bluuebunny/crossref_metadata_2025 huggingface dataset:
Equity, Empowerment, and Social Justice: Social Entrepreneurship for Formerly Incarcerated Individuals
Authors: Trivedi Chitvan , Ray Sarah M.
Published: January 2024

The high incarceration rate and systemic racism in the United States, along with entrenched social barriers, highlight the need for creative solutions to help formerly incarcerated individuals (FIIs) reintegrate successfully. This paper highlights social entrepreneurial ventures (SEVs) as powerful agents of social change, underscoring the significance of holistic approaches in successful reentry and transformation of FIIs. We delve into the potential of SEVs as catalysts for social justice within the critical HRD (CHRD) framework, examining SEV’s role in advancing learning, challenging power dynamics, empowering marginalized communities, and propelling grassroots-led social change. In doing so, we also emphasize the significance of experiential learning and dialog in cultivating collective knowledge and action within these social movements. We analyze the structural, organizational, and individual factors that demonstrate how HRD and social entrepreneurship complement and broaden modes of engagement. Ultimately, we highlight the promising synergy between SEVs and the CHRD perspective, presenting a transformative approach for both HRD scholars and practitioners and argue that by embracing the values of empowerment, equity, and social justice, HRD can play a pivotal role in fostering more inclusive, equitable, and empowering organizational landscapes.
Justice theory as a framework for policy-making consultation
Authors: Rupp Deborah E. , Pandey Niti , Rothman Dale S.
Published: January 2024

In this paper, we respond to the call by Brockner and Bobocel for leveraging justice research to address critical social issues. Pulling from research within the areas of policy studies and liberal philosophy, we make three major arguments: a) Critical social issues are “wicked problems,” which combine high decision stakes, high diversity of actors, and high uncertainty, and therefore require the simultaneous and coordinated expertise of multiple disciplines for effective intervention; b) to tackle more far-reaching issues such as these requires a broadening of what is considered “just;” and c) those working within the policy realm are aware of and actively applying many of the justice principles outlined by Brockner and Bobocel. We conclude by converting Brockner and Bobocel's evidence-based insights (along with our extensions) into a consultative framework with which policy makers can audit their progress, decisions, and actions. We argue that it is through this sort of application of justice principles that uncertainty can be managed, durable agreements can be reached, and positive social change can be achieved.
Proxy use of patient portals on behalf of children: Federally Qualified Health Centers as a case study
Authors: Dang Patrick , Chavez Arlette , Pham Cecilia , Tipton Mary , Woodard LeChauncy D , Adepoju Omolola E
Published: January 2024

Objective

This study examined the proxy use of patient portals for children in a large Federally Qualified Health Centers (FQHC) network in Texas.

Methods

We used de-identified individual-level data of patients, 0–18 years, who had 1+ visits between December 2018 and November 2020. Logistic regression was used to examine patient-, clinic-, and geographic-level factors associated with portal usage by an assumed proxy (i.e. parent or guardian).

Results

The proxy portal usage rate increased from 28% in the pre-pandemic months (November 2018–February 2020) to 34% in the pandemic months (March–Nov 2020). Compared to patients 0–5 years, patients aged 6 to 18 years had lower odds of portal usage (6–10 OR: 0.77, p < 0.001; 11–14 OR: 0.62, p < 0.001; 15–18 OR: 0.51, p < 0.001). Minoritized groups had significantly lower odds of portal usage when compared to their non-Hispanic White counterparts (non-Hispanic Black OR: 0.78, p < 0.001; Hispanic OR 0.63, p < 0.001; Asian OR: 0.69, p < 0.001). Having one chronic condition was associated with portal usage (OR: 1.57, p < 0.001); however, there were no significant differences in portal usage between those with none or multiple chronic conditions. Portal usage also varied by service lines, with obstetrics and gynecology (OR: 1.84, p < 0.001) and behavioral health (OR 1.82, p < 0.001) having the highest odds of usage when compared to pediatrics. Having a telemedicine visit was the strongest predictor of portal usage (OR: 2.30, p < 0.001), while residence in zip codes with poor broadband internet access was associated with lower odds of portal usage (OR: 0.97, p < 0.001).

Conclusion

While others have reported portal usage rates as high as 64% in pediatric settings, our analysis suggests proxy portal usage rates of 30% in pediatric FQHC settings, with race/ethnicity, age group, and chronic disease status being significant drivers of portal non-usage. These findings highlight the need for appropriate and responsive health information technology approaches for vulnerable populations receiving care in low-resource settings.
Community Activities in Primary Care: A Literature Review
Authors: Mosteiro Miguéns Diego Gabriel , Rodríguez Fernández Almudena , Zapata Cachafeiro Maruxa , Vieito Pérez Natalia , Represas Carrera Francisco Jesús , Novío Mallón Silvia
Published: January 2024

Community health promotion activities are a useful tool for a proactive approach to healthy lifestyles. However, the implementation of these types of activities at health centers is not standardized. The aim of this review was to analyse the characteristics of community activities undertaken in the primary care setting and substantiate available evidence on their health impact. We conducted a bibliographic review until November 15th, 2023 in the TRIPDATABASE, MEDLINE, EMBASE, and DIALNET databases. We included original papers on interventions, community activities, and actions and/or social prescriptions which had been implemented in a Primary Care setting, included a group approach in at least one session, and described some type of evaluation of the intervention applied. Studies targeted at professionals and those without involvement of the primary care team were excluded. The search identified 1912 potential studies. We included a total of 30 studies, comprising 11 randomized clinical trials, 14 quasi-experimental studies, 1 cohort study, and 4 qualitative studies. The issues most frequently addressed in community activities were healthy habits, physical activity, cardiovascular diseases and diabetes. Community activities can improve the physical and psychological environment of their participants, as well as their level of knowledge about the issues addressed. That said, however, implementation of these types of interventions is not uniform. The existence of a professional community-activity liaison officer at health centers, who would help integrate the health system with the community sector, could serve to standardize implementation and maximize the health impact of these types of interventions.
Values to Visit a Culturally Significant But Forbidden Land: A Case of North Korea
Authors: Choe Yunseon , Lee Gyehee , Andereck Kathleen
Published: January 2024

This study aims to identify tourists’ values, develop a tool that measures tourist values with regard to visiting culturally significant, but forbidden, destinations, such as North Korea, and segment the relevant market. A composite method of qualitative and quantitative approaches constituted the procedure for the value measurement scale development. Using this scale, market segments were constructed based on the value profile in order to test the differences among the segments with respect to key factors. Application of a mixed method approach indicates four values relevant to visiting North Korea: curiosity/novelty; historical nostalgia/wish for reunification; natural landscape appreciation; and ease of travel. Three value profiles emerged: nostalgia and reunification advocate, middle of the roader, and nature espouser. The findings of this study indicate unique values for tourists to want to visit North Korea and add to existing evidence on alternative motives, addressing the absence of a customized tourists’ value scale, in that it extracted authentic values to visit North Korea by focusing on cultural and historical context. The findings will provide DMOs, developers, and policy-makers with practical guidelines to create useful marketing tools and design targeted promotions and tourism products.
Inclusion of JD-R Theory Perspective to Enhance Employee Engagement
Authors: Faiz Rasool Samma , Almas Tahira , Afzal Farman , MOHELSKA Hana
Published: January 2024

In conformity with the job demands and resources theory, this study provides a comprehensive understanding of the impact of Pakistani hotel employees’ proactive personality and their professional identity on employee engagement and the mediating role of self-efficacy. The study was carried out by utilizing the empirical information collected from 360 hotel employees from different 4-star and 5-star hotels in Pakistan. This study employs structural equation modeling to better assess the employee engagement phenomenon. Research shows that a proactive personality and professional identity positively affects self-efficacy and employee engagement. The findings also confirm that self-efficacy is an important aspect that promotes the relationship between proactive personality and professional identity and employee engagement. In addition, this study shows that managers need to foster employees’ professional practices, improve training delivery, and encourage job flexibility in order to increase their engagement.
Granulomatous Polyangiitis Refractory to Induction With Rituximab in 3 Patients
Authors: Eshak Nouran , Ehikhueme Grace , Ramesh Malvika , Pixley John
Published: January 2024

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides are a group of immune-mediated diseases characterized by inflammation of small vessels, leading to endothelial injury with subsequent tissue damage. Current guidelines recommend induction therapy with rituximab over cyclophosphamide for severe disease activity. In this case series-based review, the authors discuss 3 cases of granulomatosis with polyangiitis (GPA) with proteinase-3 (PR3) disease that deteriorated following induction therapy with rituximab combined with mycophenolate mofetil and high-dose steroids. All 3 patients subsequently required salvage therapy with cyclophosphamide. Our experience suggests there is a temporal window where induction with rituximab is not fully effective, and deterioration or death can ensue. Expert recommendations do not offer a preferential protocol for induction with either rituximab or cyclophosphamide, with some even using a combination of both.
Burden of Caregiving for Young Stroke Survivors in the Community: A Cross-sectional Study
Authors: Aghoram Rajeswari , Priya Done Indira , Narayan Sunil K.
Published: January 2024

Introduction

Caring for young stroke survivors presents challenges for carers. Little is known about the burden experienced by them.

Aim

In this study, we estimated the caregiving burden among carers of young stroke survivors and explored its patterns and determinants.

Methods

One hundred and fifty young stroke survivors (aged <45 years at index stroke) and their caregivers were recruited in this hospital-based cross-sectional study, three or more months from the stroke. We estimated the burden of caregiving using Burden Assessment Schedule-20 (BAS). Cognitive status, physical disability, and neuropsychiatric symptoms were evaluated using standard instruments. We used descriptive statistics and performed multivariate analysis for factors associated with high burden. We used STATA ver. 14.2, Stata Corp, TX, USA.

Results

The median age of caregivers was 37.5 years (IQR 12) and 98 (65.3%) were women. The carers were most often spouses (101; 67.3%). The median total BAS score was 28 (IQR 12). Most carers (127; 84.7%) experienced some burden while 15 (10%; 95%CI: 5.2%–14.8%) reported high burden. The most common domain of burden was relationships with others (105; 70%) and marital relationships (66; 65%). Dementia (OR: 2.55; 95%CI: 1.07–6.07) and the presence of neuropsychiatric symptoms (OR: 7.62 95%CI: 2.94–19.81) were associated with an increased burden of caregiving.

Conclusion

Most caregivers of young stroke survivors experience some burden, with interpersonal relationships being the most common domain. Dementia and neuropsychiatric symptoms are associated with increased burden.
Percutaneous Transcatheter Closure of a Post-device Residual Aorta-pulmonary Window
Authors: R Jyothi Prakash , Murtaza Kamal , V Vasudev
Published: January 2024

Introduction

The aortopulmonary window (APW) is a rare congenital cardiac anomaly in which there is incomplete separation of the pulmonary artery and aorta. Percutaneous transcatheter closure is possible in a specific subset of APWs only, and surgery remains the mainstay of therapy.

Clinical summary

We report a rare case of percutaneous device closure of post-device residual APW in a 32-month-old baby who had residual shunt post the device closure at two months of age.

Discussion

Transcatheter closure of an aortopulmonary window is an effective and safe procedure for specific anatomic defects.
Valuable elements in sludge from eight municipal wastewater treatment plants in relation to their recovery potential
Authors: Valchev Dobril , Ribarova Irina , Borisov Boyan , Radovanov Viden , Lyubomirova Valentina , Kostova Irina , Dimova Galina , Karpuzova Orhideya , Lazarova Svetlana
Published: January 2024

Background

The management of sludge from municipal wastewater treatment plants (WWTPs) is a global issue, but also an opportunity for circular reuse. Recent data show that sludge reuse in agriculture has the highest share of all utilization routes in the EU. Council Directive 86/278/EEC on the spreading of sludge in agriculture, adopted more than 35 years ago, is still relevant, notwithstanding the discussion on the need to update it. Extracting critical, strategic, and precious metals and metalloids from sludge is an alternative for sludge reuse, which offers several benefits, such as avoiding the high environmental and health risks associated with using sludge directly in agriculture. Additionally, it allows for the recovery of metals, including those listed as Critical Raw Materials by the European Commission. To implement this alternative, it is necessary to first assess the metal content in the sludge and then develop economically and technically viable technologies. In this study, the content of chemical elements in the sludge of eight full-scale WWTPs in Bulgaria is analysed with focus on: (1) assessing the suitability for agricultural application by evaluating the content of macro- and micronutrients and hazardous metals; (2) assessing the possibility of using the sludge as a source of critical and precious metals.

Results

For the main nutrients, the following contents as a percentage of the sludge dry weight (DW) were recorded—2.06% to 6% for N, 1.52% to 2.67% for P and 0.47% to 0.81% for K, which are in line with case studies of successful sludge application in agriculture. Only sludge samples from two WWTPs exceeded the permitted limit for hazardous metals and metalloids. On the other hand, of the 21 metal and metalloid constituents listed in the EU Critical and Strategic Material (CRM) list, at least one of the examined samples has a content above 10 mg/kg for 15 elements. The average contents in mg/kgDW of Au (1.1), Al (19,272.9), Mg (6677.6), Ti (1730.9), Ga (20.9) and As (16.6) measured in the investigated WWTPs are among the highest or second highest reported in other countries.

Conclusions

The results of the study show prospects for optimising and improving the reuse of sewage sludge in Bulgaria. Sewage sludge from most WWTPs has potential for agricultural application due to its high nutrient content. Large amounts of accumulated critical and strategic metals, gold and silver are trapped in Bulgarian sewage sludge, indicating that sewage sludge could be considered an alternative source with high potential for these valuable elements.
Advances in understanding the genetic architecture of antibody response to paratuberculosis in sheep by heritability estimate and LDLA mapping analyses and investigation of candidate regions using sequence-based data
Authors: Usai Mario Graziano , Casu Sara , Sechi Tiziana , Salaris Sotero L. , Miari Sabrina , Mulas Giuliana , Cancedda Maria Giovanna , Ligios Ciriaco , Carta Antonello
Published: January 2024

Background

Paratuberculosis is a contagious and incurable disease that is caused by Mycobacterium avium subsp. paratuberculosis (MAP) with significant negative effects on animal welfare and farm profitability. Based on a large naturally infected flock over 12 years, we analyzed repeated enzyme-linked immunosorbent assay tests (ELISA), OvineSNP50 BeadChip genotypes and whole-genome sequences imputed from 56 influential animals. The main goals were to estimate the genetic parameters of proxy traits for resistance to MAP, identify genomic regions associated with the host’s immune response against MAP and search for candidate genes and causative mutations through association and functional annotation analyses of polymorphisms identified by sequencing.

Results

Two variables were derived from ELISA tests. The first, a binary variable, assessed the infection status of each animal over the entire productive life, while the second considered the level of antibody recorded over time. Very similar results were obtained for both variables. Heritability estimates of about 0.20 were found and a significant region capturing 18% and 13% of the genetic variance was detected on ovine chromosome 20 by linkage disequilibrium and linkage analysis on OvineSNP50 positions. Functional annotation and association analyses on the imputed sequence polymorphisms that were identified in this region were carried out. No significant variants showed a functional effect on the genes that mapped to this region, most of which belong to the major histocompatibility complex class II (MHC II). However, the conditional analysis led to the identification of two significant polymorphisms that can explain the genetic variance associated with the investigated genomic region.

Conclusions

Our results confirm the involvement of the host’s genetics in susceptibility to MAP in sheep and suggest that selective breeding may be an option to limit the infection. The estimated heritability is moderate with a relevant portion being due to a highly significant region on ovine chromosome 20. The results of the combined use of sequence-based data and functional analyses suggest several genes belonging to the MHC II as the most likely candidates, although no mutations in their coding regions showed a significant association. Nevertheless, information from genotypes of two highly significant polymorphisms in the region can enhance the efficiency of selective breeding programs.
Essential genes identification model based on sequence feature map and graph convolutional neural network
Authors: Hu Wenxing , Li Mengshan , Xiao Haiyang , Guan Lixin
Published: January 2024

Background

Essential genes encode functions that play a vital role in the life activities of organisms, encompassing growth, development, immune system functioning, and cell structure maintenance. Conventional experimental techniques for identifying essential genes are resource-intensive and time-consuming, and the accuracy of current machine learning models needs further enhancement. Therefore, it is crucial to develop a robust computational model to accurately predict essential genes.

Results

In this study, we introduce GCNN-SFM, a computational model for identifying essential genes in organisms, based on graph convolutional neural networks (GCNN). GCNN-SFM integrates a graph convolutional layer, a convolutional layer, and a fully connected layer to model and extract features from gene sequences of essential genes. Initially, the gene sequence is transformed into a feature map using coding techniques. Subsequently, a multi-layer GCN is employed to perform graph convolution operations, effectively capturing both local and global features of the gene sequence. Further feature extraction is performed, followed by integrating convolution and fully-connected layers to generate prediction results for essential genes. The gradient descent algorithm is utilized to iteratively update the cross-entropy loss function, thereby enhancing the accuracy of the prediction results. Meanwhile, model parameters are tuned to determine the optimal parameter combination that yields the best prediction performance during training.

Conclusions

Experimental evaluation demonstrates that GCNN-SFM surpasses various advanced essential gene prediction models and achieves an average accuracy of 94.53%. This study presents a novel and effective approach for identifying essential genes, which has significant implications for biology and genomics research.
Mitochondrial point heteroplasmy: insights from deep-sequencing of human replicate samples
Authors: Korolija Marina , Sukser Viktorija , Vlahoviček Kristian
Published: January 2024

Background

Human mitochondrial heteroplasmy is an extensively investigated phenomenon in the context of medical diagnostics, forensic identification and molecular evolution. However, technical limitations of high-throughput sequencing hinder reliable determination of point heteroplasmies (PHPs) with minor allele frequencies (MAFs) within the noise threshold.

Results

To investigate the PHP landscape at an MAF threshold down to 0.1%, we sequenced whole mitochondrial genomes at approximately 7.700x coverage, in multiple technical and biological replicates of longitudinal blood and buccal swab samples from 11 human donors (159 libraries in total). The results obtained by two independent sequencing platforms and bioinformatics pipelines indicate distinctive PHP patterns below and above the 1% MAF cut-off. We found a high inter-individual prevalence of low-level PHPs (MAF < 1%) at polymorphic positions of the mitochondrial DNA control region (CR), their tissue preference, and a tissue-specific minor allele linkage. We also established the position-dependent potential of minor allele expansion in PHPs, and short-term PHP instability in a mitotically active tissue. We demonstrate that the increase in sensitivity of PHP detection to minor allele frequencies below 1% within a robust experimental and analytical pipeline, provides new information with potential applicative value.

Conclusions

Our findings reliably show different mutational loads between tissues at sub-1% allele frequencies, which may serve as an informative medical biomarker of time-dependent, tissue-specific mutational burden, or help discriminate forensically relevant tissues in a single person, close maternal relatives or unrelated individuals of similar phylogenetic background.
Infectious complications following major heart surgery from the day of the surgery to hospital discharge
Authors: Pérez-Granda Maria Jesús , Barrio José María , Cuerpo Gregorio , Valerio Maricela , Muñoz Patricia , Hortal Javier , Pinto Angel González , Bouza Emilio ,   On behalf of the Cardiovascular Infection Study Group, Quintana Begoña , Sánchez Alejandro Garrido , Barranco Mónica , Perez Eduardo Sánchez , Moraga Francisco , López Alba , Bono Patricia , López Ignacio Fernández , Bernal Guillermo Rodríguez , Novoa Enma , Abella Roberto Hugo Rodríguez , Ruiz Manolo , Pedraz Alvaro , Diaz Diego Monzón , Fortuny Ramón , Lega Javier Rodríguez , Gallardo Maria Yolanda Villa , Calvo Laura Diaz , Gallego Sara Solís , Mere Carmen Garcia , Tomás Alvaro Alvarez
Published: January 2024

Background

At some point in their lives, many people will require major heart surgery (MHS). Patients are generally older adults with various risk factors for infection. However, the incidence of infection after MHS is poorly known, as reported infection data are frequently biased due to different factors like the surgical procedure, postoperative timing, and infectious syndromes or etiologic agents, among others. In addition, most patient data are retrospectively obtained.

Purpose and methods

Data were prospectively collected regarding the incidence of all nosocomial infections produced from the time of surgery to hospital discharge in a cohort of 800 adults consecutively undergoing a MHS procedure.

Results

During postoperative hospitalization, 124 of the 800 participants developed one or more infections (15.5%): during their ICU stay in 68 patients (54.8%), during their stay on the general ward post ICU in 50 (40.3%), and during their stay in both wards in 6 (4.8%). The most common infections were pneumonia (related or not to mechanical ventilation), surgical site and bloodstream. As etiological agents, 193 pathogens were isolated: mostly Gram-negative bacilli (54.4%), followed by Gram-positive bacteria (30%), viruses (4.6%) and fungi (1.5%). In our cohort, all-cause mortality was recorded in 33 participants (4.1%) and 9 infection-related deaths (1.1%) were produced. Among subjects who developed infections, overall mortality was 13.7% and in those who did not, this was only 2.3%.

Conclusion

Infection following MHS remains frequent and severe. Our data suggest that hospital-acquired infection studies should consider episodes of infection in all populations during their entire hospital stay and not only those related to specific clinical syndromes or acquired while the patient is in intensive care.
Plasma proenkephalin A and incident chronic kidney disease and albuminuria in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort
Authors: Bullen Alexander L. , Katz Ronit , Poursadrolah Sayna , Short Samuel A. P. , Long D. Leann , Cheung Katharine L. , Sharma Shilpa , Al-Rousan Tala , Fregoso Alma , Schulte Janin , Gutierrez Orlando M. , Shlipak Michael G. , Cushman Mary , Ix Joachim H. , Rifkin Dena E.
Published: January 2024

Background

Plasma proenkephalin A (PENK-A) is a precursor of active enkephalins. Higher blood concentrations have been associated with estimated glomerular filtration rate (eGFR) decline in European populations. Due to the significant disparity in incident chronic kidney disease (CKD) between White and Black people, we evaluated the association of PENK-A with incident CKD and other kidney outcomes among a biracial cohort in the U.S.

Methods

In a nested cohort of 4,400 participants among the REasons for Geographic And Racial Differences in Stroke, we determined the association between baseline PENK-A concentration and incident CKD using the creatinine-cystatin C CKD-EPI 2021 equation without race coefficient, significant eGFR decline, and incident albuminuria between baseline and a follow-up visit 9.4 years later. We tested for race and sex interactions. We used inverse probability sampling weights to account for the sampling design.

Results

At baseline, mean (SD) age was 64 (8) years, 49% were women, and 52% were Black participants. 8.5% developed CKD, 21% experienced ≥ 30% decline in eGFR and 18% developed albuminuria. There was no association between PENK-A and incident CKD and no difference by race or sex. However, higher PENK-A was associated with increased odds of progressive eGFR decline (OR: 1.12; 95% CI 1.00, 1.25). Higher PENK-A concentration was strongly associated with incident albuminuria among patients without diabetes mellitus (OR:

1.29; 95% CI 1.09, 1.53).

Conclusion

While PENK-A was not associated with incident CKD, its associations with progression of CKD and incident albuminuria, among patients without diabetes, suggest that it might be a useful tool in the evaluation of kidney disease among White and Black patients.
Postpartum depression-an exploratory mixed method study for developing an indigenous tool
Authors: Abdullah Maham , Ijaz Shirmeen , Asad Shamaila
Published: January 2024

Background and objective

Motherhood is considered to be a joyous occasion cross-culturally but can bring forth an array of issues including depression. In Asia, Pakistan is dangerously high on the prevalence of postpartum depression (PPD) with sporadic results ranging from 28 to 63%, which could be due to the use of non-indigenous tools.

Methods

An exploratory study-mixed method design was implied. During phase I mothers in the postpartum phase (up to 12 months) and experts were interviewed, items were generated, and pilot study was conducted. In second phase exploratory and confirmatory factor analysis was conducted to establish construct validity, convergent and divergent validity was also established.

Results

A pool of 46 items was generated related to postpartum depression, which was reduced to 35 items as per the factor loading of 0.5 in exploratory factor analysis. Psychometric properties of the scale revealed good reliability (Cronbach α = 0.92) and factor structure of the scale. As per exploratory factor analysis five factors were revealed, explaining 58.07% variance, and the model was confirmed by confirmatory factor analysis. The scale showed significant positive correlation with Edinburgh' postpartum depression scale, depression anxiety and stress scale; establishing convergent validity and significant negative correlation with satisfaction with life scale; establishing divergent validity of the scale.

Conclusion and implications for translation

Questionnaire of postpartum depression scale is a reliable and valid tool that can be used to measure postpartum depression in Asian mothers and provide targeted interventions.
Evaluating patient experience to improve care in a specialist antenatal clinic for pregnancy after loss
Authors: Tamber Kajal K , Barron Rebecca , Tomlinson Emma , Heazell Alexander EP
Published: January 2024

In the United Kingdom, roughly 1 in 250 babies are stillborn each year. Most women who experience stillbirth become pregnant again – 80% within a year of loss. Presently, obstetric-led care is recommended; though there is a growing body of evidence to support provision of specialist services. The Rainbow Clinic is a specialist antenatal service providing care for pregnancies after loss incorporating clinical and psychological care. This study aimed to assess patient experience at the Rainbow Clinic and identify areas for clinical improvement. A 13-item questionnaire was distributed to pregnant women who attended the Rainbow Clinics at the Oxford Road and Wythenshawe sites of Saint Mary’s Hospital, Manchester, UK between July 2016 and June 2021. Descriptive statistics and unpaired t-test were used for quantitative data and summative content analysis for qualitative data. Four-hundred and fifty-six women completed the questionnaire. The mean patient experience score per quarter was stable with an average of 21.1 (± 3.0) for the five years, with a maximum attainable score of 25. The COVID-19 pandemic had no effect on patient experience at the Rainbow Clinic (pre-pandemic vs. during-pandemic: mean 21.2 v 21.3; p = 0.75). Free-text responses demonstrated women felt positively about the antenatal care received. Identified areas for improvement included “more awareness of the [Rainbow] sticker” to ensure women with previous loss are identified; increased publicity of the Rainbow Clinic services; developing more clinics at different locations to improve accessibility; and continuing specialist input into intrapartum care. Specialist antenatal care provided by the Rainbow Clinic was rated as of a high standard. Potential future improvements include sticker alterations (or other mechanisms to identify women who have experienced a previous loss) and develop increased awareness of the clinic in other institutions.
Women’s experience of childbirth care in health facilities: a qualitative assessment of respectful maternity care in Afghanistan
Authors: Manalai Partamin , Ansari Nasratullah , Tappis Hannah , Kim Young Mi , Stekelenburg Jelle , van Roosmalen Jos , Currie Sheena
Published: January 2024

Background

Respectful maternity care (RMC) remains a key challenge in Afghanistan, despite progress on improving maternal and newborn health during 2001—2021. A qualitative study was conducted in 2018 to provide evidence on the situation of RMC in health facilities in Afghanistan. The results are useful to inform strategies to provide RMC in Afghanistan in spite of the humanitarian crisis due to Taliban’s takeover in 2021.

Methods

Focus group discussions were conducted with women (4 groups, 43 women) who had used health facilities for giving birth and with providers (4 groups, 21 providers) who worked in these health facilities. Twenty key informant interviews were conducted with health managers and health policy makers. Motivators for, deterrents from using, awareness about and experiences of maternity care in health facilities were explored.

Results

Women gave birth in facilities for availability of maternity care and skilled providers, while various verbal and physical forms of mistreatment were identified as deterrents from facility use by women, providers and key informants. Low awareness, lack of resources and excessive workload were identified among the reasons for violation of RMC.

Conclusion

Violation of RMC is unacceptable. Awareness of women and providers about the rights of women to respectful maternity care, training of providers on the subject, monitoring of care to prevent mistreatment, and conditioning any future technical and financial assistance to commitments to RMC is recommended.
Identification of CD8+ T-cell exhaustion signatures for prognosis in HBV-related hepatocellular carcinoma patients by integrated analysis of single-cell and bulk RNA-sequencing
Authors: Li Jianhao , Chen Han , Bai Lang , Tang Hong
Published: January 2024

Background

HBV infection is the leading risk factor for HCC. HBV infection has been confirmed to be associated with the exhaustion status of CD8+ T cells and immunotherapeutic efficacy in HCC. In this study, we aimed to investigate the prognostic value of the CD8+ T-cell exhaustion signature and immunotherapy response in patients with HBV-related HCC.

Methods

We identified different clusters of HBV-related HCC cells by single-cell RNA sequencing (scRNA-seq) and identified CD8+ T-cell exhaustion-related genes (TERGs) by pseudotime analysis. We conducted differential expression analysis and LASSO Cox regression to detect genes and construct a CD8+ T-cell exhaustion index (TEI). We next combined the TEI with other clinicopathological factors to design a prognostic nomogram for HCC patients. We also analysed the difference in the TEI between the non-responder and responder groups during anti-PD-L1 therapy. In addition, we investigated how HBV induces CD8+ T lymphocyte exhaustion through the inhibition of tyrosine metabolism in HCC using gene set enrichment analysis and RT‒qPCR.

Results

A CD8+ T-cell exhaustion index (TEI) was established with 5 TERGs (EEF1E1, GAGE1, CHORDC1, IKBIP and MAGOH). An AFP level > 500 ng, vascular invasion, histologic grade (G3-G4), advanced TNM stage and poor five-year prognosis were related to a higher TEI score, while HBV infection was related to a lower TEI score. Among those receiving anti-PD-L1 therapy, responders had lower TEIs than non-responders did. The TEI also serves as an independent prognostic factor for HCC, and the nomogram incorporating the TEI, TNM stage, and vascular invasion exhibited excellent predictive value for the prognosis in HCC patients. RT‒qPCR revealed that among the tyrosine metabolism-associated genes, TAT (tyrosine aminotransferase) and HGD (homogentisate 1,2 dioxygenase) were expressed at lower levels in HBV-HCC than in non-HBV HCC.

Conclusion

Generally, we established a novel TEI model by comprehensively analysing the progression of CD8+ T-cell exhaustion, which shows promise for predicting the clinical prognosis and potential immunotherapeutic efficacy in HBV-related HCC patients.
Prognostic value of plasma microRNAs for non-small cell lung cancer based on data mining models
Authors: Yan Mengqing , Kang Wenjun , Liu Xiaohua , Yang Bin , Sun Na , Yang Yongli , Wang Wei
Published: January 2024

Background

As biomarkers, microRNAs (miRNAs) are closely associated with the occurrence, progression, and prognosis of non-small cell lung cancer (NSCLC). However, the prognostic predictive value of miRNAs in NSCLC has rarely been explored. In this study, the value in prognosis prediction of NSCLC was mined based on data mining models using clinical data and plasma miRNAs biomarkers.

Methods

A total of 69 patients were included in this prospective cohort study. After informed consent, they filled out questionnaires and had their peripheral blood collected. The expressions of plasma miRNAs were examined by quantitative polymerase chain reaction (qPCR). The Whitney U test was used to analyze non-normally distributed data. Kaplan-Meier was used to plot the survival curve, the log-rank test was used to compare with the overall survival curve, and the Cox proportional hazards model was used to screen the factors related to the prognosis of lung cancer. Data mining techniques were utilized to predict the prognostic status of patients.

Results

We identified that smoking (HR = 2.406, 95% CI = 1.256–4.611), clinical stage III + IV (HR = 5.389, 95% CI = 2.290-12.684), the high expression group of miR-20a (HR = 4.420, 95% CI = 1.760–11.100), the high expression group of miR-197 (HR = 3.828, 95% CI = 1.778–8.245), the low expression group of miR-145 ( HR = 0.286, 95% CI = 0.116–0.709), and the low expression group of miR-30a (HR = 0.307, 95% CI = 0.133–0.706) was associated with worse prognosis. Among the five data mining models, the decision trees (DT) C5.0 model performs the best, with accuracy and Area Under Curve (AUC) of 93.75% and 0.929 (0.685, 0.997), respectively.

Conclusion

The results showed that the high expression level of miR-20a and miR-197, the low expression level of miR-145 and miR-30a were strongly associated with poorer prognosis in NSCLC patients, and the DT C5.0 model may serve as a novel, accurate, method for predicting prognosis of NSCLC.
Predictors of nonresponse to treatment and low adherence to internet-based cognitive behavioral therapy in depressed/anxious women facing the couple’s fertility problems: a secondary analysis of a randomized control trial
Authors: Shafierizi Shiva , Basirat Zahra , Nasiri-Amiri Fatemeh , Kheirkhah Farzan , Geraili Zahra , Pasha Hajar , Faramarzi Mahbobeh
Published: January 2024

Background

The study aimed to examine the predictors of treatment nonresponse and low adherence to Internet-based cognitive behavioral therapy and face-to-face therapy for treating depression and anxiety in women facing the couple’s fertility problems.

Methods

This is a secondary analysis based on a previous randomized controlled trial including 152 depressed/anxious women facing the couple’s fertility problems. The study defines low adherence as receiving less than 4 sessions (out of 8 sessions). Nonresponse to treatment refers to a < 50% reduction in the anxiety and depression total scores.

Results

A high level of anxiety/depression score before psychotherapy increases the risk of nonresponse to both Internet-based and face-to-face psychotherapies by 1.4 to 2 times in women facing the couple’s fertility problems after the treatment and in the 6-month follow-up. However, 4 factors, including diagnosis of mixed anxiety and depression, low education level, long marriage duration, and infertility caused by mixed female/male factors, reduced the risk of nonresponse to psychotherapies.

Conclusion

Women facing the couple’s fertility problems with high depression and anxiety scores are at risk of poor prognosis in response to psychotherapy. Psychologists and healthcare providers of infertility centers should pay more attention to the timely identification and referral of depressed/anxious patients to psychologists.
Which educational messengers do medical students prefer for receiving healthinformation? Development and psychometrics of using health messengers questionnaire
Authors: Karimian Zahra , Moradi Mehrvash , Zarifsanaiey Nahid , Kashefian-Naeeini Sara
Published: January 2024

Introduction

Individuals vary in their selection of health messengers. This research aimed to construct an instrument to measure the preferences of medical students in selecting health messengers and in the next step to validate the aforementioned questionnaire.

Method

This research is a descriptive survey with an approach to construct a questionnaire. The statistical population included all students studying at Shiraz University of Medical Sciences in March to June 2022 in the academic year 2021-2022. 500 participants were involved in the study. To determine the types of health messengers and review the texts, a group of 15 primary items consisting of the 6 components of academic sources (2-items), formal news sources (2-items), mass media (3-items), internet search (2-items), social networks and messenger applications (4-items), and informal conversation (2-items) were compiled. A 4-point scale was developed the content validity of which was confirmed using CVI and CVR method and the reliability index was calculated to be 0.818. Factor analysis was also used to determine the construct validity and factor loading of each item.

Results

The research covers university students in different medical fields. Using factor analysis, together with KMO = 0.810 and Bartlett's sphericity index P < 0.0001, saturation and the suitability of the test were confirmed. Students' preferences based on factor load were social media (28.92%), official and unofficial health sources(10.76%), academic sources (9.08%), internet search (8.18%), and mass media (7.13%), respectively. Among social media, Telegram (0.85) had the highest factor load followed by Instagram (0.79), and WhatsApp (0.71).

Conclusion

Medical students are always on the move and naturally prioritize mobile-based methods. They prefer messengers that are free from time and space restrictions. The widespread availability of mobile devices and the ability to search for and access information make it easier to test health information. Therefore, in health policy, attention should be paid to the virtual capabilities, especially mobile-based approaches.
School feeding in Ethiopia: a scoping review
Authors: Mideksa Samson , Getachew Tsegaye , Bogale Firmaye , Woldie Ermias , Ararso Desalegn , Samuel Aregash , Girma Meron , Tessema Masresha , Hadis Mamuye
Published: January 2024

Introduction

Undernutrition is a major public health problem in developing countries, especially in Sub-Saharan Africa. Undernourished children are smaller and have low weight. To solve this issue, school feeding (corn-soya blend, vegetable oil) started in 1994 in Ethiopia. Thus, this scoping review aims to map the evidence relating to school feeding programs and their potential role in managing children`s nutrition in Ethiopia.

Methods

This scoping review is informed by the methodological framework of Arksey & O’Malley for scoping reviews and recommendations on the framework by Levac and colleagues. The databases searched included the Education Resources Information Centre, International Initiative for Impact Evaluation, Cochrane Library, MEDLINE, and Google Scholar. To ensure its comprehensive search, grey literature sources were searched. The search was undertaken on 26 April 2023. Studies on school feeding, such as coverage, and studies that evaluate the educational and nutritional impacts of school feeding in Ethiopia, regardless of study designs, were included. Reports (publications) about school feeding without scientific methodology were excluded.

Result

Twenty-seven studies were included in this review. It includes cross-sectional, prospective cohort, laboratory-based analysis, experimental, case study, and qualitative study designs. The school feeding program results were inconclusive, while some indicate a positive effect on body mass index, height, thinness, anemia, weight, dropout rate, class attendance, and enrollment. The others showed that the school feeding program did not affect stunting, thinness, weight, hemoglobin level, enrollment, attendance, dropout rate, and academic achievement. Factors affecting school feeding programs negatively include poor quality food and financial constraints. However, no literature on school feeding program coverage was found.

Conclusion

School feeding programs improved nutritional status, and academic performance, although some studies show any effect. Poor-quality food provisions and financial constraints affect school feeding programs. There are mixed findings, and further research is required to determine the effect of school feeding programs conclusively. To ensure the program's sustainability, it should be supported by a national policy, and budget allocation is needed. In addition, more evidence should be generated to show the coverage of school feeding programs in Ethiopia.
Finding the missing many: improving Tuberculosis care in Kajiado county through active case finding and community approaches
Authors: Morino Gianfranco , Mulongo Caleb Mike , Cattaneo Paolo , De Vita Maria Vittoria , Paone Gabriele , Scarlata Simone , Gobbi Federico , Kinyita Salome , Odhiambo Hillary
Published: January 2024

Background

Tuberculosis related deaths remain a priority globally. Despite advancements in TB care, access to quality care remains inequitable to the disadvantage of those in rural and urban informal settlements. The Awareness, Traditions, and Innovation in combating Tuberculosis (ATI TB) project incorporated active case finding (ACF), use of GeneXpert technology and decentralized services to improve TB care in Kajiado County. This study sought to establish the impact of the project as well as implementation lessons learnt during its tenure in Kajiado County, Kenya.

Methods

This evaluation adopted a mixed-methods approach with retrospective cohort analysis for the quantitative data and qualitative data sought through key informant interviews with 28 purposively sampled respondents. The qualitative data was analyzed thematically using Taguette while quantitative data was analyzed using R Software yielding descriptive statistics and measures of association.

Results

While the males were a minority among the presumptive cases (623; 46%), they were the majority (59.3%) among the confirmed TB cases. 70% of the confirmed cases were aged between 15 and 44 years; with those aged between 25- and 34-years being majority (30% of the cases). Majority of the confirmed cases within the project were from rural Kajiado West (79; 66.9%). Though 61% of the presumptive cases were through ACF, only 7% of these tested positive. Conversely, 13% of the self-referrals tested positive. 53% (66) of the positive cases with valid data were self-referrals while ACF accounted for 47% (58) of the positives.

Conclusion

Continued capacity development among health workers, sustained and targeted sensitization and screening among vulnerable groups, strategic collaborations, alongside increased budgetary prioritization of health and TB care by government and partners, and government investments in Social Determinants of Health can ensure gains in TB care are sustained.