bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep learning-enhanced diabetic retinopathy image classification
Authors: Alwakid Ghadah , Gouda Walaa , Humayun Mamoona , Jhanjhi Noor Zaman
Published: August 2023

Objective

Diabetic retinopathy (DR) can sometimes be treated and prevented from causing irreversible vision loss if caught and treated properly. In this work, a deep learning (DL) model is employed to accurately identify all five stages of DR.

Methods

The suggested methodology presents two examples, one with and one without picture augmentation. A balanced dataset meeting the same criteria in both cases is then generated using augmentative methods. The DenseNet-121-rendered model on the Asia Pacific Tele-Ophthalmology Society (APTOS) and dataset for diabetic retinopathy (DDR) datasets performed exceptionally well when compared to other methods for identifying the five stages of DR.

Results

Our propose model achieved the highest test accuracy of 98.36%, top-2 accuracy of 100%, and top-3 accuracy of 100% for the APTOS dataset, and the highest test accuracy of 79.67%, top-2 accuracy of 92.%76, and top-3 accuracy of 98.94% for the DDR dataset. Additional criteria (precision, recall, and F1-score) for gauging the efficacy of the proposed model were established with the help of APTOS and DDR.

Conclusions

It was discovered that feeding a model with higher-quality photographs increased its efficiency and ability for learning, as opposed to both state-of-the-art technology and the other, non-enhanced model.
Toward environmentally sustainable supply chains: How contract management can help companies along their transformation journey
Authors: Hirvonen-Ere Suvi , Bask Anu
Published: August 2023

With the European Union having set ambitious environmental policy targets, company executives face mounting pressure to reach their sustainability goals. While expanding the contract-management process's utilization may hold promise for accelerating sustainable development throughout the contract lifecycle (from the pre-award through the post-award phase), the literature has afforded it little attention. Building on contingency theory and a qualitative multiple-case-study method, the paper examines how the contract-management process could proactively enhance the necessary shift to environmentally sustainable supply chains. Further, the authors explore whether contract management as a contingency variable could exert a positive influence on the sustainability practices followed in supply-chain relationships and, thereby, on sustainability performance. The preliminary findings indicate that, while expanded utilization of contract management remains modest, it already shows potential as a future success factor for companies on their journey of transformation in pursuit of sustainable supply-chain relationships. As a contingency factor, contract management might be able to make an impact by embedding sustainability in the contract process from the supplier-selection phase onward while also contributing to the final contract's solid inclusion of sustainability-related duties for the parties, whether in the main contract or via appendices. Accordingly, the authors suggest multiple, parallel avenues for future development.
Exploring Factors Influencing Technological Capability of Food Manufacturing Firms in Malaysia
Authors: AbdManap Nursyakirah , Wan Mohamed Radzi Che Wan Jasimah , Jenatabadi Hashem Salarzadeh
Published: August 2023

Malaysian manufacturing firms play an important role in the country’s social and economic development. However, the industry faces challenges in productivity and competitiveness due to rapid globalization and economic instabilities affecting countries worldwide. To address these challenges, technological capability has become an essential requirement for a firm’s technological progress to remain sustainable and competitive. This study aims to identify factors that influence the technological capability of food manufacturing firms by using a questionnaire. Using IBM SPSS Statistics 27, exploratory factor analysis (EFA) was employed to examine the dataset obtained from the survey and analyze the factors that contribute to a firm’s technological capability. Overall, firms are influenced by knowledge management, organizational learning, and organizational innovation in their technological capability development. By understanding these factors, firms can develop their technological capability and further improve their productivity, ultimately achieving a sustainable competitive advantage in the market.
Diabetes Distress and Self-Care Activities Among Patients With Diabetes Type II: A Correlation Study
Authors: Abd El Kader Aziza Ibrahim , Ibrahim Mishmisha Elsayed , Mohamed Helalia Shalabi , Osman Basma Mohamed
Published: August 2023

Introduction

Diabetes mellitus (DM) is a main, highly prevalent, and challenging public health issue. Suboptimal self-care for type II diabetes can lead to poor glycemic control, complications, and even death.

Objective

This study investigated the incidence of distress and its link with self-care habits of patients with diabetes type II.

Methods

A correlational, cross-sectional design with a convenient sample of 200 patients was used to conduct this study. Three questionnaires were administered: (A) the demographic and medical data questionnaire; (B) diabetes self-care activities in brief; and (C) the diabetes distress scale in Arabic language.

Results

The patients’ mean age was 51.78 ± 11.34; 80% of patients practiced lower levels of diabetes self-care, and 37% of them had a high level of diabetes distress. Self-care is associated with diabetes distress ( R = −0.152, p-value = .032).

Conclusion

Self-care activities can help in the early detection and management of diabetes distress. Sustained self-care education is promising to minimize diabetes distress. The potential advantages of association between diabetes distress and self-care can offer self-care programs that enhance diabetes distress management.
A city of gardeners: What happens when policy, planning, and populace co-create the food production of a novel peri-urban area?
Authors: Jansma Jan Eelco , Wertheim-Heck Sigrid CO
Published: August 2023

Urban re-orientation on feeding the city in a city-region context has encouraged local policies to spur urban agriculture by stimulating bottom-up citizen participation in urban food production. However, in real life, tensions occur between policies and practices. The misalignment of policy goals with planning instruments and the needs of practitioners in urban agriculture hampers the development of substantial urban food production. This paper introduces Oosterwold, a new peri-urban area of the Dutch city of Almere that pivots urban agriculture. Oosterwold is a unique experiment in which a top-down policy goal – producing 10% of the future urban food needs – is handed over to the self-organisation of new residents, who are bound by the rule to allocate 51% of their plot to urban agriculture. This study deploys a social practice theory–informed analysis to appraise the performance in urban agriculture. Novel in our methodology – combining an online survey ( n=111) with an analysis of aerial photos ( n=199) – we unpack the unruly nature in which urban policy and planning are shaping up through bottom-up citizen participation. Our study demonstrates that (i) it takes time for residents to adopt urban agriculture as a substantial practice in their heterogeneous lifestyle and (ii) that a focus on bottom-up approaches, such as Oosterwold residents’ self-organisation, does not imply laissez faire from planning and policy. It is inferred that a balance in policy goals, planning instruments, and the needs of the practitioners requires a shared vision and builds on supportive conditions.
A bad time to die? Exploring bereaved families/wha-nau experiences of end-of-life care under COVID-19 restrictions: a qualitative interview study
Authors: Morgan Tessa , Gott Merryn , Williams Lisa , Naden Joe , Wang Yingmin , Smith Brianna , Fanueli Elizabeth , Budi Setyawati Martyarini , Morgan Kathryn , Robinson Jackie , Anderson Natalie , Carey Melissa , Moeke-Maxwell Tess
Published: August 2023

Background:

There have been international concerns raised that, during the COVID-19 pandemic, there was an absence of good palliative care resulting in poor end-of-life care experiences. To date, there have been few studies considering the pandemic’s impact on people dying from non-COVID-19 causes and their families and friends. In particular, there has been very less empirical research in relation to end-of-life care for Indigenous, migrant and minoritised ethnic communities.

Objectives:

To explore bereaved next-of-kin’s views and experiences of end-of-life care under COVID-19 pandemic regulations.

Design:

This qualitative study involved in-depth one-off interviews with 30 ethnically diverse next-of-kin who had a family member die in the first year of the pandemic in Aotearoa, New Zealand.

Methods:

Interviews were conducted by ethnically matched interviewers/interviewees. A reflexive thematic analysis was used to explore and conceptualise their accounts.

Results:

A key finding was that dying alone and contracting COVID-19 were seen as equally significant risks by bereaved families. Through this analysis, we identified five key themes: (1) compromised connection; (2) uncertain communication; (3) cultural safety; (4) supported grieving and (5) silver linings.

Conclusion:

This article emphasises the importance of enabling safe and supported access for family/whanau to be with their family/wha-nau member at end-of-life. We identify a need for wider provision of bereavement support. We recommend that policy makers increase resourcing of palliative care services to ensure that patients and their families receive high-quality end-of-life care, both during and post this pandemic. Policy makers could also promote a culturally-diverse end-of-life care work force and the embedding of culturally-safety practices across a range of institutions where people die.
In-work poverty dynamics: trigger events and short-term trajectories in Argentina
Authors: Poy Santiago
Published: August 2023

In-work poverty (IWP) is gaining interest in the public agenda. This article is a first contribution to the analysis of IWP dynamics in Latin America, based on the study of the Argentine case. Using one-year interval panel data, the paper analyzes the trigger events that produce entries and exits from IWP, short-term poverty trajectories and the determinants associated to transient and persistent poverty. Drawing on a decomposition analysis of mutually exclusive events, the article shows that labor market events are the most relevant triggers for both exits and entries into IWP. Based on a multinomial logistic regression, the paper concludes that low education, the presence of children in the household, and having a low-quality job are the three main factors explaining persistent-poverty.
The efficacy of apneic oxygenation during intubation using a prototype of an oxygenation laryngoscope - a technical simulation
Authors: Wetsch Wolfgang A , Schroeder Daniel C , Herff Susanne J , Böttiger Bernd W , Wenzel Volker , Herff Holger
Published: August 2023

Background

Recently, a non-commercial oxygenation laryngoscope was able to maintain apneic oxygenation during simulated intubation efforts. Since that prototype was 3 mm wider than a standard Macintosh laryngoscope blade, the intubation performance of this device may differ from standard blades. A new prototype of an oxygenation laryngoscope was developed, consisting of a standard-size Macintosh blade and a fixed oxygen supply line to the side. Actually, it is unclear at which point of this blade the oxygen supply line should end to facilitate the best possible oxygen supply for apneic oxygenation.

Methods

In this simulation study using a standardized human airway manikin, the efficacy of apneic oxygenation by oxygen insufflation using standard and modified Macintosh blades was compared: a standard Macintosh blade without oxygen supply line as control, one with an additional oxygen supply line ending proximal near the handle, one with the line ending at the middle of the blade, and one with the line ending near the tip. A preoxygenated test lung was connected to an oximeter with a flow rate of 200ml/min, simulating oxygen consumption of a male adult, and to the trachea of an anatomically correctly shaped airway manikin. Apneic oxygenation was performed and oxygen content was measured over a 20-minutes observation period. Experiments were repeated five times for each laryngoscope blade.

Results

Oxygen percentage in the test lung dropped from 100 ± 0% at the start of the experiment to 53 ± 1.5% in the room air control group (p < 0.001 compared to all other groups), and to 74 ± 2.5% in the proximal oxygen line group, whereas oxygen percentage remained at 100% in both the medium and distal oxygen line groups (p = 1 between these groups; p < 0.001 between all other groups).

Conclusions

In this simulation study with a preoxygenated airway manikin, the use of a modified Macintosh laryngoscope blade with oxygen line attached at the tip or at the middle were able to maintain apneic oxygenation without measurable drop of oxygen content over 20 min. Proximal placement of the oxygen supply line still showed an advantage against room air, however it did not completely prevent room air from entering the airway.

Trial registration

Not applicable.
Enhanced recovery after surgery: comes out to the Sun
Authors: El Tahan Mohamed R. , Pahade Akhilesh , Gómez-Ríos Manuel Ángel
Published: August 2023

ERAS programs aim to reduce the length of hospital stays and lower costs, and minimize the risk of postoperative complications and readmissions while enhancing the overall patient experience. BMC Anesthesiology has initiated a new collection on ERAS, urging investigators to conduct large-scale, high-quality studies that address the existing knowledge gap.
Transjugular liver biopsy: enlarge the indications for liver biopsy with reliable diagnostic quality
Authors: Chen Miao-Yang , Yang An-Yin , Hu Yi-Fan , Yang Yong-Feng , Xiong Qing-Fang , Zhong Yan-Dan , Liu Du-Xian
Published: August 2023

Background

Complications and diagnostic efficiency for liver biopsy are main concerns for clinicians. This study aimed to assess the safety and efficacy of transjugular liver biopsy (TJLB) compared with percutaneous liver biopsy (PLB) when patients had equal level of liver function and number of passes, using propensity score matching (PSM).

Methods

The clinical and pathological data of patients who received TJLB or PLB between January 2012 and October 2022 were collected. Matching factors included age, gender, cirrhosis, portal hypertension, liver function, creatinine, number of passes, hemodialysis, history of anti-coagulation and anti-platelet, and comorbidities. Coagulation indexes were not considered as matching factors due to different indications of the two techniques.

Results

2711 PLBs and 30 TJLBs were evaluated. By PSM, 75 patients (50 PLBs, 25 TJLBs) were matched. The complication rates for TJLB and PLB were 4.0% (1/25) and 10.0% (5/50) (P > 0.05). Two PLBs had hepatic hemorrhage, one of which required only close monitoring (Grade 1) and the other needed hemostasis and rehydration therapy (Grade 2). The other 3 cases presented with mild abdominal pain (Grade 1). And only one TJLB presented with mild pain. The median number of complete portal tracts were 6.0 and 10.0 for TJLBs and PLBs (P < 0.05). Moreover, the median length of sample for TJLBs and PLBs were 10.0 and 16.5 mm (P < 0.05). The diagnostic efficiency of hepatopathy of unknown etiology of TJLB versus PLB groups before and after matching were 96.4% vs. 94.1% and 95.7% vs. 93.2%, respectively (P > 0.05).

Conclusion

TJLB is an effective invasive diagnostic procedure that expands indications for liver biopsy with reliable diagnostic quality.
Selective COX-2 inhibitors do not increase gastrointestinal reactions after colorectal cancer surgery: a systematic review and meta-analysis
Authors: Hu Ting , Liu Cheng-Jiang , Yin Xiaoming , Tang WenJuan , Yin LanFang , Bai Hui , Liu FangFang , Wang Dan , Li YiLei
Published: August 2023

Background

The effectiveness of selective COX-2 inhibitors in preventing colorectal cancer recurrence has been demonstrated, however it is unknown how safe and successful they will be over the long term. As a result, we looked at the efficacy, safety, and consequences of adding COX-2 inhibitors to the treatment plan afterward.

Methods

In patients with advanced colorectal cancer, we compared the efficacy of celecoxib at two different doses (200 mg twice day and 400 mg twice daily) with placebo. To evaluate the impacts of post-treatment, several datasets from inception to June 2022 were searched. Response rate, illness control rate, and 3-year survival were the main results. And evaluated several safety outcomes, particularly those that were susceptible to adverse events.

Results

The study comprised a total of 9 randomized controlled trials (3206 participants). Celecoxib and rofecoxib doidn’t significantly improved the 1–3 year remission rate (OR, 1.57 [95% CI: 0.95–2.57]) and disease control rate (OR, 1.08 [95% CI: 0.99–1.17]). Subgroup analysis of different doses showed that 400 mg of celecoxib significantly improved the response rate (OR, 2.82 [95%CI: 1.20–6.61]). 200 mg celecoxib was not significant (OR, 1.28 [95% CI: 0.66–2.49]). Rofecoxib also did not fully improve disease response rates. Celecoxib at any dose improved 3-year survival (OR, 1.21 [95% CI: 1.02–1.45]). It is important to note that COX-2 inhibitors did not significantly enhance the likelihood of adverse events including gastrointestinal or cardiovascular side effects at any dose.

Conclusions

For patients with advanced colorectal cancer, a reasonable chemoprevention regimen can include celecoxib 400 mg twice daily.
Correlation of health-related quality of life for older adults with diabetes mellitus in South Korea: theoretical approach
Authors: Choi Gi Won , Chang Sun Ju
Published: August 2023

Background

While some studies have explored the health-related quality of life (HRQOL) of older adults with diabetes mellitus (DM) in South Korea using a theoretical framework, these studies suffer sample-related limitations, as they focus only on a specific subgroup of older adults. To address this gap, this study aimed to investigate the predictors of HRQOL of older adults with DM in South Korea, using extensive national data and based on the theory of Health-Related Quality of Life in South Korean Older Adults with Type 2 Diabetes (The HIKOD theory).

Methods

A secondary data analysis was conducted using data from 1,593 participants aged 65 years and older with DM sourced from the 2015–2019 Korea National Health and Nutrition Examination Survey (KNHANES). The variables included in this study are as follows: demographic factors (gender, age, household income, and education level), disease-specific factors (duration of DM, treatment of DM, and control of HbA1c), barriers (number of comorbidities), resources (living alone status), psychosocial factors (perceived stress), and health-promoting behaviors (physical activity and fundus examination). Considering the complex sampling design employed in this study, statistical analyses including Rao-Scott chi-square tests, correlation analysis, and hierarchical multiple regression analysis were conducted.

Results

Mobility (45.0%) was the HRQOL dimension with which participants experienced the highest number of problems. Number of comorbidities (r = -0.36, p < 0.001), living alone status (rpb = 0.16, p < 0.001), perceived stress (rpb = 0.14, p < 0.001), and physical activity (rpb = 0.12, p < 0.001) were correlated with HRQOL. While adjusting for background factors, HRQOL was negatively predicted by higher number of comorbidities (estimate B = -0.03, p < 0.001), living alone (estimate B = -0.03, p = 0.043), higher perceived stress (estimate B = -0.09, p < 0.001), and lower physical activity (estimate B = -0.03, p < 0.001).

Conclusion

Complex and diverse factors influence HRQOL among older adults with DM in South Korea. To improve their HRQOL, intervention programs that integrally regard HRQOL, along with various predictors, are necessary.
Psittacosis caused severe community-acquired pneumonia accompanied by acute hypoxic respiratory failure: a multicenter retrospective cohort study from China
Authors: Tang Xiao , Wang Na , Liu Gang , Tan Hai , Li Ai-Min , Gao Yan-Qiu , Yao Meng-Ying , Wang Na , Jing Hui-Dan , Di Qing-Guo , Chen Liang , Wang Rui , Li Xu-Yan , Li Ying , Yuan Xue , Zhao Yu , Li Qi , Tong Zhao-Hui , Sun Bing
Published: August 2023

Introduction

Psittacosis can cause severe community-acquired pneumonia (CAP). The clinical manifestations of psittacosis range from subclinical to fulminant psittacosis with multi-organ failure. It is essential to summarize the clinical characteristic of patients with severe psittacosis accompanied by acute hypoxic respiratory failure (AHRF).

Methods

This retrospective study included patients with severe psittacosis caused CAP accompanied by AHRF from 19 tertiary hospitals of China. We recorded the clinical data, antimicrobial therapy, respiratory support, complications, and outcomes. Chlamydia psittaci was detected on the basis of metagenomic next-generation sequencing performed on bronchoalveolar lavage fluid samples. Patient outcomes were compared between the treatment methods.

Results

This study included 45 patients with severe CAP and AHRF caused by psittacosis from April 2018 to May 2021. The highest incidence of these infections was between September and April. There was a history of poultry contact in 64.4% of the patients. The median PaO2/FiO2 of the patients was 119.8 (interquartile range, 73.2 to 183.6) mmHg. Four of 45 patients (8.9%) died in the ICU, and the median ICU duration was 12 days (interquartile range, 8 to 21) days. There were no significant differences between patients treated with fluoroquinolone initially and continued after the diagnosis, fluoroquinolone initially followed by tetracycline, and fluoroquinolone combined with tetracycline.

Conclusion

Psittacosis caused severe CAP seems not rare, especially in the patients with the history of exposure to poultry or birds. Empirical treatment that covers atypical pathogens may benefit such patients, which fluoroquinolones might be considered as an alternative.
Prevalence and genotypes distribution of virus hepatitis B and hepatitis delta virus in chronic liver diseases in Kazakhstan
Authors: Ilyassova Bibigul S. , Abzhaparova Balzhan , Smailova Dariga S. , Bolatov Aidos , Baymakhanov Bolatbek , Beloussov Vyacheslav , Solomadin Maxim , Shamsivaliyeva Kunsulu , Alpysbayava Gulnara , Issakova Gaukhar , Granica Joanna , Mukushkina Dina , Sagatov Inkar Y. , Kaniyev Shokan
Published: August 2023

Background

The geographical distribution of hepatitis B virus (HBV) and hepatitis D virus (HDV) genotypes is uneven and has its own clinical and organizational implications for health systems. Despite the introduction of vaccination and successful antiviral therapy the prevalence of chronic hepatitis B (with or without delta agent) increased over the past 5 years. This study aimed for the first time to investigate the molecular epidemiology of HBV and HDV in Kazakhstan.

Methods

Total 834 chronic hepatitis B (with or without delta agent) patients were included to the study from November 2017 to June 2019. The material was collected from the regional hepatological сenters from 13 cities of Kazakhstan. Genotyping of HBV/HDV isolates was carried out using phylogenetic analysis of null-binary sequences of Kazakhstani isolates, in comparison with the reference sequences. Nucleotide sequence alignment was performed using the ClustalW algorithm, the “neighbor-joining” method was used for the construction of phylogenetic trees and subsequent analysis.

Results

Overall 341 samples were PCR-positive and genotyped for HBV. Comparison and phylogenetic analysis of nucleotide sequences of HBV isolates showed that they were represented by genotypes HBV-D (95.9%), HBV-A (3.5%) and HBV-C (0.6%). At the same time, the identity of the nucleotide sequences of Kazakhstani isolates were: HBV-D (95–100%); HBV-A (97.2–100%) and HBV-C (99%). 256 samples were PCR positive and genotyped for HDV, all of them belonged to genotype 1.

Conclusion

This study describes for the first time the molecular epidemiology of HBV and HDV in Kazakhstan. The data obtained expand the knowledge of the global epidemiology of viruses; have potential implications for public health policy and for further clinical research on chronic hepatitis in Kazakhstan.

Trial registration

ClinicalTrials.gov NCT05095181 (registered on 27/10/2021).
Defining aggressive prostate cancer: a geospatial perspective
Authors: Wiese Daniel , DuBois Tesla D. , Sorice Kristen A. , Fang Carolyn Y. , Ragin Camille , Daly Mary B. , Reese Adam C. , Henry Kevin A. , Lynch Shannon M.
Published: August 2023

Background

Spatial analysis can identify communities where men are at risk for aggressive prostate cancer (PCan) and need intervention. However, there are several definitions for aggressive PCan. In this study, we evaluate geospatial patterns of 3 different aggressive PCan definitions in relation to PCan-specific mortality and provide methodologic and practical insights into how each definition may affect intervention targets.

Methods

Using the Pennsylvania State Cancer Registry data (2005–2015), we used 3 definitions to assign “aggressive” status to patients diagnosed with PCan. Definition one (D1, recently recommended as the primary definition, given high correlation with PCan death) was based on staging criteria T4/N1/M1 or Gleason score ≥ 8. Definition two (D2, most frequently-used definition in geospatial studies) included distant SEER summary stage. Definition three (D3) included Gleason score ≥ 7 only. Using Bayesian spatial models, we identified geographic clusters of elevated odds ratios for aggressive PCan (binomial model) for each definition and compared overlap between those clusters to clusters of elevated hazard ratios for PCan-specific mortality (Cox regression).

Results

The number of “aggressive” PCan cases varied by definition, and influenced quantity, location, and extent/size of geographic clusters in binomial models. While spatial patterns overlapped across all three definitions, using D2 in binomial models provided results most akin to PCan-specific mortality clusters as identified through Cox regression. This approach resulted in fewer clusters for targeted intervention and less sensitive to missing data compared to definitions that rely on clinical TNM staging.

Conclusions

Using D2, based on distant SEER summary stage, in future research may facilitate consistency and allow for standardized comparison across geospatial studies.
Sleep, social media use and mental health in female adolescents aged 12 to 18 years old during the COVID-19 pandemic
Authors: Chalermchutidej Wikanda , Manaboriboon Boonying , Sanpawitayakul Gornmigar , Theppiban Supparat , In-iw Supinya
Published: August 2023

Background

Adolescents with high social media (SM) use experienced poor sleep quality and high anxiety and depression levels. The study aimed to investigate the characteristics of sleep, use of SM, mental health in female aged 12 to 18 years old, and to assess the association between poor sleep, SM usage, and mental health.

Methods

In total, 219 Thai female adolescents were recruited between December 2019 and September 2020 and completed self-administrative questionnaires three periods of time (baseline, 3 months and 6 months later). The questionnaires included: the Pittsburgh Sleep Quality Index (PSQI), depression screening (PHQ-9), Screen for Child Anxiety Related Emotional Disorders (SCARED). Demographic and use of social media data were also included. Cochran’s Q test, correlation coefficient, and binary logistic regression were performed.

Results

Participants’ mean age was 14.52 (range 12–17) years. Average Thai-PSQI global scores did not differ during 3 periods (p = 0.13) but average time of sleep latency, sleep duration, and SM usage were significant different (p = 0.002, p = 0.001, and p = < 0.001, respectively). There were positive correlations between PSQI scores and total SM usage at baseline (r = 0.14; P < 0.05) and 6 months (r = 0.20; P < 0.05). Anxiety, depression, and self-perception of poor sleep were significantly related to poor sleep quality during the 3 periods. After adjusting for confounding factors, depression and self-reported poor sleep were the only significant factors predicting poor sleep quality.

Conclusions

Poor sleep was associated with SM usage, depression, and anxiety in this population. Time-limited SM usage should be implemented for Thai female adolescents to improve sleep-related outcomes.
Awareness of head and neck cancer among patients attended at a regional referral hospital in Tanzania
Authors: Abraham Zephania Saitabau , Mchele Kisula , Kahinga Aveline Aloyce
Published: August 2023

Background

Head and neck cancers (HNCs) are considered to be lethal and about 50% of the cases are diagnosed at advanced stages and are associated with poor prognosis. Despite the high disease burden globally, there are scarce studies on awareness of HNCs and this is the first study to explore such awareness in Tanzania. The study aimed at determining awareness of head and neck cancer among patients attended at a regional referral hospital in Tanzania.

Methods

A hospital based cross sectional study was conducted at Geita Regional Referral Hospital from April to May 2022 where 315 respondents were recruited. Simple random sampling technique was utilized and data was collected using structured questionnaires and analyzed using Statistical Package for Social Sciences (SPSS) version 23. Chi-square test was performed to establish the relationship between the selected independent and dependent variables. P-value < 0.05 was considered to be statistically significant.

Results

More than half (54.9%) of the respondents considered themselves to be somewhat knowledgeable on head neck cancer. In the same study, 56.2% of the respondents didn’t know anatomical sites of head and neck cancer and over half (65.9%) of the respondents didn't know signs and symptoms of head and neck cancer. Cigarette smoking (73.7%) and alcohol consumption (65.1%) were the most correctly identified risk factors for HNCs. Regarding treatment options and preventive measures, 75.2% of the respondents knew cessation of cigarette smoking as a preventive measure for HNCs and surgery (91.7%) was the most known treatment option for head and neck. Similarly, a significant association was found between awareness on HNCs and some of the socio-demographic characteristics of the respondents.

Conclusions

Although majority of respondents considered themselves to be somewhat knowledgeable on HNCs, awareness by patients on anatomical sites, clinical features, risk factors, preventive measures and curability of head and neck cancer at the Regional Referral Hospital was minimal.
Positive Emotions Training (PoET) as an online intervention to improve mental health: a feasibility study
Authors: Niemann Lara , von Gruner Celin , Zhang Xiao Chi , Margraf Jürgen , Totzeck Christina
Published: August 2023

Background

Positive psychology interventions are known to have an impact on mental health as well as on a number of beneficial characteristics like optimism, gratitude and self-efficacy. The Positive Emotions Training (PoET) is one of the first holistic training programs covering eleven positive psychology constructs. The goal of this study was to test PoET’s feasibility in the general population and to assess possible effects on positive and negative mental health factors. Additionally, possible effects on optimism, gratitude, happiness, resilience, and self-efficacy were examined.

Methods

The sample (n = 101) was not randomized. Participants were allocated to PoET (n = 55) or control group (n = 46) that did not receive treatment initially. The PoET group completed two training sessions (3.5 h each) that were conducted in an online format with groups of about 30 people. All participants completed positive and negative mental health measures at the beginning of the first training session and at the beginning of the second one as well as 30 days after the second session. Two-factorial repeated measures ANOVAs were conducted to test for possible effects of PoET on mental health.

Results

The results showed that the contents were comprehensible and that the conduction of the training was feasible overall. In addition, a significant decrease of depression and anxiety symptoms as well as a significant increase of optimism were found in the PoET group. No significant changes were found in the control group.

Conclusions

Results indicate that PoET is an applicable intervention for improving mental health in the general population.

Trial registration

Retrospectively registered at ClinicalTrials.gov on 21/02/2023 (Identifier/Trial registration number: NCT05737251).
Case reports of collision and composite carcinomas of the thyroid: an insight into their origin and clinical significance
Authors: Ma Tao , Wang Ruixiao , Zhou Xu , Liu Liqiang , Pan Aijing , Wang Hongmei , Huang Lingyan
Published: August 2023

Background

Collision and composite carcinomas of the thyroid are extremely rare, and their clinical and biological characteristics are poorly understood.

Case presentation

The first case was a 41-year-old female patient with a right thyroid nodule. Pathological diagnosis was papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma composite carcinoma. Surgical treatment was right thyroid lobectomy + left partial thyroidectomy + right central neck lymph node dissection. The second case was a 60-year-old female with bilateral thyroid nodules. Total thyroidectomy was performed, and the pathological diagnosis was thyroid collision carcinoma involving follicular thyroid carcinoma on the left side and PTC on the right side.

The clinical, histological and gene changes of collision and composite carcinomas of the thyroid are poorly described. With different biological invasion characteristics, the ideal treatment and the prognosis is currently unknown and individualized treatment is necessary.

Conclusions

It is recommended that in composite carcinoma, each cancer is evaluated and treated according to the most severe tumor. Collision carcinoma should be treated as two separate synchronous primary tumors. For both collision and composite carcinomas of the thyroid, the follow-up after treatment should be extensive.
The interaction between CRY1 Polymorphism and Alternative Healthy Eating Index (AHEI) on cardiovascular risk factors in overweight women and women with obesity: a cross-sectional study
Authors: Firouzabadi Fatemeh Dehghani , Mirzababaei Atieh , Shiraseb Farideh , Tangestani Hadith , Mirzaei Khadijeh
Published: August 2023

Background

According to some studies, diet can be interaction with CRY1 polymorphism and may be related to obesity and the risk of cardiovascular diseases (CVD). So, this study examined the interaction between CRY1 polymorphism and AHEI on cardiovascular risk factors in overweight women and women with obesity.

Methods

This cross-sectional study was performed on 377 Iranian women with overweight and obesity aged 18–48(BMI ≥ 25 kg/m2). Dietary intake was evaluated by the use of a food frequency questionnaire (FFQ) with 147 items. The AHEI was calculated based on previous studies. Anthropometric and biochemical measurements were assessed and the bioelectrical impedance analysis method was used for body analysis. The rs2287161 was genotyped by the restriction fragment length polymorphism (PCR-RFLP) method. Objects were divided into three groups based on rs2287161 genotypes.

Results

Our findings determined that the prevalence of the C allele was 51.9% and the G allele was 48.0%. The mean age and BMI were 36.6 ± 9.1years and 31 ± 4 kg/m2 respectively. After controlling for confounders (BMI, age, total energy intake, and physical activity), this study demonstrated that there was a significant interaction between CC genotype and adherence to AHEI on odds of hyper LDL (OR = 1.94, 95% CI = 1.24–3.05, P for interaction = 0.004), hypertension (OR = 1.80, 95% CI = 1.11–2.93, P for interaction = 0.01) and hyperglycemia (OR = 1.56, 95% CI = 0.98–2.47, P for interaction = 0.05).

Conclusions

This study indicated that adherence to AHEI can reduce the odds of hyper LDL, hypertension, and hyperglycemia in the CC genotype of rs2287161.
Job satisfaction and moral distress of nurses working as physician assistants: focusing on moderating role of moral distress in effects of professional identity and work environment on job satisfaction
Authors: Kim Minsub , Oh Younjae , Lee Joo Yun , Lee Eunhee
Published: August 2023

Background

Physician assistant was created in response to a shortage of physicians. However, this profession is not officially recognized in Korea. Many nurses are working as physician assistants. Their job satisfaction was low due to role conflict. Job satisfaction plays a major role in providing high quality nursing. This study aimed to investigate effects of work environment and professional identity on job satisfaction and identify the mediating role of moral distress in such effects.

Methods

Participants were 112 nurses working as physician assistants. They were recruited from three General Hospitals. A questionnaire scale was used to collect data. Data were analyzed using frequency, descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation, and Macro Model 4 with SPSS Statistics.

Results

Job satisfaction of nurses working as physician assistants had a score of 3.08 out of 5. It showed significant associations with work environment and professional identity. Moral distress had a partial mediating role in relationships of job satisfaction with work environment and professional identity.

Conclusion

Many nurses are working as physician assistants, although physician assistant as a profession is not officially recognized in Korea. Nurses working as physician assistants experience confusion about their professional identity and moral distress. For better nursing outcomes, physician assistant policy should be improved, and various strategies should be provided to improve their job satisfaction.
A successful nursing education promotes newly graduated nurses’ job satisfaction one year after graduation: a cross-sectional multi-country study
Authors: Koskinen Sanna , Brugnolli Anna , Fuster-Linares Pilar , Hourican Susan , Istomina Natalja , Leino-Kilpi Helena , Löyttyniemi Eliisa , Nemcová Jana , Meyer Gabriele , De Oliveira Célia Simão , Palese Alvisa , Rua Marília , Salminen Leena , Sveinsdóttir Herdís , Visiers-Jiménez Laura , Zeleníková Renáta , Kajander-Unkuri Satu ,   on behalf of the ProCompNurse Consortium and the COMPEUnurse Consortium
Published: August 2023

Background

Job satisfaction is a key factor for the successful transition of newly graduated nurses (NGNs) and for retaining NGNs in their workplaces. However, there is limited evidence of the relationship between satisfaction regarding the nursing education program and NGNs’ job satisfaction in the first year after graduation. Therefore, this study aims to examine the association of the nursing education related factors and NGNs’ job satisfaction.

Methods

A cross-sectional study design with the utilization of data collected from the same respondents one year earlier as educational factors was applied. The data were collected from NGNs (n = 557) in 10 European countries using an electronic survey between February 2019 and September 2020, and analyzed in detail for four countries (n = 417). Job satisfaction was measured with three questions: satisfaction with current job, quality of care in the workplace, and nursing profession. Nursing education related factors were satisfaction with nursing education program, level of study achievements, nursing as the 1st study choice, intention to stay in nursing, and generic nursing competence. The data were analyzed statistically using logistic regression.

Results

Most of the NGNs in the 10 countries were satisfied with their current job (88.3%), the quality of care (86.4%) and nursing profession (83.8%). Finnish, German, Lithuanian and Spanish NGNs’ satisfaction with the nursing education program at graduation was statistically significantly associated with their job satisfaction, i.e., satisfaction with their current job, the quality of care, and the nursing profession. Moreover, NGNs who had fairly often or very often intention to stay in nursing at graduation were more satisfied with their current job, with the quality of care, and with the nursing profession compared with NGNs who had never or fairly seldom intention to stay in nursing at graduation.

Conclusions

Nursing education plays a significant role in NGNs’ job satisfaction one year after graduation, indicating the importance to start career planning already during nursing education. Both nursing education providers and healthcare organizations could plan in close collaboration a transition program for NGNs to ease the transition phase and thus increase the NGNs’ job satisfaction and ultimately the high-quality care of the patients.
Societal costs and health related quality of life in adult atopic dermatitis
Authors: Beretzky Zsuzsanna , Koszorú Kamilla , Rencz Fanni , Hajdu Krisztina , Borza Júlia , Bodai Katalin , Feifei Xu , Szegedi Andrea , Sárdy Miklós , Brodszky Valentin
Published: August 2023

Background

Cost-of-illness studies are widely used for healthcare decision-making in chronic conditions. Our aim was to assess the cost-of-illness of adult atopic dermatitis (AD) from the societal perspective in Hungary.

Methods

We conducted a multicentre, cross-sectional questionnaire survey between February 2018 and January 2021. Data was collected from consecutive AD patients aged ≥ 18 years and their physicians at dermatology departments in Hungary. We calculated direct and indirect costs, including costs for treatments, outpatient visits, hospital admissions, informal care, travel costs and productivity loss. To assess indirect costs, the Work Productivity and Activity Impairment (WPAI) questionnaire was used to collect data, and costs were estimated with the human capital approach. Generalized linear model was used to analyse predictors of total, direct and indirect costs.

Results

Altogether 218 patients completed the survey (57.8% female) with an average age of 31.3 (SD = 11.7). Patients’ average Dermatology Life Quality Index (DLQI) score was 13.5 (SD = 8.5). According to Eczema Area and Severity Index (EASI) score, 2.3% (n = 5), 21.2% (n = 46), 54.4% (n = 118) and 22.1% (n = 48) had clear, mild, moderate, and severe AD, respectively. We found that the average total, direct medical, direct non-medical and indirect annual costs per patients were €4,331, €1,136, €747, and €2450, respectively, with absenteeism and presenteeism being the main cost drivers, accounting for 24% and 29% of the total cost of AD. A one-year longer disease duration led to, on average, 1.6%, and 4.2% increase in total and direct non-medical costs, respectively. Patients with worse health-related quality of life (higher DLQI score) had significantly higher total, direct medical, direct non-medical costs, and indirect costs.

Conclusions

Our results indicate a substantial economic burden of AD from a societal perspective, mainly driven by productivity losses.
Comparison of pay-for-performance (P4P) programs in primary care of selected countries: a comparative study
Authors: Jamili Sara , Yousefi Mehdi , pour Hossein Ebrahimi , Houshmand Elahe , Taghipour Ali , Tabatabaee Seyed Saeed , Adel Amin
Published: August 2023

Background

Pay for performance (P4P) schemes provide financial incentives or facilities to health workers based on the achievement of predetermined performance goals. Various P4P programs have been implemented around the world. There is a question of which model is suitable for p4p implementation to achieve better results. The purpose of this study is to compare pay for performance models in different countries.

Methods

This is a descriptive-comparative study comparing the P4P model in selected countries in 2022. Data for each country are collected from reliable databases and are tabulated to compare their payment models. the standard framework of the P4P model is used for data analysis.

Results

we used the standard P4P model framework to compare pay for performance programs in the primary care sector of selected countries because this framework can demonstrate all the necessary features of payment programs, including performance domains and measures, basis for reward or penalty, nature of the reward or penalty, and data reporting. The results of this study show that although the principles of P4P are almost similar in the selected countries, the biggest difference is in the definition of performance domains and measures.

Conclusions

Designing an effective P4P program is very complex, and its success depends on a variety of factors, from the socioeconomic and cultural context and the healthcare goals of governments to the personal characteristics of the healthcare provider. considering these factors and the general framework of the features of P4P programs are critical to the success of the p4p design and implementation.
Trend analysis of malaria in urban settings in Ethiopia from 2014 to 2019
Authors: Teka Hiwot , Golassa Lemu , Medhin Girmay , Balkew Meshesha , Sisay Chalachew , Gadisa Endalamaw , Nekorchuk Dawn M. , Wimberly Michael C. , Tadesse Fitsum Girma
Published: August 2023

Background

Urbanization generally improves health outcomes of residents and is one of the potential factors that might contribute to reducing malaria transmission. However, the expansion of Anopheles stephensi, an urban malaria vector, poses a threat for malaria control and elimination efforts in Africa. In this paper, malaria trends in urban settings in Ethiopia from 2014 to 2019 are reported with a focus on towns and cities where An. stephensi surveys were conducted.

Methods

A retrospective study was conducted to determine malaria trends in urban districts using passive surveillance data collected at health facilities from 2014 to 2019. Data from 25 towns surveyed for An. stephensi were used in malaria trend analysis. Robust linear models were used to identify outliers and impute missing and anomalous data. The seasonal Mann-Kendal test was used to test for monotonic increasing or decreasing trends.

Results

A total of 9,468,970 malaria cases were reported between 2014 and 2019 through the Public Health Emergency Management (PHEM) system. Of these, 1.45 million (15.3%) cases were reported from urban settings. The incidence of malaria declined by 62% between 2014 and 2018. In 2019, the incidence increased to 15 per 1000 population from 11 to 1000 in 2018. Both confirmed (microscopy or RDT) Plasmodium falciparum (67%) and Plasmodium vivax (28%) were reported with a higher proportion of P. vivax infections in urban areas. In 2019, An. stephensi was detected in 17 towns where more than 19,804 malaria cases were reported, with most of the cases (56%) being P. falciparum. Trend analysis revealed that malaria cases increased in five towns in Afar and Somali administrative regions, decreased in nine towns, and had no obvious trend in the remaining three towns.

Conclusion

The contribution of malaria in urban settings is not negligible in Ethiopia. With the rapid expansion of An. stephensi in the country, the receptivity is likely to be higher for malaria. Although the evidence presented in this study does not demonstrate a direct linkage between An. stephensi detection and an increase in urban malaria throughout the country, An. stephensi might contribute to an increase in malaria unless control measures are implemented as soon as possible. Targeted surveillance and effective response are needed to assess the contribution of this vector to malaria transmission and curb potential outbreaks.