bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comprehensive Metabolite Profile of Green and White Asparagus (Asparagus officinalis L.) and Their Antioxidant Properties in Differing Cultivation Conditions
Authors: Kim Tae Jin , Park Young Jin , Yi Tae Gyu , Seo Woo Duck , Park Nam Il , Kim Jae Kwang
Published: April 2024

Asparagus ( Asparagus officinalis L.) is a food crop with a variety of pharmacological effects that can be classified as green or white, depending on cultivation methods. However, no research has been conducted on the profiles of primary and secondary metabolites in green and white asparagus. Hence, the aim of this study was to comprehensively analyze and understand the metabolic variations associated with the color differences in asparagus under different cultivation conditions. Through extensive profiling of primary and secondary metabolites, we identified 48 hydrophilic compounds, nine policosanols, seven terpenoids, six flavonoids, and one phenolic acid. Multivariate and metabolic pathway analyses revealed notable distinctions between green and white asparagus. Green asparagus contained high levels of flavonoids, policosanols, and primary metabolites (organic and amino acids). In contrast, white asparagus contained high levels of sugars, proline, and terpenoids (tocopherols, phytosterols, and protodioscin). These results suggest that green asparagus has higher energy and amino acid synthesis metabolism for plant development and growth through photosynthesis under light cultivation conditions than white asparagus. In contrast, white asparagus accumulated stress-related metabolites, such as sucrose, proline, and phenylalanine, under dark cultivation conditions. In addition, flavonoid metabolism was activated under light conditions, whereas terpenoid biosynthesis was activated under dark conditions. The DPPH and ABTS scavenging activities of green asparagus were at least twice as high as those of white asparagus. Overall, green asparagus is a good source of nutrients and contains more antioxidants than white asparagus. These findings might be the first report of comprehensive metabolome in asparagus, and they will significantly contribute to understanding the effects of different cultivation conditions on the asparagus metabolome.
Augmented Stress Weight-bearing CT for Evaluation of Subtle Lisfranc Injuries in the Elite Athlete
Authors: Campbell Tanner , Mok Anthony , Wolf Megan R. , Frager Luke , Long Rachel , Wentzel Dylan , Tarakemeh Armin , Morey Tucker , Everist Brian , Vopat Bryan G.
Published: April 2024

Background

Lisfranc injuries refer to a disruption or displacement of the tarsometatarsal joint of the foot. Subtle Lisfranc injuries can go undiagnosed on conventional imaging leading to devastating consequences and poor functional outcomes for elite athletes. Objective. The objective of this case study is to present a novel imaging technique using weight-bearing computed tomography (CT) with enhanced stress to identify subtle, dynamically unstable Lisfranc injuries. We illustrate this with a case presentation of an elite athlete who ultimately required surgical fixation for a subtle Lisfranc injury.

Materials and Methods

To perform an augmented stress weight-bearing CT, the patient was positioned standing, with their feet facing forward, and weight equally distributed. The patient was then coached to symmetrically raise both heels from the scanner platform. This plantarflexion provided augmented stress on the midfoot, allowing for more sensitive imaging of the Lisfranc injury. The weight-bearing CT and augmented stress images undergo 3D reconstruction and postprocessing to render coronal and sagittal images, allowing for comparison of the standard weight-bearing and augmented stress images.

Results

We present the case of a 22-year-old collegiate football lineman sustaining a Lisfranc injury. The injury diagnosis was made by magnetic resonance imaging (MRI) and clinical examination, without evidence of injury on weight-bearing XR or standard weight-bearing CT. With augmented stress CT imaging, the Lisfranc instability was noted, leading to surgical fixation, and return to sport the next season.

Conclusion

We propose this technique for diagnosing subtle, unstable Lisfranc injuries where clinical suspicion persists despite inconclusive imaging, particularly in elite athletes. Further research is needed with larger sample sizes to investigate the sensitivity of this novel imaging technique for the detection of Lisfranc injury.

Levels of Evidence:

Level 4: Case Report
Playing With Ancestors: Writing as an Act of Vulnerable Listening
Authors: Singha Shagun
Published: April 2024

This paper explores the possibilities of engaging in playful interactions with ancestral forces, expanding the boundaries of academic writing. Specifically, it examines the interplay between writing and inquiry, emphasizing play as a means of communion with both human and nonhuman ancestors, fostering vulnerable listening within academic discourse. Departing from conventional productivity-centric writing approaches, the paper advocates for a paradigm wherein writing responds to curiosity, evoking play, and imagination, while also embracing experimentation and learning. This conceptual shift envisions writing as a dynamic companion, extending its engagement beyond human ancestors through a posthuman theoretical perspective. Similar to play, writing emerges from interactive experiences, offering a conduit for establishing profound connections with the external world. Engaging with ancestral figures through playful frameworks necessitates embodied practice, encompassing sensory, emotional, and sociocultural dimensions. The paper employs practices of storytelling, metaphors, and nonlinear narratives in an exploration of three nonhuman ancestors in particular: moths, ladders, and trees.
Mai: Remembering, Forgetting, and the Art of Writing Qualitatively
Authors: Wozolek Boni
Published: April 2024

Using grief as a node of beginning, this paper considers how all qualitative writing is an intra-action through which the process of engaging with one’s memory, remembering, and collective memory co-constitutes subjectivities and agency within and across the writing process. Therefore, this paper argues that through writing qualitatively, both the author, as well as broader sociopolitical norms and values be and become in ways that are worth our attention and intention as researchers and participants in local and less local contexts.
Perspectives on social dialogue
Authors: Hiessl Christina
Published: April 2024

Perspectives on social dialogue.
Perceptions and effectiveness of episodic future thinking as digital micro-interventions based on mobile health technology
Authors: Persson Dan Roland , Bardram Jakob E. , Bækgaard Per
Published: April 2024

Objective

Delay discounting denotes the tendency for humans to favor short-term immediate benefits over long-term future benefits. Episodic future thinking (EFT) is an intervention that addresses this tendency by having a person mentally “pre-experience” a future event to increase the perceived value of future benefits. This study explores the feasibility of using mobile health (mHealth) technology to deliver EFT micro-interventions. Micro-interventions are small, focused interventions aiming to achieve goals while matching users’ often limited willingness or capacity to engage with interventions. We aim to explore whether EFT delivered as digital micro-interventions can reduce delay discounting, the users’ perceptions, and if there are differences between regular EFT and goal-oriented EFT (gEFT), a variant where goals are embedded into future events.

Method

A randomized study was conducted with 208 participants allocated to either gEFT, EFT, or a control group for a 21-day study.

Results

Results indicate intervention groups when combined achieved a significant reduction of [Formula: see text] in delay discounting ([Formula: see text]) compared to the control. When split into gEFT and EFT separately only the reduction of [Formula: see text] in EFT delay discounting was significant ([Formula: see text]). We further explore and discuss thematic user perceptions.

Conclusions

Overall, user perceptions indicate gEFT may be slightly better for use in micro-interventions. However, perceptions also indicate that audio-based EFT micro-interventions were not always preferable to users, with findings suggesting that future EFT micro-interventions should be delivered using different forms of multimedia based on user preference and context and supported by other micro-interventions to maintain interest.
Uplifting and Uncanny Conversations Around Death and Dying: Qualitative Study Among Indian Adolescents and Emerging Adults
Authors: Naik Neha S.
Published: April 2024

This study explores perspectives of adolescents and emerging adults on having conversations around death and dying, if there is a value in discussing death early in life, and to explore the views on likelihood of introducing death education in Indian curriculum. Using constructivist grounded theory of qualitative research, the study inquired the perspectives of adolescents and emerging adults employing semi-structured interviews. All participants showed interest in discussing the topic; they actively participated in sharing their views, something that they heard, and inquiring about cultural practices. In analyzing the interview data, mainly three themes emerged: 1. Understanding death in relation to shadow and spirit stories; 2. Existential view on death and managing grief and anxiety; 3. Social and cultural narratives into death education. This study sets out to address a gap in research among adolescents and emerging adult attitudes and opinions toward death. However, there is a need to understand barriers in normalizing conversations around death and dying in wider communities in India and further research is essential.
Return to Sports and Clinical Results After All-Arthroscopic Biceps Tenodesis Using a 2.7-mm Knotless PEEK Suture Anchor
Authors: Bischofreiter Martin , Gattringer Michael , Gruber Michael S. , Kindermann Harald , Himmelstoss Paul , Ortmaier Reinhold , Mattiassich Georg
Published: April 2024

Background:

The long head of the biceps tendon (LHBT) is a well-known source of pain in the shoulder, especially in active patients.

Purpose:

To evaluate the outcomes and return-to-sports rate after all-arthroscopic suprapectoral tenodesis of the LHBT using a small knotless anchor.

Study Design:

Case series; Level of evidence, 4.

Methods:

In this retrospective study, 27 patients—who underwent all-arthroscopic tenodesis of the LHBT using a 2.7-mm knotless polyether ether ketone anchor—were evaluated. Sports activities, the return-to-sports rate, and other sports-related parameters (eg, pain during sports, level of sports) were examined. Sports-related data, the Constant score with isometric force (at 90° of abduction in the scapular plane), the American Shoulder and Elbow Surgeons (ASES) score, the Simple Shoulder Test (SST) score, the visual analog scale (VAS) score for satisfaction, range of motion, and the presence of a Popeye deformity were assessed at a mean follow-up of 15.3 ± 8.7 months. The data were initially analyzed using descriptive statistics.

Results:

The postoperative ASES, Constant, and SST scores were 81.61, 85.74 and 8.85, respectively. Of the 27 patients, 4 patients (14.8%) showed a Popeye deformity. Preoperatively, 25 patients (92.6%) participated regularly in some type of sports activity. All 25 patients (100.0%) were able to return to sports activities after surgery. 24 (96.0%) returned to the same level preoperatively, with 88.0% (22/25) within 6 months. Patient satisfaction with the outcome was high (VAS score: 2.15 ± 2.78). Neither bicipital groove pain nor cramping was reported. There were no signs of osteolytic bone around the anchor or a fracture of the humeral bone.

Conclusion:

Our clinical results after using a 2.7-mm knotless anchor for LHBT tenodesis as well as the return-to-sports rate were satisfying. Using an anchor this size can lower the risk of cortical bone damage and therefore the risk of fractures of the humeral head while still enabling patients to perform at a high level.
Analysis of the Most Popular Online Ankle Fracture–Related Patient Education Materials
Authors: Arif Haad A. , LeBrun Gavin , Moore Simon T. , Friscia David A.
Published: April 2024

Background:

Given the increasing accessibility of Internet access, it is critical to ensure that the informational material available online for patient education is both accurate and readable to promote a greater degree of health literacy. This study sought to investigate the quality and readability of the most popular online resources for ankle fractures.

Methods:

After conducting a Google search using 6 terms related to ankle fractures, we collected the first 20 nonsponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI) instruments. Quality was evaluated using custom created Ankle Fracture Index (AFI).

Results:

A total of 46 of 120 articles met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 8.4 ± 0.5, 57.5 ± 3.2, and 10.5 ± 0.5, respectively. The average AFI score was 15.4 ± 1.4, corresponding to an “acceptable” quality rating. Almost 70% of articles (n = 32) were written at or below the recommended eighth-grade reading level. Most articles discussed the need for imaging in diagnosis and treatment planning while neglecting to discuss the risks of surgery or potential future operations.

Conclusion:

We found that online patient-facing materials on ankle fractures demonstrated an eighth-grade average reading grade level and an acceptable quality on content analysis. Further work should surround increasing information regarding risk factors, complications for surgery, and long-term recovery while ensuring that readability levels remain below at least the eighth-grade level.
The Course of Recovery From Moderate and Severe COVID-19 and its Sequelae: A Three-month Observational Follow-up Study in Indian Population
Authors: Gupta Deepika , Garg Jony , Palta Sanjeev , Vashista Kshitiz , Dhiman Deepanshu
Published: April 2024

Introduction

Challenges associated with COVID-19 are not only associated with its acute phase but also with its sequelae. Multiple studies have been conducted on long-term follow ups of patients suffering from COVID-19. In a detailed search of the literature, we did not find any long-term follow up study in the Indian population.

Methodology

The present study is an ambi-directional observational follow up study. A total of 83 patients were included in the study and a follow up was conducted at 2, 6 and 12 weeks after recovery from acute phase of moderate to severe COVID-19. The primary objective was to identify symptoms pertaining to respiratory, cardiac, neurological and mental health in post-COVID period. Secondary objectives were to identify patients consistent with a diagnosis of post-COVID syndrome and to assess the difference in the recovery profile between moderate and severe cases.

Results

Significant improvement was observed in fatigue, cough, SpO2, breath-holding time and EuroQL-5D with maximum improvement by 12 weeks of recovery. Patients having longer ICU stays and requiring non-invasive ventilation had a longer persistence of symptoms. Forty-five patients had symptoms persistent even after 12 weeks consistent with a diagnosis of post-COVID syndrome.

Conclusion

We observed 50% of the patients in the cohort had complete resolution of symptoms by six weeks follow up. Therefore, a follow up period of at least six weeks is warranted for all patients suffering from moderate to severe COVID-19, along with continuous screening of patients who tend to develop post-COVID-19 syndrome.
The dialectical matrix of class, gender, race
Authors: Bieler Andreas , Morton Adam David
Published: April 2024

Is gender oppression a structurally necessary feature of capitalism? Is discrimination based on race in-built into the reproduction of racial capitalism? By assessing wider contributions within and between Marxism Feminism and Black Marxism, this paper seeks to address the multiple oppressions of class, patriarchy, and race. Intersectional and dual-systems theorising establishes an analytical differentiation of patriarchy and capitalism, or capitalism and racism, as spheres in an external relation. We argue that this external theorising is at odds with Marx’s dialectics that avoids binary separations in its method of abstraction. As a result, we seek to revitalise dialectically understandings of class, gender, and race through a philosophy of internal relations, as a movement of internally related antagonisms comprising a social totality. Through an excursus on Marx’s conceptualisation of primitive accumulation, we draw on arguments that distinguish the logical and historical presuppositions of capital alongside highlighting elements that capital incorporates, internalises, and transforms as its results. This focus on logical and historical questions in relation to the origins of capital through conditions of primitive accumulation and its ongoing reproduction affirms patriarchal and racial oppressions as living dialectically in internal relation to capital.
Maxillary and Midface Advancement With Rigid External Distraction: A Review and Technical Recommendations for Optimized Halo Placement
Authors: La-Anyane Okensama M. , Rezania Nikki , Harmon Kelly A. , Tragos Christina , Polley John W. , Figueroa Alvaro A.
Published: April 2024

Background: The use of a rigid external distraction (RED) is recognized as a viable treatment option for patients with severe maxillary and midface hypoplasia. However, there is limited research on the technical placement of the RED device and its impact on patient outcomes. This systematic review examined variations in RED placement as reported in published clinical photos from journal articles, discusses its potential connection to distraction outcomes, and provides suggestions for proper placement of the device. Material and Methods: Articles in which RED was utilized and included clinical photos of patients wearing the RED device were systematically reviewed using PRISMA guidelines. Data extraction and RED placement photo assessment were performed, including subjective analysis of the images and objective angular measurement of device placement. Results: Despite the reporting of satisfactory outcomes in 83% of the reviewed articles, 64% of the photos depicted variations to the recommended halo frame placement. Of these photos, the halo frame was angled inferiorly in 73.8% and 45.16% of those studies depicting inferiorly angled halos reported adverse events. The vertical bar placement was angled posteriorly in 45% of the articles, and 44.4% of these articles reported complications. Conclusion: Photos from the literature show a high variability in RED device placement, with varying outcomes and complication rates. When placed optimally, with consideration to technical placement details such as cranial pin placement and distraction vector angles, the RED system should allow predictable maxillary and midface advancements with minimal complications.
Basin effects from 3D simulated ground motions in the Greater Los Angeles region for use in seismic hazard analyses
Authors: Moschetti Morgan P , Thompson Eric M , Withers Kyle
Published: April 2024

We develop basin-depth-scaling models (i.e. “basin terms”) from the long-period ([Formula: see text]) simulated ground motions of the Southern California Earthquake Center (SCEC) CyberShake project for use in seismic hazard analyses at sites within the sedimentary basins of southern California. Basin terms use the Next Generation Attenuation (NGA)-West-2 ground-motion models (GMMs) as reference models and use their functional forms with slight modifications. We investigate the use of two approaches to incorporate the time-averaged shear-wave velocity in the upper 30 m ([Formula: see text]) in these calculations and find that the use of site-specific and uniform [Formula: see text] has minor effects on the resulting basin terms for this data set. By centering the simulated ground motions on the basin terms, we separate the information from the simulations about absolute ground-motion level from information relating to the relative amplifications, such as the differences between shallow- and deep-basin sites. Recent observations from sedimentary basins of southern California indicate that additional amplification effect may persist at relatively shallow basin depths (i.e. the GMM basin terms should have positive values when differential depths, [Formula: see text], are near zero), and we present models for “centered” and “adjusted” basin-depth scaling models that reflect this potential. The simulation-modified GMMs are appropriate for crustal sources and for deep-basin sites ([Formula: see text]) within basins of the Greater Los Angeles region, for the magnitudes and distances defined by each of the reference NGA-West-2 GMMs.
A Retrospective of Monique Aubry’s Contributions
Authors: Aubry Monique , Sergi Viviane
Published: April 2024

This article has three main objectives: (1) to present Monique Aubry’s professional trajectory, (2) to describe her intellectual legacy, and (3) to reveal her craft and work values. The first two sections are narrated by Monique in her own voice. The third part is based on conversations between Monique and Viviane Sergi, her colleague, collaborator, and friend, which took place in May and June 2023, while writing the other parts of this article.
Efficiency dynamics among onion growers in Maharashtra: a comparative analysis of drip irrigation adopters and non-adopters
Authors: Kale Rajiv B. , Gavhane Abhishek D. , Thorat Vishal S. , Gadge S. S. , Wayal Sagar M. , Gaikwad Shivam Y. , Singh Sharadveer , Khandagale Kiran S. , Bhat Rohini , Mahajan Vijay
Published: April 2024

Background

Onions are economically and nutritionally important vegetable crops. Despite advances in technology and acreage, Indian onion growers face challenges in realizing their full productivity potential. This study examines the technical efficiency of onion growers, the factors influencing it, and the constraints faced by those adopting drip irrigation in the Ghod river basin of western Maharashtra. A sample of 480 farmers including those practicing drip irrigation and those not practicing it, was selected from Junnar, Shirur, Parner, and Shrigonda blocks of the basin. The primary data was collected through semi-structured interviews. Analytical tools such as the Cobb-Douglas production function (represents technological relationship between multiple inputs and the resulting output), a single-stage stochastic frontier model, the Tobit model, and descriptive statistics were used to assess the technical efficiency of onion production at the farm level.

Results

According to the maximum likelihood estimates of the stochastic frontier analysis, drip adopters exhibited a mean technical efficiency of 92%, while for non-adopters it was 65%. It indicates that the use of drip irrigation technology is associated with higher technical efficiency. The association of technical efficiency and socio-economic characters of households showed that education, extension contacts, social participation, and use of information sources had a positive influence on technical efficiency, while family size had a negative influence on the drip irrigation adopters. For non-drip adopters, significant positive effects were observed for landholding, extension contact, and information source use. The major constraints faced by drip system adopters included a lack of knowledge about the proper operating techniques for drip systems and the cost of maintenance.

Conclusion

The differences with inputs associated with two irrigation methods showed that the response of inputs to increase onion yield is greater for farmers who use drip irrigation than for farmers who do not, and are a result of the large differences in the technical efficiencies. These inefficiencies and other limitations following the introduction of drip irrigation, such as lack of knowledge about the proper operations, need to be addressed through tailored training for farmers and further interventions.
Outreach work in Belgian primary care practices during COVID-19: results from the cross-sectional PRICOV-19 study
Authors: Vanden Bossche Dorien , Van Poel Esther , Vanden Bussche Pierre , Petré Benoit , Ponsar Cécile , Decat Peter , Willems Sara
Published: April 2024

Background

General practitioners (GPs) have a vital role in reaching out to vulnerable populations during and after the COVID-19 pandemic. Nonetheless, they experience many challenges to fulfill this role. This study aimed to examine associations between practice characteristics, patient population characteristics and the extent of deprivation of practice area on the one hand, and the level of outreach work performed by primary care practices (PCPs) during the COVID-19 pandemic on the other hand.

Methods

Belgian data from the international PRICOV-19 study were analyzed. Data were collected between December 2020 and August 2021 using an online survey in PCPs. Practices were recruited through randomized and convenience sampling. Descriptive statistics and ordinal logistic regression analyses were performed. Four survey questions related to outreach work constitute the outcome variable. The adjusted models included four practice characteristics (practice type, being a teaching practice for GP trainees; the presence of a nurse or a nurse assistant and the presence of a social worker or health promotor), two patient population characteristics (social vulnerability and medical complexity) and an area deprivation index.

Results

Data from 462 respondents were included. First, the factors significantly associated with outreach work in PCPs are the type of PCP (with GPs working in a group performing more outreach work), and the presence of a nurse (assistant), social worker or health promotor. Second, the extent of outreach work done by a PCP is significantly associated with the social vulnerability of the practice’s patient population. This social vulnerability factor, affecting outreach work, differed with the level of medical complexity of the practice’s patient population and with the level of deprivation of the municipality where the practice is situated.

Conclusions

In this study, outreach work in PCPs during the COVID-19 pandemic is facilitated by the group-type cooperation of GPs and by the support of at least one staff member of the disciplines of nursing, social work, or health promotion. These findings suggest that improving the effectiveness of outreach efforts in PCPs requires addressing organizational factors at the practice level. This applies in particular to PCPs having a more socially vulnerable patient population.
Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial
Authors: Hager Anne-Gabrielle Mittaz , Mathieu Nicolas , Carrard Sophie , Bridel Alice , Wapp Christina , Hilfiker Roger
Published: April 2024

Background

Falls have a major impact on individual patients, their relatives, the healthcare system and related costs. Physical exercise programmes that include multiple categories of exercise effectively reduce the rate of falls and risk of falling among older adults.

Methods

This 12-month, assessor-blinded, three-armed multicentre randomised clinical trial was conducted in adults aged ≥ 65 years identified as at risk of falling. Four hundred and five participants were randomly allocated into 3 groups: experimental group (n = 166) with the Test&Exercise partially supervised programme based on empowerment delivered with a tablet, illustrated manual and cards, reference group (n = 158) with the Otago partially supervised programme prescribed by a physiotherapist delivered with an illustrated manual and control group (n = 81) with the Helsana self-administrated programme delivered with cards. Experimental and reference groups received partially supervised programmes with 8 home sessions over 6 months. Control group received a self-administered program with a unique home session. The 3 groups were requested to train independently 3 times a week for 12 months. Primary outcome was the incidence rate ratio of self-reported falls over 12 months. Secondary outcomes were fear of falling, basic functional mobility and balance, quality of life, and exercise adherence.

Results

A total of 141 falls occurred in the experimental group, 199 in the reference group, and 42 in the control group. Incidence rate ratios were 0.74 (95% CI 0.49 to 1.12) for the experimental group and 0.43 (95% CI 0.25 to 0.75) for the control group compared with the reference group. The Short Physical Performance Battery scores improved significantly in the experimental group (95% CI 0.05 to 0.86; P = 0.027) and in the reference group (95% CI 0.06 to 0.86; P = 0.024) compared with the control group.

Conclusion

The self-administered home-based exercise programme showed the lowest fall incidence rate, but also the highest dropout rate of participants at high risk of falling. Both partially supervised programmes resulted in statistically significant improvements in physical performance compared with the self-administered programme.

Trial registration

NCT02926105. ClinicalTrials.gov. Date of registration: 06/10/2016.
Predictors of neonatal mortality among neonates admitted to the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital, Sidama regional state, Ethiopia
Authors: Taye Kefyalew , Kebede Yenew , Tsegaw Desalegn , Ketema Worku
Published: April 2024

Background

Despite promising efforts, substantial deaths occurred during the neonatal period. According to estimates from the World Health Organization (WHO), Ethiopia is among the top 10 nations with the highest number of neonatal deaths in 2020 alone. This staggering amount makes it difficult to achieve the SDG (Sustainable Development Goals) target that calls for all nations to work hard to meet a neonatal mortality rate target of ≤ 12 deaths per 1,000 live births by 2030. We evaluated neonatal mortality and it’s contributing factors among newborns admitted to the Neonatal Intensive Care Unit (NICU) at Hawassa University Comprehensive Specialized Hospital (HUCSH).

Methods

A hospital-based retrospective cross-sectional study on neonates admitted to the NICU from May 2021 to April 2022 was carried out at Hawassa University Comprehensive Specialized Hospital. From the admitted 1044 cases over the study period, 225 babies were sampled using a systematic random sampling procedure. The relationship between variables was determined using bivariate and multivariable analyses, and statistically significant relations were indicated at p-values less than 0.05.

Results

The magnitude of neonatal death was 14.2% (95% CI: 0.099–0.195). The most common causes of neonatal death were prematurity 14 (43.8%), sepsis 9 (28.1%), Perinatal asphyxia 6 (18.8%), and congenital malformations 3 (9.4%). The overall neonatal mortality rate was 28 per 1000 neonate days. Neonates who had birth asphyxia were 7.28 times more probable (AOR = 7.28; 95% CI: 2.367, 9.02) to die. Newborns who encountered infection within the NICU were 8.17 times more likely (AOR = 8.17; 95% CI: 1.84, 36.23) to die.

Conclusion

The prevalence of newborn death is excessively high. The most common causes of mortality identified were prematurity, sepsis, perinatal asphyxia and congenital anomalies. To avert these causes, we demand that antenatal care services be implemented appropriately, delivery care quality be improved, and appropriate neonatal care and treatment be made available.
Psychometric properties of the Arabic versions of the long (27 items) and short (13 items) forms of the interpersonal mindfulness scale (IMS)
Authors: Fekih-Romdhane Feten , Malaeb Diana , Azzi Vanessa , Hallit Rabih , Dabbous Mariam , Sakr Fouad , Obeid Sahar , Hallit Souheil
Published: April 2024

Background

There is a lack of measures and data on interpersonal mindfulness from non-Western cultures, which can hinder advances in our understanding of the construct, its conceptual representation, and its effects on human connection and relationships within different cultural settings. To fill this gap and help spark future research in this area in the Arab world, the current study aimed to examine the psychometric properties of an Arabic translation of the 27-item and the 13-item versions of the interpersonal Mindfulness Scale (IMS) in a sample of Arabic-speaking adolescents from the general population.

Methods

A web-based survey was conducted in a sample of 527 Lebanese community adolescents (Mean age = 15.73 ± 1.81 years; 56% females). The IMS was translated from English into Arabic using the forward-backward translation method. Participants completed the long and short forms of the IMS, as well as the Buss–Perry Aggression Questionnaire-Short Form (BPAQ-SF), and the 5-item Brief Irritability Test.

Results

Confirmatory factor analyses provided support to the four-factor structure of both the 27-item and the 13-item IMS (i.e., Presence, Awareness of Self and Others, Nonjudgmental Acceptance, and Nonreactivity). The original and the short form versions of the IMS yielded excellent internal consistency in our sample, with a Cronbach’s α coefficients of 0.95 and 0.90, and McDonald’s omega coefficients of 0.95 and 0.90, respectively. Multigroup comparisons suggested the factorial invariance of the Arabic 27-item and 13-item IMS between male and female participants at the metric, configural, and scalar levels. Finally, the concurrent validity of both full-length and short form of the IMS appeared to be good and comparable, as attested by patterns of correlations in expected directions with outcome variables (i.e., aggression, anger, hostility, and irritability).

Conclusion

The present findings provide support for the good psychometric qualities of the Arabic translation of the IMS in both long and short forms, suggesting that these scales are suitable for use to measure interpersonal mindfulness in Arabic-speaking youth, at least in Lebanon. We expect that the IMS, in particular its shortest form, will prompt more systematic investigation of interpersonal mindfulness in the Arabic-speaking populations, especially with regard to enhancing healthy communications with others and building effective social relationships.
Genetic association between smoking and DLCO in idiopathic pulmonary fibrosis patients
Authors: Yuan Ziheng , Lei Wanyang , Xing Xiqian , He Xiaohua , Huang Xiaoxian , Wei Li , Lv Yuanyuan , Qiu Shuyi , Yuan Ziyu , Wang Jiyang , Yang Mei
Published: April 2024

Background

Observational studies have shown that smoking is related to the diffusing capacity of the lungs for carbon monoxide (DLCO) in individuals with idiopathic pulmonary fibrosis (IPF). Nevertheless, further investigation is needed to determine the causal effect between these two variables. Therefore, we conducted a study to investigate the causal relationship between smoking and DLCO in IPF patients using two-sample Mendelian randomization (MR) analysis.

Methods

Large-scale genome-wide association study (GWAS) datasets from individuals of European descent were analysed. These datasets included published lifetime smoking index (LSI) data for 462,690 participants and DLCO data for 975 IPF patients. The inverse-variance weighting (IVW) method was the main method used in our analysis. Sensitivity analyses were performed by MR‒Egger regression, Cochran’s Q test, the leave-one-out test and the MR-PRESSO global test.

Results

A genetically predicted increase in LSI was associated with a decrease in DLCO in IPF patients [ORIVW = 0.54; 95% CI 0.32–0.93; P = 0.02].

Conclusions

Our study suggested that smoking is associated with a decrease in DLCO. Patients diagnosed with IPF should adopt an active and healthy lifestyle, especially by quitting smoking, which may be effective at slowing the progression of IPF.
Measuring moral distress in health professionals using the MMD-HP-SPA scale
Authors: Girela-Lopez Eloy , Beltran-Aroca Cristina M. , Boceta-Osuna Jaime , Aguilera-Lopez Dolores , Gomez-Carranza Alejandro , Lopez-Valero Manuel , Romero-Saldaña Manuel
Published: April 2024

Background

Moral distress (MD) is the psychological damage caused when people are forced to witness or carry out actions which go against their fundamental moral values. The main objective was to evaluate the prevalence and predictive factors associated with MD among health professionals during the pandemic and to determine its causes.

Methods

A regional, observational and cross-sectional study in a sample of 566 professionals from the Public Health Service of Andalusia (68.7% female; 66.9% physicians) who completed the MMD-HP-SPA scale to determine the level of MD (0-432 points). Five dimensions were used: i) Health care; ii) Therapeutic obstinacy-futility, iii) Interpersonal relations of the Healthcare Team, iv) External pressure; v) Covering up of medical malpractice.

Results

The mean level of MD was 127.3 (SD=66.7; 95% CI 121.8-132.8), being higher in female (135 vs. 110.3; p<0.01), in nursing professionals (137.8 vs. 122; p<0.01) and in the community setting (136.2 vs. 118.3; p<0.001), with these variables showing statistical significance in the multiple linear regression model (p<0.001; r2=0.052). With similar results, the multiple logistic regression model showed being female was a higher risk factor (OR=2.27; 95% CI 1.5-3.4; p<0.001). 70% of the sources of MD belonged to the dimension "Health Care" and the cause "Having to attend to more patients than I can safely attend to" obtained the highest average value (Mean=9.8; SD=4.9).

Conclusions

Female, nursing professionals, and those from the community setting presented a higher risk of MD. The healthcare model needs to implement an ethical approach to public health issues to alleviate MD among its professionals.
Attitudes of the Portuguese population towards advance directives: an online survey
Authors: Macedo João Carlos , Castro Luísa , Nunes Rui
Published: April 2024

Background

Advance directives (ADs) were implemented in Portugal in 2012. Although more than a decade has passed since Law 25/2012 came into force, Portuguese people have very low levels of adherence. In this context, this study aimed to identify and analyse the attitudes of people aged 18 or older living in Portugal towards ADs and to determine the relationships between sociodemographic variables (gender/marital status/religion/level of education/residence/whether they were a health professional/whether they had already drawn up a living will) and people’s attitudes towards ADs.

Methods

An online cross-sectional analytical study was conducted using a convenience sample. For this purpose, a request (email) that publicized the link to a –form—which included sociodemographic data and the General Public Attitudes Toward Advance Care Directives (GPATACD) scale—was sent to 28 higher education institutions and 30 senior universities, covering all of mainland Portugal and the islands (Azores and Madeira). The data were collected between January and February 2023.

Results

A total of 950 adults from completed the online form. The lower scores (mean 1 and 2) obtained in most responses by applying the GPATACD scale show that the sample of the Portuguese population has a very positive attitude towards ADs. The data showed that women, agnostics/atheists, health professionals and those who had already made a living will had more positive attitudes (p < 0.001) towards ADs. There were no statistically significant differences in the attitudes of the Portuguese population sample towards ADs in relation to marital status, education level, and residence.

Conclusion

The results obtained enable us to confirm that this sample of the Portuguese population has a positive attitude towards ADs. We verify that there are certain fringes of this sample with certain sociodemographic characteristics (women, agnostics/atheists, health professionals and those who had already made a living will) that have a more positive attitude towards ADs. This data could facilitate the implementation and adjustment of relevant measures, particularly in the field of health education and aimed at groups with less favourable attitudes, to increase the effectiveness of voluntary exercise of citizens’ autonomy in end-of-life care planning.
Is it possible to make ‘living’ guidelines? An evaluation of the Australian Living Stroke Guidelines
Authors: Wiles Louise , Hibbert Peter D , Zurynski Yvonne , Smith Carolynn L. , Arnolda Gaston , Ellis Louise A. , Lake Rebecca , Easpaig Brona Nic Giolla , Molloy Charlotte , Middleton Sandy , Braithwaite Jeffrey , Hill Kelvin , Turner Tari
Published: April 2024

Background

Keeping best practice guidelines up-to-date with rapidly emerging research evidence is challenging. ‘Living guidelines’ approaches enable continual incorporation of new research, assisting healthcare professionals to apply the latest evidence to their clinical practice. However, information about how living guidelines are developed, maintained and applied is limited. The Stroke Foundation in Australia was one of the first organisations to apply living guideline development methods for their Living Stroke Guidelines (LSGs), presenting a unique opportunity to evaluate the process and impact of this novel approach.

Methods

A mixed-methods study was conducted to understand the experience of LSGs developers and end-users. We used thematic analysis of one-on-one semi-structured interview and online survey data to determine the feasibility, acceptability, and facilitators and barriers of the LSGs. Website analytics data were also reviewed to understand usage.

Results

Overall, the living guidelines approach was both feasible and acceptable to developers and users. Facilitators to use included collaboration with multidisciplinary clinicians and stroke survivors or carers. Increased workload for developers, workload unpredictability, and limited information sharing, and interoperability of technological platforms were identified as barriers. Users indicated increased trust in the LSGs (69%), likelihood of following the LSGs (66%), and frequency of access (58%), compared with previous static versions. Web analytics data showed individual access by 16,517 users in 2016 rising to 53,154 users in 2020, a threefold increase. There was also a fourfold increase in unique LSG pageviews from 2016 to 2020.

Conclusions

This study, the first evaluation of living guidelines, demonstrates that this approach to stroke guideline development is feasible and acceptable, that these approaches may add value to developers and users, and may increase guideline use. Future evaluations should be embedded along with guideline implementation to capture data prospectively.
Advance directives in the emergency department–a systematic review of the status quo
Authors: Weber Vincent , Hübner Aurelia , Pflock Sandra , Schamberger Lukas , Somasundaram Rajan , Boehm Lennert , Bauer Wolfgang , Diehl-Wiesenecker Eva
Published: April 2024

Background

Providing individualised healthcare in line with patient wishes is a particular challenge for emergency healthcare professionals. Documentation of patient wishes (DPW), e.g. as advance directives, can guide clinicians in making end-of-life decisions that respect the patient’s wishes and autonomy. However, patient centered decisions are hindered by limited availability of DPWs in emergency settings.

Objective

This systematic review aims to congregate present data on recorded rates for DPW existence and availability in the emergency department (ED) as well as contributing factors for these rates.

Methods

We searched MEDLINE, Google Scholar, Embase and Web of Science databases in September 2023. Publications providing primary quantitative data on DPW in the ED were assessed. Publications referring only to a subset of ED patients (other than geriatric) and investigating DPW issued after admission were excluded.

Results

A total of 22 studies from 1996 to 2021 were included in the analysis. Most were from the US (n = 12), followed by Australia (n = 4), Canada (n = 2), South Korea, Germany, the United Kingdom and Switzerland (n = 1 each). In the general adult population presenting to the ED, 19.9–27.8% of patients reported having some form of DPW, but only in 6.8% or less it was available on presentation. In the geriatric population, DPW rates (2.6–79%) as well as their availability (1.1–48.8%) varied widely. The following variables were identified as positive predictors of having DPW, among others: higher age, poorer overall health, as well as sociodemographic factors, such as female gender, having children, being in a relationship, higher level of education or a recent previous presentation to hospital.

Conclusions

Existence and availability of a recorded DPW among ED patients was low in general and even in geriatric populations mostly well below 50%. While we were able to gather data on prevalence and predictors, this was limited by heterogeneous data. We believe further research is needed to explore the quality of DPW and measures to increase both rates of existence and availability of DPW in the ED.
1-Deoxynojirimycin containing Morus alba leaf-based food modulates the gut microbiome and expression of genes related to obesity
Authors: Jaiswal Varun , Lee Mi-Jin , Chun Ju Lan , Park Miey , Lee Hae-Jeung
Published: April 2024

Background

Obesity is a serious disease with an alarmingly high incidence that can lead to other complications in both humans and dogs. Similar to humans, obesity can cause metabolic diseases such as diabetes in dogs. Natural products may be the preferred intervention for metabolic diseases such as obesity. The compound 1-deoxynojirimycin, present in Morus leaves and other sources has antiobesity effects. The possible antiobesity effect of 1-deoxynojirimycin containing Morus alba leaf-based food was studied in healthy companion dogs (n = 46) visiting the veterinary clinic without a history of diseases. Body weight, body condition score (BCS), blood-related parameters, and other vital parameters of the dogs were studied. Whole-transcriptome of blood and gut microbiome analysis was also carried out to investigate the possible mechanisms of action and role of changes in the gut microbiome due to treatment.

Results

After 90 days of treatment, a significant antiobesity effect of the treatment food was observed through the reduction of weight, BCS, and blood-related parameters. A whole-transcriptome study revealed differentially expressed target genes important in obesity and diabetes-related pathways such as MLXIPL, CREB3L1, EGR1, ACTA2, SERPINE1, NOTCH3, and CXCL8. Gut microbiome analysis also revealed a significant difference in alpha and beta-diversity parameters in the treatment group. Similarly, the microbiota known for their health-promoting effects such as Lactobacillus ruminis, and Weissella hellenica were abundant (increased) in the treatment group. The predicted functional pathways related to obesity were also differentially abundant between groups.

Conclusions

1-Deoxynojirimycin-containing treatment food have been shown to significantly improve obesity. The identified genes, pathways, and gut microbiome-related results may be pursued in further studies to develop 1-deoxynojirimycin-based products as candidates against obesity.