control in diabetic chronic kidney disease (CKD) patients on maintenance hemodialysis is of great challenge, resulting in increased risk of morbidity and mortality. This study aimed to determine the prevalence and determinants of poor glycemic control among diabetic CKD patients on maintenance hemodialysis.

Methodology

A cross-sectional study was conducted in 12 dialysis centers located in four regions of Tanzania from March to June 2023. The study population was diabetic CKD patients above 18 years on maintenance hemodialysis for three months or more. A consecutive sampling technique was used for patient recruitment, and a semi-structured questionnaire was used to collect data. The primary outcome was poor glycemic control were considered when glycated hemoglobin (HbA1c) levels were <  6% or > 8%. Statistical Package for Social Sciences (SPSS) version 23 was used for data analysis. Univariate and multivariable regression models were used to evaluate the determinants of poor glycemic control. A p-value < 0.05 was considered statistically significant.

Results

Out of 233 enrolled patients, the overall prevalence of poor glycemic control was 55.4%, whereby 27.0% had HbA1c < 6% and 28.33% had HbA1c > 8%. A high risk of HbA1c > 8% was observed among patients who were on antidiabetic medication (2.16 (95% CI: 1.06–4.41) p =  0.035) and those attending dialysis sessions less than 3 times a week (1.59 (95% CI: 1.02–2.48) p =  0.040). The lower risk of HbA1c < 6% was observed in patients dialyzed using glucose-containing dialysates than those dialyzed with glucose-free dialysate (0.57 (95% CI 0.36–0.87) p =  0.020).

Conclusion

The high prevalence of poor glycemic control among diabetic CKD patients, as revealed by this study, has significant implications. Patients on antidiabetic medication and those with less than three dialysis sessions per week are at a high risk of HbA1c > 8%. Conversely, patients dialyzed using glucose-free dialysates are at a high risk of HbA1c < 6%.

Glycemic control in diabetic chronic kidney disease (CKD) patients is a great challenge due to altered glucose homeostasis, gluconeogenesis, tubular glucose reabsorption and inaccuracy of glycemic regulation metrics [1]. Furthermore, changed renal pharmacokinetics of antihyperglycemic agents (AHA), uremic milieu, and dialysis therapy also contribute to this challenge [2]. Based on the severe risk of hyperglycemia and hypoglycemia in patients with diabetic end-stage renal disease (ESRD), glycemic control is of paramount importance.
Why are individuals tracing travel trends? A case study of City Walk in Malaysia
Authors: Wang Zhenbin , Zhang Hui , Ramachandran Sridar , Cheng Suiying
Published: February 2025

Studying the emerging travel trends of City Walk is a beneficial activity for young groups. However, there is a lack of research and understanding regarding the motivation and mechanism behind these trends, both in theory and practice. The aim of this study was to investigate the motivation of persons who follow the travel trend of City Walk and evaluate how behavioral intentions are formed by exploring the link between motivation and behavioral intention using the self-determination theory, and social influence theory. Social influence, variety seeking, and self-identification were extrinsic and intrinsic motivations of behavioral intention. A quantitative purposive survey approach was employed, wherein 315 young individuals aged 18 to 40 were recruited to respond. The findings derived from the partial least squares structural equation modeling demonstrate that extrinsic incentives related to social influence, variety seeking, and health care have a considerable impact on behavioral intention, and to some extent influence self-identification. Self-identification has a mediating role in the relationship between health care and behavioral intention. By examining both theoretical and practical aspects, it seeks to provide useful theoretical insights and practical contributions to advance research and industry in the field of rural tourism.
The impact of Duration of Untreated Psychosis on functioning and quality of life over one year of Coordinated Specialty Care (CSC)
Authors: Hazan Hadar , Tayfur Sümeyra N. , Zhou Bin , Li Fangyong , Gibbs-Dean Toni , Karmani Sneha , Kline Emily , Ferrara Maria , Corbera Silvia , Riley Sarah , Yoviene Sykes Laura A. , Tek Cenk , Keshavan Matcheri S. , Srihari Vinod H.
Published: February 2025

Background

This study examined the relationship between the Duration of Untreated Psychosis (DUP) and functional outcomes at baseline, 6 months, and 12 months after admission to Coordinated Specialty Care (CSC).

Methods

A total of 246 participants from two U.S. public-sector CSC programs were categorized into Low and High DUP groups using two criteria: (i) a median split of the DUP distribution and (ii) the World Health Organization (WHO) aspirational standard of 3 months. Changes in global functioning (GAF), social functioning (GF: Social), and occupational functioning (GF: Role), symptom severity (PANSS), and quality of life (QoL) were assessed using a Linear Mixed Model Repeated Measures (MMRM) analysis across the three time points. A Generalized Linear Model (GLM) with a logit link function was applied to analyze binary outcomes, specifically the status of being Neither in the Labor Force, Education, or Training (NLFET). Both models adjusted for time and site as covariates and used an unstructured variance-covariance matrix to account for within-subject correlations in repeated measures. The difference-in-differences method was employed to estimate the impact of DUP on outcomes over time, with results reported as least square means for continuous outcomes, odds ratios for binary outcomes, and 95% confidence intervals (CI) for both Low and High DUP groups.

Results

No significant differences were observed between the Low and High DUP groups at baseline. By 6 months, participants in the Low DUP group (DUP < 3 months) exhibited significantly greater improvements (reduction) in NLFET status (3-month OR = 3.25, p = 0.03; median split OR = 2.25, p = 0.03) and global functioning, GF: Role, and GF: Social. By 12 months, the Low DUP group continued to show significantly greater NLFET status improvement (3-month OR = 3.59, p = 0.03; median split OR = 3.40, p = 0.0032). Improvements in global functioning were sustained at 12 months, while social and occupational functioning gains were not. No significant differences were observed between groups for quality of life or symptom severity over time.

Conclusion

Shorter DUP is linked to more rapid functional recovery within the first year after CSC admission.
Blueprint for progress: Understanding the driving forces of BIM adoption in Kingdom of Saudi Arabia (KSA) construction industry
Authors: Iqbal Muzaffar , Ullah Irfan , Abdou Heba , Alzara Majed , Yosri Ahmed M.
Published: February 2025

Building information modeling (BIM) as a virtual and digital mode of representing construction activities gained significant attention and facilitated construction projects. Nevertheless, many driving forces (DFs) trigger the adoption of BIM. Different kinds of studies have been conducted regarding the DFs of BIM adoption in developed countries. However, few studies have classified the adoption of DFs of BIM technology in developing countries such as the Kingdom of Saudi Arabia (KSA). A range of previous literature identified these DFs in a different context, but there is a need to answer two main questions. First, what DFs could influence BIM adoption in the construction sector of (KSA); second, what could be the possible framework to prioritize these DFs. Therefore, Fuzzy Delphi Methodology (FDM), Interpretive structural modeling (ISM), and MICMAC were applied to answer these questions. Study results highlight that ’Reduced cycle time of the design process’ and ’Efficient construction planning and management’, are the main DFs to BIM adoption in the construction sector of (KSA). This study is the first to employ a hybrid FDM, ISM, and MICMAC approach to evaluate BIM implementation DFs in the KSA context. This study informs policymakers and industry practitioners in (KSA) to develop targeted strategies for effective BIM adoption. This study enhances collaboration and communication among construction industry stakeholders by understanding the significant DFs and their interrelationships.
Patient perceived weight stigma and patient-centered language use preferences: A cross-sectional mixed methods analysis conducted in a large academic medical center
Authors: Kane Ryan M. , Williams Selvi B. , Reynolds Kimberly , Kincanon Abby , Hager Marcy R. , McDougall Craig , Purnell Jonathan Q. , Carney Patricia A.
Published: February 2025

Background

Due to the rising prevalence of obesity and its impact on healthcare, patient-specific context is needed to optimize weight management with an emphasis on reducing health care-associated weight stigma. Our survey aimed to explore institution-specific patient experiences of weight stigma and preferences for patient-centered language use regarding weight management care.

Methods

This cross-sectional analysis adopted a concurrent mixed methods design with a sample of individuals who opted in to complete patient experience surveys after receiving care at a large academic medical center in the United States (U.S.). Categorical and continuous variables were assessed using Chi-squared and analysis of variance. We used classical content analysis to qualitatively analyze free-text data for thematic coding.

Results

After a 1-week survey fielding period, 3,219 of 16,758 patients completed the survey, yielding a response rate of (19.2%) with 2,816 having available electronic health record body mass index (BMI) data. Patients were comfortable discussing weight with their primary care providers but showed variation in the preferred approach and terms. Female patients with higher BMIs reported higher rates of delayed and canceled care due to prior weight stigma (25.6% and 12.2% for patients with class 3 obesity), and preferred a slower, gentler, and less direct approach with term preferences for “healthy eating plan” and against “obesity.” Qualitative analysis yielded 27 themes grouped into three domains: Emotional Hinderances, Perceptual Hinderances, and Perceived Helpfulness.

Conclusions

Findings from our large single institution cohort expand on the existing weight stigma literature by identifying patient language preferences and healthcare experiences according to patient weight class and sex. Given the potential impact of understanding context-specific patient language use preferences to reduce weight stigma, we recommend other healthcare systems use a similar process to address weight stigma as part of a coordinated health system improvement initiative to enhance patient-centered weight management care.
Type 1 diabetes incidence during COVID-19 pandemic has not been influenced by COVID-19 vaccination in northern Italy region, Lombardy
Authors: Mameli Chiara , Valsecchi Camilla , Cereda Danilo , Scarioni Simona , Barcellini Lucia , Boriello Catia , Bonfanti Riccardo , Brambilla Ilaria , Calcaterra Valeria , Calzi Elena , Cardani Roberta , Cogliardi Anna , Felappi Barbara , Florini Giorgia , Frontino Giulio , Guerraggio Lucia Paola , Hajro Adelina , Macedoni Maddalena , Macellaro Patrizia , Petitti Agnese , Pistone Carmelo , Provero Cristina , Radaelli Silvia , Redaelli Francesca Chiara , Rigamonti Andrea , Scaramuzza Andrea , Sordelli Silvia , Spiri Daniele , Pelliccia Ciretta , Zampolli Maria , Zuccotti Gian Vincenzo
Published: February 2025

Objective

To describe the trends of type 1 diabetes(T1D) incidence in 0–17-year-olds over the years 2020–2023, and the COVID-19 vaccination uptake in Lombardy region.

Methods

Data about children and adolescents aged 0–17 years who received a diagnosis of T1D from 2020 to 2023 were extracted from the public computerized registry of the healthcare system of the Lombardy Region (Italy). After calculating the annual T1D incidence, the incidence in 2020, prior to the availability of vaccination, was compared to subsequent years. A separate analysis was conducted for the 12–17 age group, the first to receive vaccination.

Results

One thousand two hundred seventy-three T1D onsets were recorded. The distribution of T1D showed no significant annual variation by sex (p-trend = 0.338), mean age (9 years, p = 0.537) and age distribution (p-trend = 0.563). T1D incidence [95% CI/100.000] did not significantly change comparing 2020 [18.94/100.000 (CI 16.88–21.18)] with 2021 [21.82/100.000 (CI 18.90–23.44)], 2022 [20.77/100.000 (CI 18.59–23.13)] and 2023 [19.68/100.000 (CI 16.61–20.94)]. No differences in incidence were observed in the 12–17 age group during 2021–2023 when COVID-19 vaccination was available when compared to 2020 (p-wald > 0.05). The COVID-19 vaccination coverage was lower in children with diabetes onset compared to the same-age general population (38 vs 42%).

Conclusions

The incidence of T1D in children remained stable during the COVID-19 pandemic, regardless of the uptake of the vaccination.
Talent identification of 12-year old male Australian rules footballers: Physical advantages and prognosis for junior and senior national-level selection
Authors: Larkin Paul , Wijekulasuriya Gyan , Greer Sam
Published: February 2025

Talent identification focuses on the ability to identify and select young athletes who show potential for future sporting success. The aim of this study was to compare the anthropometry and physical performance of male youth Australian Football players selected and not selected into a high performance sports academy program. Its secondary aim was to determine whether selection into a talent development environment at 12 years old affects the odds of selection into subsequent junior national level representative and senior professional Australian Football programs. 168 youth males (11.7 ± 0.4 years) who nominated for the selection process to attend a specialised high school sports academy completed a series of physical and anthropometric assessments. The data collection period occurred over seven years (2013–2019), with a prognostic period between one to ten years. Results found selected 12 years olds were taller and had greater lower body power, speed and aerobic fitness than non-selected athletes. A combination of height, aerobic fitness, and lower body power best distinguished between selected and non-selected players. This discriminant analysis had high accuracy and greater sensitivity than specificity. Further, athletes selected into the talent development environment had a much greater likelihood of being selected into junior state/national (54-fold) and senior professional (5-fold) teams than non-selected athletes. Overall, the findings demonstrate some support for the prognostic ability of selection into a talent development program at 12 years old to predict later selection in the talent pathway. These findings support the role of talent development programs in the development of male Australian footballers.
Cross-cultural adaptation and multicentric validation of the Italian version of the Simplified Evaluation of CONsciousness Disorders (SECONDs)
Authors: Hakiki Bahia , Pancani Silvia , De Nisco Agnese , Romoli Anna Maria , Draghi Francesca , Maccanti Daniela , Estraneo Anna , Magliacano Alfonso , Spinola Marcella , Fasano Cinzia , Leonardi Matilde , Cacciatore Martina , Magnani Francesca Giulia , Sattin Davide , Ippoliti Camilla , Barbadoro Filippo , Grippo Antonello , Macchi Claudio , Martial Charlotte , Gosseries Olivia , Cecchi Francesca
Published: February 2025

Introduction

The Coma Recovery Scale-Revised (CRS-R) is the recommended tool to assess consciousness in patients with prolonged Disorders of Consciousness (pDoC). However, the time needed to administer it may limit its use. A shorter tool has been validated: the Simplified Evaluation of CONsciousness Disorders (SECONDs). This multicentre study aimed to develop and validate a cross-cultural adaptation of the SECONDs into Italian.

Methods

An interdisciplinary expert team, from both Fondazione Don Carlo Gnocchi and Istituto Neurologico Carlo Besta, led the translation processes. Independent certified translators were also involved in a blinded modality. Patients diagnosed with Unresponsive Wakefulness Syndrome (UWS) or Minimally Conscious State (MCS) admitted to 3 Italian rehabilitation units were enrolled. The CRS-R and SECONDs were administered in 5 sessions over two weeks by 3 blinded examiners at each center (3 times, with 2 sessions conducted by the same examiner). Weighted Fleiss’ kappa and Spearman correlation coefficients were used to assess intrarater and interrater reliability and concurrent validity.

Results

Sixty adults with pDoC were assessed: 23 women; median age: 64 years; 14 trauma, median post-onset time: 2 months. Intrarater and interrater reliability showed almost perfect agreement (kappa coefficients 0.968 and 0.935, respectively; p<0.001). The comparison of CRS-R vs. SECONDs on the same day or the best out of 5 SECONDs/CRS-R led to a substantial to almost perfect agreement both for the total score of the CRS-R and the SECONDs’ Additional Index (ρ = 0.772–1.000; p<0.001) and for the consciousness diagnosis (k = 0.784–0.935; p<0.001). The disagreement rate between the overall best diagnosis of the SECONDs and the best CRS-R diagnosis was 6.7%.

Conclusion

The Italian version of the SECONDs has been cross-culturally adapted to serve as a shorter assessment tool for the diagnosis of pDoC. Our study shows its excellent reliability and concurrent validity when compared to the CRS-R.
On the hedge and safe-haven abilities of bitcoin and gold against blue economy and green finance assets during global crises: Evidence from the DCC, ADCC and GO-GARCH models
Authors: Manzli Yasmine Snene , Fakhfekh Mohamed , Béjaoui Azza , Alnafisah Hind , Jeribi Ahmed
Published: February 2025

This paper investigates the diversification, hedging, and safe-haven capabilities of Bitcoin and gold against blue economy and green finance assets using three different MGARCH models (DCC, ADCC, and GO-GARCH) during adverse events such as the COVID-19 health crisis and the 2022 Russia-Ukraine conflict. Blue economy assets, which refer to sectors that sustainably utilize ocean resources, are a key focus alongside green finance assets. The findings reveal that during crises, Bitcoin demonstrates robust safe-haven characteristics, particularly against blue economy assets like BJLE and OCEN. Conversely, gold exhibits pronounced safe-haven properties against specific blue economy and green finance assets such as BJLE and FAN. The GO-GARCH model highlights gold’s strong diversification and safe-haven roles, especially against BJLE. Bitcoin, on the other hand, is more effective as a diversifier for PIO. Moreover, the GO-GARCH model consistently outperforms the DCC and ADCC models in terms of hedging effectiveness, showing that gold is the preferred hedging instrument for GNR and TAN, while Bitcoin is more effective for other blue and green assets. The results underscore the distinct roles of Bitcoin and gold in portfolio management strategies, offering insights for investors navigating market uncertainties in the context of sustainable investments.
Breastfeeding self-efficacy status and associated factors among postpartum mothers at Hadiya Zone public hospitals, Southern Ethiopia
Authors: Nigussiee Lemlem , Demeke Tigist , Bagilkar Vinod , Firetsidk Yemisrach , Abageda Mulatu , Belachew Tefera
Published: February 2025

Background

Breastfeeding is a crucial health-promoting behavior that has several positive effects on the health of both mothers and newborns. Breastfeeding self-efficacy (BFSE) status is an important factor that is positively related to breastfeeding, as it influences a woman’s decision to breastfeed or not. Therefore, the objective of this study is to assess the BFSE status and its associated factors among postpartum mothers at public hospitals in the Hadiya Zone.

Method

A cross-sectional study design was conducted from August 1–30, 2022, at public hospitals in the Hadiya Zone, southern Ethiopia. Data were collected from 416 participants using a pretested, structured questionnaire. Study participants were selected using a systematic random sampling technique from four public hospitals. The data were entered into Epi Data version 3.1 and analyzed using the SPSS version 24. Bivariable analysis was conducted initially, and variables with p values ≤ 0.25 were entered into multivariable logistic regression. Statistical significance was declared at a p value ≤ 0.05.

Results

The results of this study showed that 48% had a high level of BFSE. On multivariable logistic regression analysis, the variables age ≥ 35 years old [AOR = 3.596; 95% CI (1.564, 8.26)], age 20 to 34 [AOR = 2.352; 95% CI (1.2275, 4.506)], spontaneous vaginal delivery [AOR = 2.755; 95% CI (1.636, 5.566)], breastfeeding experience [AOR =1.845; 95% CI (1.028, 3.3)], more than secondary educational status [AOR = 6.856; 95% CI (2.670–17.603)], and intended pregnancy [AOR = 4.156; 95% CI (2.239, 7.714)] were significantly associated with high breastfeeding self-efficacy status.

Conclusion

The study findings suggest that mothers attending postpartum care at Hadiya Zone Hospital have a low status of breastfeeding self-efficacy. Therefore, efforts should be made to enhance mothers’ breastfeeding self-efficacy status before they are discharged from the hospital.
Modelling protein-protein interactions for the design of vaccine chimeric antigens with protective epitopes
Authors: Contreras Marinela , Rafael Marta , Sobrino Isidro , Almazán Consuelo , Pastor Comín Juan J. , Valdés James J. , Prudencio Carlos Roberto , de Lima Neto Daniel Ferreira , Borin Veniamin A. , Agarwal Pratul K. , Kasaija Paul D. , Fernández-Melgar Rubén , Rutaisire Justus , de la Fuente José
Published: February 2025

Ticks and tick-borne diseases are a growing burden worldwide and vaccines are effective control interventions. Vaccine formulations with tick antigens such as BM86/BM95 (BM) and Subolesin (SUB) have shown reduction in tick fitness and infestation in immunized hosts. However, antigen combination is a challenging approach to improve vaccine efficacy (E) against multiple tick species. Herein, in silico and in music algorithms were integrated to model BM-SUB protein-protein interactions to apply a quantum vaccinology approach for combining protective epitopes or immunological quantum in the chimeric antigen Q38-95. Cattle immunized with Q38-95 and infested with African blue tick Rhipicephalus decoloratus showed an 82% E similar to BM86 and higher than SUB. The immune mechanisms activated in cattle in response to vaccination with Q38-95 were mediated by anti-BM/SUB antibodies that interfered with BM-SUB interactions and through activation of other innate and adaptive immune pathways. The results support modelling protein-protein interactions affecting E to identify and combine candidate protective epitopes in chimeric antigens.
Where is communication breaking down? Narrative tensions in obesity-in-pregnancy clinical encounters
Authors: Dadouch Rachel , Lalani Sarenna , Windrim Rory , Maxwell Cynthia , Kingdom John , D’Souza Rohan , Parsons Janet
Published: February 2025

There are numerous biomedical and psychosocial challenges associated with obesity in pregnancy that impede communication between healthcare providers (HCPs) and patients. We conducted a narrative study informed by stigma theory to understand specific areas of communication breakdown in obesity-in-pregnancy clinical encounters. Sixteen patients and 19 HCPs participated in in-depth, semi-structured interviews. We explored how participants positioned obesity-in-pregnancy clinical encounters within their broader narratives. Employing narrative analysis, we identified five narrative tensions contributing to communication challenges: 1) obesity as a detriment to health versus an acceptable biologic variation; 2) obesity as the result of personal choice versus the result of uncontrollable circumstances; 3) a regular pregnancy versus a high-risk diagnosis; 4) a typical and problem-free clinical encounter versus a tremendously difficult clinical encounter; and 5) talking openly about Body Mass Index (BMI) and related co-morbidities versus sidestepping the topic. How participants positioned themselves relative to prevailing societal discourses regarding obesity in general influenced these tensions. These narrative tensions revealed specific areas where communication is vulnerable to breaking down during the obesity-in-pregnancy clinical encounter. Participants’ (both HCPs and patients) past experiences of clinical encounters–and the meanings they ascribe to them–shape subsequent encounters, and our analysis illuminates the complexities of this interactive space. This research has implications for improving clinical practice and education.
Validity of heart rate measurements in wrist-based monitors across skin tones during exercise
Authors: Hung Stanley Hughwa , Serwa Kelsey , Rosenthal Gillian , Eng Janice J.
Published: February 2025

Purpose

To evaluate the accuracy of a wrist-based heart rate (HR) monitor at different exercise intensities across different skin tones.

Methods

Using a cross-sectional design, we compared HR measures from the wrist-based photoplethysmography Fitbit Charge 5 to the Polar H10 chest strap at rest and during the YMCA Protocol using a recumbent cycle ergometer. Participant were grouped into three skin tone categories: light (Fitzpatrick Scale Skin Types 1+2), medium (Types 3+4), and darker skin tone (Types 5+6). HR measures using the Polar chest strap during the exercise test were categorized as <40%, 40–60%, or >60% HR reserve (HRR). Absolute error in beats per minute (bpm) between the two devices was calculated for each measure. A linear mixed effects model was used to assess interaction effects between skin tone and exercise intensity, with participants as the random effect. Bland-Altman plots were used for visual analyses.

Results

Twenty-five participants [mean (SD): 25.8 (1.9) years old; 64% female] were included with 495 observations of simultaneous Fitbit and Polar HR recordings collected during exercise. During exercise, we observed a statistically significant interaction effect between skin tone and exercise intensity. Compared with light skin tone at <40% HRR, mean error was greater for medium skin tone at >60% HRR [mean error (95%CI): 11.8 (5.6–17.9) bpm, p<0.001] and darker skin tone at 40–60% HRR [7.6 (1.7–13.5) bpm, p = 0.011] and >60% HRR [11.7 (5.3–18.0) bpm, p<0.001].

Conclusion

HR measurement error using a wrist-based device was greater with increasing exercise intensity for people with darker skin tones.
Prevalence and associated factors of diabetic ketoacidosis among patients with diabetes mellitus at the University of Gondar Comprehensive and Specialized Referral Hospital Northwest, Ethiopia
Authors: Birhanu Abebe , Ambachew Sintayehu , Baye Netsanet , Getnet Emiyamrew , Admas Sintayehu , Gebrie Eshet , Worede Abebaw
Published: February 2025

Background

Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetic ketoacidosis is one of the life-threatening complications in diabetic individuals with, high morbidity and mortality globally. However, the data related to the prevalence and associated factors of diabetic ketoacidosis are limited in the study setting.

Objective

To assess the prevalence of diabetic ketoacidosis and its associated factors among diabetic mellitus patients at the University of Gondar Comprehensive Specialized Hospital.

Methods

A hospital-based cross-sectional study was conducted from March 1 to September 30, 2021. A total of 405 diabetic patients aged 20 and above were selected using a systematic random sampling technique. A total of 810 blood and urine samples (each 405) were collected using sterile serum separator tubes and urine collection cups, respectively. Sociodemographic and clinical data was collected using a structured questionnaire. Chemical analysis of urine was done using urine reagent strips to determine urine ketone bodies and PH. BECKMAN COULTER DxC700 AU clinical chemistry analyzer instrument was used to determine electrolytes and metabolites. The data was entered using Epi-Data version 4.6 and transferred to SPSS version 25 for analysis. Bivariable and multivariable logistic regression analyses were used to determine the factors associated with the diabetic ketoacidosis. The results were considered statistically significant if the adjusted odds ratio was reported with a 95% confidence interval and a P-value below 0.05.

Results

The overall prevalence of diabetic ketoacidosis among diabetic patients was 35/405 (8.6%, 95% CI: 6.0–11.0%). Of these cases, 25 (71.4%) had type 1 diabetes mellitus, while 10 (28.6%) had type 2 diabetes mellitus. Statistically significant factors associated with diabetic ketoacidosis included being a young adult aged 20–29 years (AOR = 2.262; 95% CI = 1.090–4.758; P = 0.013), unemployment (AOR = 2.578; 95% CI = 1.457–6.113; P = 0.017), the presence of infection (AOR = 2.819; 95% CI = 1.138–8.428; P = 0.024), and being T1DM (AOR = 3.106; 95% CI = 1.150–7.273; P = 0.003).

Conclusions and recommendations

The prevalence of diabetic ketoacidosis among follow-up diabetes patients in this study was high, particularly among those aged 20–29 years, unemployed, or with infections. Increased vigilance, regular monitoring, timely infection management, and comprehensive diabetes education are essential for early detection and prevention of DKA. Social and financial support for unemployed diabetic patients can further enhance access to care and reduce DKA risk.
The recombinant spike S1 protein induces injury and inflammation in co-cultures of human alveolar epithelial cells and macrophages
Authors: Liu Yanru , Yu Hong , He Jia , Li Jianyin , Peng Denggao
Published: February 2025

The current lack of a straightforward and convenient modeling approach to simulate the onset of acute lung injury (ALI) has impeded fundamental research and hindered the screening of therapeutic drugs in coronavirus disease 2019 (COVID-19). The co-cultured human pulmonary alveolar epithelial cells (HPAEpics) and alveolar macrophages (AMs) were exposed to the complete medium, three concentrations of recombinant spike S1 protein (0.1, 1, and 10 μg/mL), or lipopolysaccharide (LPS) (10 μg/mL). The cells were harvested at 1, 2, and 3 days post-exposure. Lactate dehydrogenase (LDH) release, and IL-6, TNF-ɑ, and malondialdehyde (MDA) production were quantified and compared. Compared to those exposed to medium, co-cultures of HPAEpics and AMs exposed to a concentration of S1 protein at 10 μg/mL demonstrated significantly increased levels of LDH release (22.9% vs. 9.1%, and 25.7%), IL-6 (129 vs. 74, and 110 pg/mg of protein), and TNF-ɑ (75 vs. 51, and 86 pg/mg of protein) production, and similar to those exposed to LPS. However, no statistically significant differences were observed in MDA production. Compared to those harvested at 1 or 2 days post-exposure, co-cultured cells harvested at 3 days post-exposure exhibited increased levels of LDH release (23.4% vs. 14.9%, or 16.7%), IL-6 (127 vs. 81, or 97 pg/mg of protein) and MDA (5.6 vs. 3.2, or 3.8 nmol/mg of protein) production, but exhibited lower TNF-ɑ (58 vs. 79 pg/mg of protein) production than those harvested at 2 days post-exposure. After 3 days of exposure, co-cultures of HPAEpics and AMs showed significantly increased levels of LDH release (25.3% vs. 18.4%), and MDA production (5.5 vs. 4.3 nmol/mg of protein) compared to HPAEpics monocultures, and increased levels of LDH release (25.3% vs. 13.8%), IL-6 (139 vs. 98 pg/mg of protein) and MDA (5.5 vs. 4.7 nmol/mg of protein) production, and decreased TNF-ɑ (59 vs. 95 pg/mg of protein) production compared to AMs monocultures. Conclusions: The exposure to a concentration of S1 protein at 10 μg/mL in co-cultures of HPAEpics and AMs induced significant injury and inflammation three days post-exposure. This methodology for establishing a COVID-19-associated ALI model may have promising potential applications and value.
Discovery of bimodal hepatitis B virus ribonuclease H and capsid assembly inhibitors
Authors: Bradley Daniel P. , Valkner Caleb J. , Li Qilan , Gasonoo Makafui , Meyers Marvin J. , Prifti Georgia-Myrto , Moianos Dimitrios , Zoidis Grigoris , Zlotnick Adam , Tavis John E.
Published: February 2025

Hepatitis B virus (HBV) ribonuclease H (RNaseH) inhibitors are a potent class of antivirals that prevent degradation of the viral pregenomic RNA during reverse transcription and block formation of mature HBV DNAs. Development of HBV RNaseH inhibitors is entering advanced preclinical analyses. To ensure the mechanism of action was fully understood, we defined the effects of RNaseH inhibitors on other steps of HBV replication. Some N-hydroxypyridinedione (HPD) HBV RNaseH inhibitors significantly reduced accumulation of capsids in HBV-replicating cells. A representative HPD 1466, with a 50% effective concentration against HBV replication of 0.25 µM, decreased capsid and core protein accumulation by 50–90% in HepDES19 and HepG2.2.15 cells. Surprisingly, 1466 did not affect pregenomic RNA encapsidation, demonstrating a specific effect on empty capsids. HBV genomic replication was not necessary for 1466’s inhibitory effect as it decreased capsid accumulation in cells transfected with replication-deficient mutants blocking pgRNA encapsidation (Δ-bulge), DNA synthesis (YMHA), and RNaseH (D702A) activities. 1466 also decreased capsid and core protein accumulation in cells transfected with a core protein expression plasmid, indicating that other HBV products are unneeded. 1466 reduced initial capsid assembly rates in biochemical assembly reactions employing purified core protein (Cp149), demonstrating a specific effect on HBV core protein. We conclude that the bimodal HPD HBV RNaseH inhibitor 1466 is the prototypic member of a new class of capsid assembly modulators (CAM) that inhibits capsid assembly rather than accelerating it, as all other CAM classes do. We propose that this class be called CAM-I, for CAM-inhibitor. These results lay the foundation for identifying bimodal HBV antivirals targeting the RNaseH and capsid assembly.
First Patient Dosed in Phase 1 / 2a Trial Evaluating TUB-030 in Advanced Solid Tumors
Authors:   Sunvalley Communication, LLC / ADC Review, Hofland Peter
Published: February 2025

A first patient was dosed in the clinical trial with TUB-030 (see: ADC Drug map), a 5T4-directed antibody-drug conjugate conjugated being developed by Tubulis built with ethynylphosphonamidate conjugation chemistry.
Path Analy sis of variables affecting preservice early childhood teachers' intention to use digital education
Authors:   Center For Educational Research, Kim Jeonghyun
Published: February 2025

Purpose: This study aimed to identify the relationship between the influencing factors on preservice early childhood teachers' digital education practices and find implications for digital education in teacher education institutions. The variables analyzed in this study are digital education satisfaction, digital literacy, perceived ease of use, perceived usefulness, and intention to use digital education.
Methods: For the study, a survey was conducted among 85 early childhood education students who took the digital education class at A University in 2022 and 2023. The questionnaire consisted of 8 questions on digital education satisfaction, 20 questions on digital literacy, 4 questions on perceived usefulness, 3 questions on perceived ease of use, and 3 questions on intention to use digital education. The collected data were analyzed using SPSS for descriptive statistics, correlation analysis, and reliability analysis, and Mplus was utilized to verify the appropriateness of the established paths between the variables.
Results: First, preservice early childhood teachers' digital education satisfaction and digital literacy influenced perceived ease of use. Second, perceived ease of use had a significant effect on perceived usefulness. However, for digital education satisfaction and digital literacy, the effect on perceived usefulness was not significant. Third, perceived ease of use and perceived usefulness influenced the intention to use digital education.
Conclusion: It is necessary to organically link curricula such as liberal arts and majors related to digital literacy to lower the entry barrier for pre-service early childhood teachers to implement digital education, support pre-service early childhood teachers to recognize the usefulness of digital education, and expand field-oriented classes that can be easily transferred to the educational field.