bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors related to parents’ adherence to childhood immunization
Authors: Hobani Fatimah , Alhalal Eman
Published: April 2022

Background

Immunizations protect children from deadly infectious diseases. Yet, there is still insufficient understanding of the factors associated with parents’ non-adherence to immunizations in contexts outside of Western countries. The aim of this study is twofold: (a) to investigate non-adherence to immunizations for children aged 6 months to 6 years in Saudi Arabia based on the number of immunizations missing or delayed by more than one month; and (b) to examine the underlying factors that predict the extent of non-adherence based on the Health Belief Model framework.

Methods

A cross-sectional study was carried out in 22 randomly selected primary health care centers. Structured interviews were also conducted to collect data using the modified Health Belief Model questionnaire. Multiple regression analysis was used to assess the predictors of the extent of non-adherence.

Results

Based on data from 220 participants, 51.8% of parents did not adhere with childhood immunizations. There was no significant relationship between parents’ sociodemographic characteristics and the extent of their hesitancy about children’s immunizations. The linear combination of perception of infectious disease severity, perception of their children’s susceptibility, perception of immunization benefits, perception of fewer barriers to obtaining immunizations, cues to action related to immunizations, and self-efficacy predicted the extent of non-adherence to immunizations (F (11.220) = 2.595,p < 0.001) and explained 12% of its variance. Yet, only perceived children’s susceptibility, perceived barriers, and self-efficacy independently predicted parents’ non-adherence.

Conclusion

Saudi Arabia’s high proportion of non-adherence to childhood immunizations should be addressed. For instance, a health education program could be developed to increase parents’ awareness that their children are susceptible to health risks. Paying a special attention to existing barriers in accessing and receiving the immunizations is crucial. In addition, building parents’ self-efficacy, which is confident in making healthy decisions, such as keeping their children’s immunizations up to date, is important.
Characterizing tobacco and marijuana use among youth combustible tobacco users experiencing homelessness – considering product type, brand, flavor, frequency, and higher-risk use patterns and predictors
Authors: Glasser Allison M. , Hinton Alice , Wermert Amy , Macisco Joseph , Nemeth Julianna M.
Published: April 2022

Background

Cigarette smoking is three times more prevalent among youth experiencing homelessness compared with the general population. Co-use of tobacco and marijuana is also common. The aim of this study is to characterize tobacco and marijuana use among youth experiencing homelessness who use combustible tobacco in a Midwestern city to inform smoking cessation intervention.

Methods

This study included 96 youth (ages 14–24 years; 52% male, 39% female, 5% transgender/non-binary) attending a homeless drop-in center who had used at least one combustible tobacco product in the past week. We assessed past-month use of tobacco products and marijuana, other product use characteristics (e.g., frequency, brand and flavor), and psychosocial predictors of more frequent (i.e., daily) use of combustible tobacco and marijuana.

Results

Most youth experiencing homelessness with past-week combustible tobacco use had used cigarettes (n = 85, 88.5%), cigars (n = 89, 92.7%), and marijuana (n = 82, 85.4%) in the past month. One-third (n = 34) used electronic vapor products (EVPs), 19.8% (n = 19) smoked hookah, and 11.5% (n = 11) used smokeless tobacco (ST). Most marijuana users co-administered with tobacco (n = 67, 69.8%). Daily combustible tobacco smoking was associated with having a child and smoking out of boredom/habit. Daily marijuana use was associated with using substances to cope with one’s housing situation. Newport (n = 66, 72.5%) and Black & Mild (n = 48, 51.1%) were the most popular brands of cigarettes and cigars among ever users. Most non-combustible tobacco ever users reported not having a usual brand (EVPs: n = 51, 73.9%; ST: n = 16, 57.1%). Cigar smokers reported the most varied selection of flavors.

Conclusions

Young combustible tobacco users experiencing homelessness engage in high-risk use patterns, including poly-tobacco use, co-use of tobacco with marijuana, and frequent combustible product use. Interventions that consider the full context of tobacco and marijuana use are needed to support smoking cessation in this population.
Trends in growth and nutritional status of high school graduates in Hangzhou, China, 2011–2020
Authors: Duan Xu , Zhou Yi-nan , Chen Yun
Published: April 2022

Background

During past decades, there was a positive trend in growth and nutrition status of adolescents in China, but there was significant regional disparity. The purpose of this study is to investigate the trends in growth and nutritional status of high school graduates in Hangzhou between 2011 and 2020.

Methods

High school graduates (Grade 12) who finished the physical examination of the national college entrance examination between 2011 and 2020 (n=481,353)were included in this study. Data were obtained from the database of physical examination of the national college entrance exam. Height and weight were measured; body mass index (BMI) was calculated from height and weight. Thinness, overweight and obesity were defined according to the International Obesity Task Force criteria. For the vast majority of the high school graduates were 18 years old or nearly 18 years old, the cutoffs of 18 years were adopted. Those are 18.5, 25 and 30 kg/m2, for thinness, overweight and obesity respectively.

Results

There was a significant growth trend in height, weight and BMI in both sexes (P < 0.001). Height increased by 1.80 cm in boys and 1.45 cm in girls. Weight increased by 4.62 kg in boys and 2.51 kg in girls. BMI increased by 1.09 kg/m2 in boys and 0.60 kg/m2 in girls. An increase trend was found in the prevalence of overweight and obesity in both sexes (P < 0.001). Overweight increased by 7.43% (from 9.05 to 16.48%) among boys and 4.05% (from 4.57 to 8.62%) among girls. Obesity increased by 3.85% (from 2.29 to 6.14%) among boys and 1.76% (from 0.64 to 2.40%) among girls. The prevalence of thinness fluctuated in both boys and girls, 12.42–15.59% among boys and 18.97–23.68% among girls. Boys had higher odds of overweight and obesity and lower odds of thinness than girls (P < 0.001).

Conclusions

There is a positive trend in growth and nutritional status of high school graduates in Hangzhou. However, there is still a considerable prevalence of thinness, it indicates a double burden of undernutrition and overnutrition.
Influence of frailty and its interaction with comorbidity on outcomes among total joint replacement
Authors: Lian Qiang , Li Kangxian , Yang Qinfeng , Lian Yun , Zhao Mingchen , Shi Zhanjun , Wang Jian , Zhang Yang
Published: April 2022

Background

Patients with frailty get more and more attention in clinical practice. Yet, no large-scale studies have explored the impact of frailty on the perioperative acute medical and surgical complications following TJA. what is more, comorbid diseases may lead, at least additively, to the development of frailty. There also no studies to find the possible interaction between comorbidity and frailty on the postoperative complications after TJA.

Methods

Discharge data of 2,029,843 patients who underwent TJA from 2005 to 2014 from the National Inpatient Sample (NIS) database, which was analyzed using cross-tabulations and multivariate regression modeling. Frailty was defined based on frailty-defining diagnosis clusters from frailty-defining diagnosis indicator of Johns Hopkins Adjusted Clinical Groups.

Results

Among patients who underwent total joint replacement surgeries, 50,385 (2.5%) were identified as frail. Frailty is highly associated with old age, especially for those over the age of 80, meanwhile females and black races have a high Charlson comorbidity index (CCI) of ≥ 3, together with emergency/urgent admission and teaching hospital. While comorbidity is associated with greater odds of acute medical complications, and frailty has a better predictive effect on in-hospital deaths, acute surgical complications. Furthermore, frailty did not show an enhancement in the predictive power of the Charlson comorbidity score for postoperative complications or in-hospital deaths but postoperative LOS and hospitalization costs.

Conclusion

Frailty can be used to independently predicted postoperative surgical and medical complications, which also has a synergistic interaction with comorbidity for patients who are preparing to undergo TJA.
Acceptability, simplicity, and relevance of the new human papillomavirus/DNA test among 35-year-old ever-married women in a district of Sri Lanka: focus group discussions
Authors: Perera K. C. , Mapitigama K. N. , Abeysena T. C.
Published: April 2022

Background

Two major drawbacks of the present cervical cancer screening programme in Sri Lanka are, the suboptimal sensitivity of the pap smear and the low coverage. The sensitivity of the HPV/DNA screening test is high. The objective of the study was to explore the acceptability relevance and simplicity of the new HPV/DNA screening implementation among ever-married women in a district of Sri Lanka.

Methods

Focus group discussions (FGD) (n = 3) in the public health divisions of the Kalutara district were used to collect data during December 2018. The study population comprised of ever-married women 35 years old, who, carried out an HPV/DNA test at a community Well Woman Clinics (WWCs) (n = 89). A list of WWCs was prepared according to an alphabetical order under urban, rural, and estate sector categories and allocated a number. One WWC was selected from each sector randomly for the three FGDs representing the estate, rural, and urban clinics. A convenient sampling technique was used to select participants for each FGD (n = 8). The information collected at each interview was summarized at the end of each interview. The analysis was done with manual content.

Results

Most of the participants were Sinhalese (n = 17, 70.9%), Buddhist (n = 18, n = 75%), and non-working (n = 18, n = 75%). The community awareness of HPV/DNA screening and field staff performance were highly appreciated by most of the participants. Most were aware of the high sensitivity of the HPV/DNA test, therefore the early detection rate of cervical cancer precursors is high. Most of the participants expressed the HPV/DNA test as a convenient and neutral test. Most were mentioned the necessity of repeated clinic visits for the pap test and colposcopy in HPV/DNA screened positive follow-up but there was marked acceptability (n = 23, 95.8%) for HPV/DNA test.

Conclusions

Acceptability of the new HPV/DNA screening test was high. Most of the participants perceived the HPV/DNA test to be simple and also relevant. Therefore, the HPV/DNA screening test can be recommended to be incorporated into the National Cervical Cancer Screening Programme as its suitability was well explored in the Sri Lankan setting.
Socioeconomic inequality in barriers for accessing health care among married reproductive aged women in sub-Saharan African countries: a decomposition analysis
Authors: Alamneh Tesfa Sewunet , Teshale Achamyeleh Birhanu , Yeshaw Yigizie , Alem Adugnaw Zeleke , Ayalew Hiwotie Getaneh , Liyew Alemneh Mekuriaw , Tessema Zemenu Tadesse , Tesema Getayeneh Antehunegn , Worku Misganaw Gebrie
Published: April 2022

Background

Accessibility of health care is an essential for promoting healthy life, preventing diseases and deaths, and enhancing health equity for all. Barriers in accessing health care among reproductive-age women creates the first and the third delay for maternal mortality and leads to the occurrence of preventable complications related to pregnancy and childbirth. Studies revealed that barriers for accessing health care are concentrated among individuals with poor socioeconomic status which creates health inequality despite many international organizations top priority is enhancing universal health coverage. Therefore, this study aimed to assess the presence of socioeconomic inequality in barriers for accessing health care and its contributors in Sub-Saharan African countries.

Methods

The most recent DHS data of 33 sub-Saharan African countries from 2010 to 2020 were used. A total sample of 278,501 married reproductive aged were included in the study. Erreygers normalized concentration index (ECI) and its concentration curve were used while assessing the socioeconomic-related inequality in barriers for accessing health care. A decomposition analysis was performed to identify factors contributing for the socioeconomic-related inequality.

Results

The weighted Erreygers normalized Concentration Index (ECI) for barriers in accessing health care was − 0.289 with Standard error = 0.005 (P value < 0.0001); indicating that barriers in accessing health care was disproportionately concentrated among the poor. The decomposition analysis revealed that wealth index (42.58%), place of residency (36.42%), husband educational level (5.98%), women educational level (6.34%), and mass media exposure (3.07%) were the major contributors for the pro-poor socioeconomic inequalities in barriers for accessing health care.

Conclusion

In this study, there is a pro-poor inequality in barriers for accessing health care. There is a need to intensify programs that improve wealth status, education level of the population, and mass media coverage to tackle the barriers for accessing health care among the poor.
Predictors of patient safety competency among emergency nurses in Iran: a cross-sectional correlational study
Authors: Habibi Soola Aghil , Ajri-Khameslou Mehdi , Mirzaei Alireza , Bahari Zahra
Published: April 2022

Aims

This study aimed to assess predictors of patient safety competency among emergency nurses.

Background

The role of emergency nurses is to provide high-quality health care to patients and ensure their safety. The patient safety competency includes the absence of unnecessary or potential harm when providing health care to patients. In providing health care, effective teamwork can affect patient safety and outcomes. Psychological safety is essential to effective teamwork. Psychological safety allows health care workers to accept the interpersonal risks needed to perform effective teamwork and maintain patient safety.

Methods

This study was cross-sectional correlational research. Using convenience sampling methods, 254 emergency department nurses from five educational hospitals were enrolled in the study. Patient Safety in Nursing Education Questionnaire was used to measure the patient safety competency, the teamwork questionnaire to examine the teamwork, and Edmondson psychological safety questionnaire was used to measure psychological safety. Descriptive statistics, t-test, one-way analysis of variance (ANOVA), Pearson’s r correlation coefficient, and multivariate stepwise linear regression analysis were applied using SPSS 14.0.

Results

Participants’ mean patient safety competency score was 2.97 (1-4). Between 18 independent variables evaluated in the multiple regression analysis, seven had a significant effect on the patient safety competency of emergency nurses (R2: 0.39, p < .001).

Conclusions

The patient safety competency of emergency department nurses was primarily related to the structure and leadership of the team and secondary to psychological safety and experience in patient safety activity. The results demonstrated that policymakers and hospital managers should improve and enhance team structure and leadership via supervision and cooperation with the nursing staff. The development of training programs in patient safety activities, improvement, and increase of psychological safety at the levels of the nursing units is essential to increase patient safety competencies in the emergency nursing program.
A blockchain-based secure storage scheme for medical information
Authors: Sun Zhijie , Han Dezhi , Li Dun , Wang Xiangsheng , Chang Chin-Chen , Wu Zhongdai
Published: April 2022

Medical data involves a large amount of personal information and is highly privacy sensitive. In the age of big data, the increasing informatization of healthcare makes it vital that medical information is stored securely and accurately. However, current medical information is subject to the risk of privacy leakage and difficult to share. To address these issues, this paper proposes a healthcare information security storage solution based on hyperledger fabric and the attribute-based access control framework. The scheme first utilizes attribute-based access control, which allows dynamic and fine-grained access to medical information, and then stores the medical information in the blockchain, which can be secured and tamper-proof by formulating corresponding smart contracts. In addition, this solution also incorporates IPFS technology to relieve the storage pressure of the blockchain. Experiments show that the proposed scheme combining access control of attributes and blockchain technology in this paper can not only ensure the secure storage and integrity of medical information but also has a high throughput when accessing medical information
Are cellulose ethers safe for the conservation of artwork? New insights in their VOC activity by means of Oddy testing
Authors: Steger Simon , Eggert Gerhard , Horn Wolfgang , Krekel Christoph
Published: April 2022

Cellulose ethers, like methyl cellulose (MC) or hydroxypropyl cellulose (HPC), are widely used in conservation. They also occur as additives and rheology modifiers in various products like dispersions or gels. Do such products release harmful volatile organic compounds (VOC) during their accelerated aging? A mass testing series utilizing the Oddy test of 60 commercial cellulose ethers ranks the products in safe for permanent use (P, no corrosion), only for temporary use (T, slight corrosion), and unsuitable at all (F, heavy corrosion). Results show that 55% of the products passed the test whereas 33% are for temporary use as slight corrosion occurred on at least one metal coupon and only 11% failed the Oddy test. Raman measurements of the corrosion products identified oxides like massicot, litharge, cuprite, and tenorite among carbonates (hydrocerussite, plumbonacrite), and acetates like basic lead acetate, lead acetate trihydrate as well as lead formate as main phases. For example, commercial, industrial Klucel® G (HPC) scored a T rating through slight corrosion on the lead coupon. Basic lead acetate among other phases indicates the presence of acetic acid. Additional measurements of the sample with thermal desorption GC–MS utilizing the BEMMA scheme confirm the high acetic acid outgassing and reveal the presence of a small amount of formaldehyde.
Comparative morpho-anatomical standardization and chemical profiling of root drugs for distinction of fourteen species of family Apocynaceae
Authors: Kumar Pankaj , Bhushan Anil , Gupta Prasoon , Gairola Sumeet
Published: April 2022

Background

The root drugs of the family Apocynaceae are medicinally important and used in Indian Systems of Medicine (ISM). There is often a problem of misidentification and adulteration of genuine samples with other samples in the market trade. Keeping in view the adulteration problem of raw drug material, comparative macroscopic and microscopic (qualitative and quantitative) characterisation and chemical analysis (TLC and LC–MS profiling) of a total of 14 economically important root drugs of family Apocynaceae were done for practical and rapid identification. A total of 33 qualitative botanical characteristics of root samples were subjected to Principal Component Analysis (PCA) and Cluster analysis to identify taxonomically significant characteristics in the distinction of root drug samples at the species level.

Results

Comparative qualitative and quantitative data on morphological, macroscopic, and microscopic characters were generated for the studied 14 species. Despite the similarity in some root characters, a combined study involving the surface, anatomical, and powder features helped distinguish root samples at the species level. The relative relationship between selected species was represented as clustering or grouping in the dendrogram. PCA analysis determined significant characters leading to species grouping and identification. Results showed that clustering of xylem vessels in cross-section, pore size, and distribution in the cut root, the shape of starch grains, the thickness of cork zone were among the most notable characters in species distinction. Chemical profiling revealed unique fingerprints and content of chemical compounds, which were significant in identification of root drug samples.

Conclusions

The comparative botanical standards and chemical profiles developed in the present study can be used as future reference standards for the quick, easy, and correct identification of root drug samples to be used in the herbal drug industry. Further, the identified significant microscopic characters have the potential for taxonomic studies in species delimitation.
Improve data classification performance in diagnosing diabetes using the Binary Exchange Market Algorithm
Authors: Rezaei Faranak , Abbasitabar Maryam , Mirzaei Shirin , Kamari Direh Zahra , Ahmadi Sahar , Azizi Zahra , Danialy Darya
Published: April 2022

Today's lifestyle has led to a significant increase in referrals to medical centers to diagnose various diseases. To this end, over the past few years, researchers have turned to new diagnostic methods, including data mining and artificial intelligence, intending to facilitate the detection process and increase reliability. The high volume of data available in medical centers can be considered one of the main problems in using these methods. The optimal selection of essential and influential features reduces the maximum dimension for better diagnosis with more reliability of results. In this paper, a new approach uses a Binary Exchange Market Algorithm (BEMA) to identify essential and practical features in the diabetes dataset and determine the best algorithm binary function (type of sigmoid function) to improve the performance of the EMA algorithm is presented. For validation and efficiency of the proposed BEMA algorithm, several SVM, KNN, and NB classification models have been used to train and test the final model. The results obtained from the evaluations show that the proposed BEMA-SVM combined method has a better performance than the previous methods to improve accuracy and offer an effect equivalent to 98.502%. Also, to provide better results and more reliability than the proposed method, researchers can use a combination of several classes with the proposed method, which is outside the scope of this study.
Evaluation of an extracorporeal ozone-based bactericide system for the treatment of Escherichia coli sepsis
Authors: Skorup Paul , Fransson Anette , Gustavsson Jenny , Sjöholm Johan , Rundgren Henrik , Özenci Volkan , Wong Alicia Y. W. , Karlsson Tomas , Svensén Christer , Günther Mattias
Published: April 2022

Background

Sepsis is associated with substantial mortality rates. Antibiotic treatment is crucial, but global antibiotic resistance is now classified as one of the top ten global public health risks facing humanity. Ozone (O3) is an inorganic molecule with no evident function in the body. We investigated the bactericide properties of ozone, using a novel system of extracorporeal ozone blood treatment. We hypothesized that ozone would decrease the concentration of viable Escherichia coli (E. coli) in human whole blood and that the system would be technically feasible and physiologically tolerable in a clinically relevant model of E. coli sepsis in swine.

Methods

The E. coli strain B09-11822, a clinical isolate from a patient with septic shock was used. The in vitro study treated E. coli infected human whole blood (n = 6) with ozone. The in vivo 3.5-h sepsis model randomized swine to E. coli infusion and ozone treatment (n = 5) or E. coli infusion and no ozone treatment (n = 5). Live E. coli, 5 × 107 colony-forming units (CFU/mL) was infused in a peripheral vein. Ozone treatment was initiated with a duration of 30 min after 1.5 h.

Results

The single pass in vitro treatment decreased E. coli by 27%, mean 1941 to 1422 CFU/mL, mean of differences − 519.0 (95% CI − 955.0 to − 82.98, P = 0.0281). pO2 increased (95% CI 31.35 to 48.80, P = 0.0007), pCO2 decreased (95% CI − 3.203 to − 1.134, P = 0.0069), oxyhemoglobin increased (95% CI 1.010 to 3.669, P = 0.0113). Methemoglobin was not affected. In the sepsis model, 9/10 swine survived. One swine randomized to ozone treatment died from septic shock before initiation of the treatment. Circulatory, respiratory, and metabolic parameters were not affected by the ozone treatment. E. coli in arterial blood, in organs and in aerobic and anaerobic blood cultures did not differ. Hemoglobin, leucocytes, and methemoglobin were not affected by the treatment.

Conclusions

Ozone decreased the concentration of viable E. coli in human whole blood. The system was technically feasible and physiologically tolerable in porcine sepsis/septic shock and should be considered for further studies towards clinical applications.
Distinctive signatures of pathogenic and antibiotic resistant potentials in the hadal microbiome
Authors: He Liuqing , Huang Xinyu , Zhang Guoqing , Yuan Ling , Shen Enhui , Zhang Lu , Zhang Xiao-Hua , Zhang Tong , Tao Liang , Ju Feng
Published: April 2022

Background

Hadal zone of the deep-sea trenches accommodates microbial life under extreme energy limitations and environmental conditions, such as low temperature, high pressure, and low organic matter down to 11,000 m below sea level. However, microbial pathogenicity, resistance, and adaptation therein remain unknown. Here we used culture-independent metagenomic approaches to explore the virulence and antibiotic resistance in the hadal microbiota of the Mariana Trench.

Results

The results indicate that the 10,898 m Challenger Deep bottom sediment harbored prosperous microbiota with contrasting signatures of virulence factors and antibiotic resistance, compared with the neighboring but shallower 6038 m steep wall site and the more nearshore 5856 m Pacific basin site. Virulence genes including several famous large translocating virulence genes (e.g., botulinum neurotoxins, tetanus neurotoxin, andClostridium difficiletoxins) were uniquely detected in the trench bottom. However, the shallower and more nearshore site sediment had a higher abundance and richer diversity of known antibiotic resistance genes (ARGs), especially for those clinically relevant ones (e.g.,fosX,sul1, and TEM-family extended-spectrum beta-lactamases), revealing resistance selection under anthropogenic stresses. Further analysis of mobilome (i.e., the collection of mobile genetic elements, MGEs) suggests horizontal gene transfer mediated by phage and integrase as the major mechanism for the evolution of Mariana Trench sediment bacteria. Notably, contig-level co-occurring and taxonomic analysis shows emerging evidence for substantial co-selection of virulence genes and ARGs in taxonomically diverse bacteria in the hadal sediment, especially for the Challenger Deep bottom where mobilized ARGs and virulence genes are favorably enriched in largely unexplored bacteria.

Conclusions

This study reports the landscape of virulence factors, antibiotic resistome, and mobilome in the sediment and seawater microbiota residing hadal environment of the deepest ocean bottom on earth. Our work unravels the contrasting and unique features of virulence genes, ARGs, and MGEs in the Mariana Trench bottom, providing new insights into the eco-environmental and biological processes underlying microbial pathogenicity, resistance, and adaptative evolution in the hadal environment.
Development of an educational package for the universal human papillomavirus (HPV) vaccination programme: a co-production study with young people and key informants
Authors: Fisher Harriet , Chantler Tracey , Finn Adam , Kesten Joanna , Hickman Matthew , Letley Louise , Mounier-Jack Sandra , Thomas Clare , Worthington Katie , Yates Julie , Audrey Suzanne
Published: April 2022

Background

The English schools-based human papillomavirus (HPV) vaccination programme is routinely offered to all young people aged 12–13 years, to prevent cancers affecting the cervix, vulva, vagina, penis, anus and mouth. Lower uptake among some population groups has been identified, in part, because of unmet information needs among young people. To address these unmet needs we report intervention planning and development processes to co-produce an educational package about the HPV vaccine.

Methods

We used co-production research methodologies and the ‘person-based approach’ involving the following iterative stages: (i) collating and analysing primary and secondary evidence, including HPV vaccine communication materials, interviews and workshops; (ii) developing guiding principles; (iii) undertaking a behavioural analysis informed by the Behaviour Change Wheel and the Behaviour Change Technique taxonomy; (iv) development of a preliminary logic model; (v) co-production of resources, and; (vi) refinement of resources informed by feedback from young people and key informants.

Results

We co-produced EDUCATE, a theory-based educational package, that is designed to be delivered to young people prior to being offered the HPV vaccine to support uptake. Young people and key informants identified the following key issues to include as content: (i) HPV-related information; (ii) how vaccines work; (iii) safety and side-effects of the HPV vaccine; (iii) eligibility for the HPV vaccination programme, and; (iv) preparation of young people to receive the HPV vaccine. A manual for professionals (e.g. immunisation nurses, school staff) delivering the intervention and a PowerPoint presentation, interspersed with five short films, were co-produced with young people and key informants. Following feedback, the content of the EDUCATE package was refined to increase acceptability, engagement, and persuasiveness to the target users.

Conclusion

Engagement with young people and key informants was integral to the development of our rigorously developed, theory-based intervention to address young people’s information needs about the HPV vaccination programme. The acceptability and persuasiveness of the package has been maximised by working closely with young people and key informants to develop the content. An implementation study to examine how the EDUCATE package is implemented in practice and the impact on uptake of the HPV vaccination programme is underway.
PTSD is associated with impaired event processing and memory for everyday events
Authors: Pitts Barbara L. , Eisenberg Michelle L. , Bailey Heather R. , Zacks Jeffrey M.
Published: April 2022

Current theories of posttraumatic stress disorder (PTSD) propose that memory abnormalities are central to the development and persistence of symptoms. While the most notable memory disturbances in PTSD involve memory for the trauma itself, individuals often have trouble remembering aspects of everyday life. Further, people with PTSD may have difficulty segmenting ongoing activity into discrete units, which is important for our perception and later memory of the activity. The current study investigated whether PTSD diagnosis and symptom severity predicted event segmentation and memory for everyday activities. To do so, 63 people with PTSD and 64 controls with a trauma history watched, segmented, and recalled videos of everyday activities. Viewers with higher PTSD symptom severity showed lower agreement on locations of event boundaries and recalled fewer fine-grained actions than did those with lower symptom severity. These results suggest that PTSD symptoms alter event segmentation, which may contribute to subsequent memory disturbances.
Temperature change of the pulpal floor and restoration with preheated bis-GMA free and containing resin composite (a randomized clinical trial)
Authors: Nasser AlShimaa , Mahmoud Nermin A. , Riad Mona I.
Published: April 2022

Background

Preheating is one of several innovative approaches and improvements developed to increase the durability and clinical behavior of resin composites. Development of preheated composites is to reduce its viscosity in order to improve resin composite adaptation and placement ease. The purpose of this clinical trial was to study the effect of preheating Bis-GMA free and Bis-GMA-containing resin composites at different temperatures on the pulpal floor and restoration temperature. A total of twenty individuals (N = 40) have two carious posterior teeth that need to be restored were randomly assigned to one of two groups based on the type of restorative materials used: (group 1) Bis-GMA-containing resin composite VisCalor bulk (VCB), and (group 2) Bis-GMA-free resin composite Admira Fusion x-tra (AFX). Preheating temperatures of 50 °C and 70 °C were utilized to separate each group into two subgroups. Class I or II cavities were prepared. Thermometer device with two separate K-type temperature probes was used to measure the base line temperature values at the pulpal floor before beginning the restorative procedure (C0), pulpal floor during packing of preheated composite (C1), the top composite surface after packing and before curing (C2), pulpal floor after curing of the preheated composite (C3), and top composite surface after curing (C4). One-way ANOVA and the Kruskal–Wallis test were used to analyze the data.

Results

The measured temperature of pulpal floor for both preheated VCB or AFX at 50 °C or 70 °C revealed significant increasing from base line measured temperature to during packing as well as after curing with (P-value < 0.001). There was no significant difference for mean composite surface temperature for both preheated materials at 50 °C or 70 °C whether before or after curing.

Conclusions

Preheating of bulk fill Bis-GMA free and containing resin composite rises both the pulpal floor and the restoration temperature; meanwhile, the rise in temperature was limited. The application of the curing unit caused the greatest temperature rise.
Adherence, safety and efficacy of antiretroviral therapy among children at a tertiary hospital in India
Authors: Rajput Kiran , Roy Joanna Mary , Chaudhari Suhas , Sawant Vishal Dnyaneshwar
Published: April 2022

Background

Successful response to treatment of HIV infection is largely determined by adherence to antiretroviral therapy (ART) and manifests as an improvement in CD4 counts. Certain challenges to attaining high rates of adherence are specific to the paediatric population since children are dependent on a caregiver and are not often disclosed with the status of being infected. Analysing the factors affecting adherence, monitoring the side effects related to therapy and the progress of CD4 counts will help identify challenges to treatment and improve quality of life in these children.

Results

89.6% of children (n = 86) showed optimal adherence to ART. The relationship of the caregiver to the child (biological parents) and the rise in CD4 count were the only factors found to be significantly associated with adherence to ART. The most reported side effect following ART was a skin rash, associated with the use of Nevirapine.

Conclusions

Adherence to ART in the paediatric age group can be improved by facilitating counselling services and regular monitoring of therapy in children who are not under direct care of their biological parents. Monitoring the safety profile of ART along with the CD4 count is necessary to limit adverse effects and monitor efficacy to treatment.
A comparative study of the cardioprotective effect of Metformin, Sitagliptin and Dapagliflozin on Isoprenaline induced myocardial infarction in non-diabetic rats
Authors: Ibrahim Mostafa Mahmoud , Khedr Mohamed Mostafa , Morsy Manal Hamza , Badae Noha Mohamed , Elatrebi Soha
Published: April 2022

Background

Acute myocardial infraction (AMI) is a leading cause of morbidity. As anti-diabetic drugs affect the cardiovascular risk of diabetic patients independent of their glucose lowering effect, this study was aimed to explore the cardioprotective effects of metformin, sitagliptin and dapagliflozin on electrocardiogram (ECG) changes, IL-1β, troponin I, caspase 3 in isoprenaline (ISO) induced MI in non-diabetic rats. The present study was conducted on 40 adult male Wistar albino rats. The rats were randomly assigned into 5 groups, 8 each: I-Normal Control (NC) group, II-ISO-induced MI control (ISO-MI) injected with ISO subcutaneously at a dose of 100 mg/kg to induce experimental AMI. III-A- Metformin treated ISO-induced MI group (300 mg/kg/day), III-B-Sitagliptin treated ISO-induced MI group (10 mg/kg/day) and III-C- Dapagliflozin treated ISO-induced MI group (5 mg/kg/day).

Results

Treated groups showed significant improvement at p < 0.05 of ECG parameters with a decrease HR, ST amplitude and QT interval as compared to ISO-MI group. There was significant reduction at p < 0.05 of serum levels of IL-1β, troponin I and caspase 3 in the treated groups.

Conclusions

All medications proved to be effective in alleviating the harmful effects caused by ISO-induced MI evidenced by ECG readings and biochemical parameters. However, Dapagliflozin demonstrated a superior effect to Metformin and Sitagliptin.
On the quest for hidden ovarian teratomas in therapy-refractory anti-NMDA receptor encephalitis: a case report
Authors: Cirkel Christoph , Cirkel Anna , Royl Georg , Frydrychowicz Alex , Tharun Lars , Deichmann Steffen , Rody Achim , Münte Thomas F. , Machner Björn
Published: April 2022

Background

Anti-NMDA-receptor (anti-NMDAR) encephalitis is often associated with ovarian teratoma (OT). The best management of anti-NMDAR encephalitis patients with normal imaging studies (pelvic ultrasound/MRI) but clinically high risk of OT (e.g., female, adult, black) is unclear. We report on the surprising diagnostic quest in a young black woman with anti-NMDAR encephalitis, in whom invasive procedures could finally disclose two OTs that were hidden from the initial non-invasive diagnostics.

Case report

The patient presented with a one-week history of psychotic symptoms, developing oro-facial dyskinesia, seizures and coma, eventually requiring mechanical ventilation. NMDA-receptor antibodies were positive in serum and cerebrospinal fluid. Pelvic MRI and transabdominal ultrasound were normal. Exploratory laparoscopy was also unremarkable at first, but due to a suspicious echogenic mass (15 mm) in the right ovary on perioperative transvaginal ultrasound, an ovarian incision was performed which led to the detection of a first OT and its removal via ovarian-preserving cystectomy. Following a severe therapy-refractory clinical course despite aggressive immunotherapy and tumor removal, 6 months later bilateral oophorectomy was performed as ultima ratio, disclosing a second micro-OT (6 mm) in the left ovary. Unfortunately, the patient has not improved clinically yet.

Conclusions

In therapy-refractory anti-NMDAR encephalitis with high risk of OT, small and bilateral OTs hidden from primary non-invasive diagnostics should be considered, which may trigger further invasive diagnostic procedures.
Quaternionic quantum mechanics for N = 1, 2, 4 supersymmetry
Authors: Rawat Seema , Rawat A. S.
Published: April 2022

Background

Quaternions have emerged as powerful tools in higher-dimensional quantum mechanics as they provide homogeneous four-dimensional structure in quantum field theories, offer compact representations, and incorporate spin naturally. Quantum field theories then lead to the unification of fundamental interactions so the use of quaternion becomes necessary when we are dealing with higher-dimensional theories. On the other hand, supersymmetry is the theory of bosons and fermions and is an essential constituent of grand unified theories. The use of quaternion in supersymmetric field theories provides an excellent framework for higher-dimensional unification theories.

Result

A complete theory for supersymmetric quaternionic quantum mechanics has been constructed for N = 1, 2, 4 supersymmetry in terms of one, two, and four supercharges and Hamiltonians, respectively. It has been shown that N = 4 SUSY is the quaternionic extension of the N = 2 complex SUSY and N = 1 real SUSY; also spin is the natural outcome of using quaternion units. Pauli and Dirac Hamiltonian and their relationship have also been obtained in quaternion space. It has been shown that quaternionic quantum mechanics are superior to ordinary and complex quantum mechanics because in the quaternion framework we do not need three different theories for N = 1,2,4 SQM but a single theory only.

Conclusions

It has been concluded that N = 1 real SUSY is equal to N = 2 complex SUSY which in turn is equal to N = 4 quaternion SUSY so one can arrive at higher-dimensional quantum field theories starting from lower-dimensional quantum theories. Higher-dimensional quaternion field theories are suitable for nonphotonic light cone particles which are not allowed in complex QFT, also noncommutative nature of quaternion gives an extra degree of freedom and may provide the possibility of some new particle, dark matter, or new phenomenon. Though quaternions provide an excellent framework in higher-dimensional field theories, there are certain challenges due to their noncommutativity as calculations become tedious where large terms are involved. Keeping in view the noble features of quaternion, we expect some development to get a better understanding of N = 8 supergravity, maximal supergravity (D = 11 − n), and maximal supersymmetry theories (N = 10) in terms of quaternion operators.
Satisfaction with Amplification in Daily Life (SADL) questionnaire in Hindi: a survey report on evaluating the benefit with amplification
Authors: Chandanshive Chandrahas U. , Jorasia Rajesh , Penwal Suman S.
Published: April 2022

Background

The present study aimed to translate the Satisfaction with Amplification in Daily Life (SADL) questionnaire into Hindi. The translated questionnaire was administered to 80 Hindi-speaking individuals with hearing impairment.

Results

A good reliability was found in the questions using the Cronbach alpha test. The Pearson r correlation revealed a significant positive correlation between the degree of hearing loss and the global satisfaction scores. It suggests that there is a direct proportion of degree of hearing loss and global scores as the user has severe hearing loss the communication difficulty is also great in magnitude.

Conclusion

From the findings of the current study, it can be inferred that the Hindi translation of the SADL questionnaire can be used in clinical settings to measure the hearing aid/s outcome after fitting.
Hematology/Oncology Fellowship Programs' Participation in the Quality Oncology Practice Initiative
Authors: Makhoul Issam , Anders Michael , Siegel Robert , Chiang Anne , Markham Merry-Jennifer , Chen Ronald C. , Mougalian Sarah , Arnaoutakis Konstantinos , Giuliani Meredith , Im Annie , Kozlik Mary May Priscilla , Crist Stephanie T.S. , Garrett-Mayer Elizabeth , Kamal Arif
Published: April 2022

PURPOSE:

In the first decade of this millennium, ASCO pioneered a quality measurement tool, the Quality Oncology Practice Initiative (QOPI). Despite an Accreditation Council for Graduate Medical Education (ACGME) requirement since 2012 for oncology fellows to participate in quality improvement (QI) projects, the uptake of QOPI remains modest.

METHODS:

This study examined reasons for low QOPI participation by surveying participating and nonparticipating HemOnc Fellowship Programs. The survey elicited views toward QI and QOPI as well as ideas about making the program more helpful.

RESULTS:

Among 69 fellowship programs, only 39% (n = 27) participated in QOPI. Other findings were that (1) the majority of programs considered their fellows' QI projects beneficial but were not fulfilling the ACGME standard for all fellows' QI participation; (2) nonparticipating programs were unfamiliar with but interested in QOPI; (3) participating programs tended to view QI as easier to conduct and more beneficial than nonparticipating programs; and (4) programs that withdrew from QOPI and participating programs alike were dissatisfied with the educational benefit and data abstraction burden for fellows.

CONCLUSION:

Academic oncology programs generally valued QI but many have not fully engaged in it. Fellows in programs participating in QOPI may have had less difficulty conducting QI and their projects may have been more beneficial than that of nonparticipating programs. However, perceived lack of educational benefits for fellows and the burden of manual data abstraction from the electronic medical record are impediments to satisfaction with the program. Higher faculty involvement and longitudinal reports for each fellow may significantly increase participation.
Dynamic behavior and driving region of thermoacoustic combustion oscillations in a swirl-stabilized turbulent combustor
Authors: Asami Kazuki , Kawada Takeshi , Kishiya Sena , Gotoda Hiroshi
Published: April 2022

We attempt to identify the driving region of combustion oscillations by methodologies based on symbolic dynamics, synchronization, and complex networks. As the equivalence ratio is increased, the dynamic behavior of pressure fluctuations transitions from a stable combustion state to high-amplitude combustion oscillations via type-II intermittent combustion oscillations and the subsequent low-amplitude combustion oscillations. Rayleigh index-based transition network entropy is a useful indicator for determining the driving region of low-amplitude combustion oscillations. We clearly observe that a critical slowing down begins to appear in the combustion state close to the formation region of type-II intermittent combustion oscillations with temporally increasing equivalence ratio.
Changes in Sex Steroids and Relation With Menopausal Complaints in Women Undergoing Risk-reducing Salpingo-oophorectomy
Authors: van Winden Lennart J , Vermeulen Ravi F M , van den Noort Vincent , Gaarenstroom Katja N , Kenter Gemma G , Brood-van Zanten Monique M A , Korse Catharina M , van Beurden Marc , van Rossum Huub H
Published: April 2022

Context

Risk-reducing salpingo-oophorectomy (RRSO) is performed in BRCA1 or 2 mutant carriers to minimize ovarian cancer risk. Although studies have been performed investigating sex steroid levels, menopausal complaints, and sexual functioning in relation to RRSO, their exact relationship remains unknown.

Objectives

To investigate the impact of RRSO on serum sex steroid levels and their association with menopausal complaints and sexual functioning.

Methods

This prospective observational cohort study included 57 premenopausal and 37 postmenopausal women at risk of ovarian cancer and opting for RRSO. Data collection involved validated questionnaires on sexual functioning and menopausal complaints. Testosterone, androstenedione, estradiol, and estrone levels in serum determined by liquid chromatography-tandem mass spectrometry were obtained 1 day before, 6 weeks, and 7 months after RRSO.

Results

In premenopausal women, all 4 steroids were decreased both 6 weeks (P < 0.01) and 7 months (P < 0.01) after RRSO. Furthermore, in these women, decreases in estrogens were associated with a decrease in sexual functioning 7 months after RRSO (P < 0.05). In postmenopausal women, only testosterone was decreased 6 weeks and 7 months (P < 0.05) after RRSO, which was associated with an increase in menopausal complaints at 7 months post-RRSO (P < 0.05).

Conclusion

Our results suggest that in premenopausal women, decreases in estrogens are related to a decrease in sexual functioning and that in postmenopausal women, testosterone is decreased after RRSO, which indicates that postmenopausal ovaries maintain some testosterone production. Furthermore, in postmenopausal women, a large decrease of testosterone was associated with more menopausal complaints, indicating that future studies investigating testosterone supplementation are warranted.