bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal Factors in Relation to Early Childhood Caries Among Preschool Children in Myanmar
Authors: Thwin Kaung Myat , Takehara Sachiko , Kawaguchi Yoko , Ogawa Hiroshi
Published: August 2023

A cross-sectional study was conducted among 3- to 5-year-old preschool children in Yangon City in 2016-2017 to investigate the association between their caries experience and maternal factors. Children’s oral examination and questionnaire surveys to their mothers were conducted. Children’s caries prevalence was 82.9% with mean dmft of 6.4 ± 4.9. Mean oral health knowledge score of their mothers was 8.5 ± 2.8. Mother’s educational level and oral health knowledge were significant predictors of childhood caries. Third- or later-born children were twice more likely to have dental caries than first-born children ( P = .022). Mother’s regular dental check-up resulted in significantly lower odds ratios for caries development in her child. Children’s caries experience was high and mother’s oral health knowledge regarding the importance of primary teeth was unsatisfactory. It is, therefore, necessary to improve awareness and attentiveness for prevention of childhood caries among parents and guardians in Myanmar.
Longitudinal outcomes following peripheral vascular intervention among older persons living with HIV
Authors: Kentoffio Katherine , Sun Tianyu , Xu Jiaman , Parikh Rushi V , Hsue Priscilla Y , Secemsky Eric A
Published: August 2023

Background:

Persons living with human immunodeficiency virus (HIV, PLWH) have an increased risk of peripheral artery disease (PAD) in comparison to the general population. However, a gap remains in understanding optimal management for this condition. This study assesses longitudinal outcomes associated with peripheral endovascular intervention (PVI) for PAD among PLWH.

Methods:

All Medicare fee-for-service patients undergoing femoropopliteal artery PVI between April 1, 2015 and December 31, 2018 were identified and stratified by HIV serostatus. The primary outcome was major adverse limb events (MALE), defined as major amputation or arterial embolism/thrombosis following an index procedure. The subdistribution hazard was used to evaluate the association between HIV serostatus and MALE, accounting for the competing risk of death. Results were adjusted for sociodemographics and major comorbidities.

Results:

Of 168,553 patients who underwent PVI, 357 (0.21%) were PLWH. The average age was 77.0 ± 7.6 years; 80.3% had hypertension, 70.3% had hyperlipidemia, and 24.6% had tobacco use disorder. Compared to those without HIV, PLWH were younger and had a higher burden of cardiovascular risk factors. MALE were substantially more frequent among PLWH, with a cumulative incidence of 24.6%, compared to 14.5% among those without HIV. The adjusted subdistribution hazard ratio was 1.26 (95% CI 1.00–1.58, p = 0.05). The use of guideline-directed statin therapy was low in both groups in the 90 days following revascularization (57.9% in PLWH vs 58.1% in those without HIV, p = 0.95).

Conclusion:

Among US Medicare beneficiaries, PLWH had poorer long-term outcomes following PVI. Greater attention to the management of symptomatic PAD is warranted for the HIV population, particularly following revascularization.
‘Trying to battle a very slow version of the system that exists outside’: Experiences of waiting for healthcare in English prisons
Authors: Bellass Sue , Canvin Krysia , Sheard Laura
Published: August 2023

Prison has been described as the ultimate form of time-punishment – a place where time is no longer a commodity for individuals to spend, but is ordered by a system which symbolises its power through the control of segments of people’s lives. As such, a prison sentence epitomises the experience of waiting. Yet anticipating release is not the only form of waiting within carceral life; waiting for healthcare in its various forms also shapes people’s temporal experience. Drawing on interviews with 21 people who have lived in prison, this article describes how experiences of waiting for healthcare are mediated by expectation or hope, perceptions of the relationship between behaviour and healthcare access, and the consequences of waiting for care. Constraints on the autonomy of people in prison mean that waiting for healthcare differs in important ways from waiting for healthcare in the community, and can be perceived as an additional form of punishment. The experience of waiting for prison healthcare can affect physical and psychological well-being, and can in itself be understood as a pain of imprisonment.
A novel microwave-based non-destructive testing system for detection of sub-surface defects in natural flax fiber reinforced composite material
Authors: Anbalagan Arunkumar , Ramalingam Vimal Samsingh , Sundarsingh Esther Florence , Subbaraj Sangeetha
Published: August 2023

In the work presented here, microwave non-destructive testing using a rectangular waveguide loaded with a novel planar unit cell filter for the inspection of defects in the composite is studied. The proposed planar filter is designed as a unit cell with a copper (annealed) microstrip component on an FR-4 substrate. The waveguide loaded with the planar filter exhibits a reflection coefficient of −35.919 dB at a frequency of 10.548 GHz. This planar filter waveguide is used as the sensor probe for the non-destructive testing method proposed here and is aimed to increase the sensitivity by measuring the differences in permittivity of materials. Computer simulation technology software (CST studio suite) is used for implementing the design, simulation, and material/defect evaluation. The defects studied are voids, cracks, and delamination in an epoxy-based natural flax fiber-reinforced composite material. The performance-improved microwave sensor probe is used to pick up permittivity variations in the presence of defects in lax-based natural fiber-reinforced composite material.
Intravaginal Combination Therapy of Acetic and Lactic Acid in premenopausal women with recurrent vulvovaginal candidiasis: A randomized, double-blind placebo-controlled feasibility trial
Authors: Strydom Moira Bradfield , Khan Sohil , Walpola Ramesh L , Testa Chris , Ware Robert S , Tiralongo Evelin
Published: August 2023

Background:

Recurrent vulvovaginal candidiasis management primarily entails azole therapy used as required or as an extended daily or weekly maintenance therapy for 6 months or more. Unfortunately, relapse within 3–6 months of ceasing maintenance therapy is experienced for more than half the patients, for whom indefinite treatment is required.

Objectives:

To explore the feasibility of trial design examining a prophylaxis treatment to prevent recurrent vulvovaginal candidiasis symptomatic episodes and reduce adverse effects.

Study Design:

A double-blinded randomized controlled feasibility trial was conducted in Australia. Women with recurrent vulvovaginal candidiasis were enrolled.

Methods:

An intravaginal prophylaxis application of lactic acid and acetic acid (Intravaginal Combination Therapy of Acetic and Lactic Acid) was compared with placebo. Primary outcomes comprised recruitment and retention, compliance to study medications and study assessments. Secondary outcomes included the reduction of symptomatic recurrence over the trial period and the acceptability, satisfaction, safety and tolerability of the intervention. The feasibility of quality-of-life measures was also explored.

Results:

Fifteen participants were enrolled and randomized (active = 9, placebo = 6). Consent rate was 23.4%. Eight participants were lost to follow-up (active = 5, placebo = 3). Forty-seven per cent of participants (n = 7) were 100% compliant with the intervention, six of which completed the trial with good assessment compliance. The blinding process was effective. The study demonstrated a reduction in relapse in both active and placebo groups with only four participants across both groups reporting symptomatic episodes while enrolled. The intervention demonstrated good tolerability. Quality-of-life data showed minimal variance with a high quality-of-life measure.

Conclusion:

This trial assesses the feasibility of conducting a large-scale study exploring the efficacy of the Intravaginal Combination Therapy of Acetic and Lactic Acid intravaginal intervention and hints on the importance of psychological support through appropriate disease-specific communication and clinical attention. Consideration of the reported recruitment challenges, the inclusion of suitable quality-of-life measures and digital data collection is warranted for adaptation to a fully powered trial.
Serum homocysteine level in newly diagnosed young patients with abnormal glucose tolerance
Authors: Rijal Amrit , Sultana Nusrat , Hasan Mashfiqul , Morshed Md Shahed , Hasanat Muhammad Abul
Published: August 2023

Background:

Hyperhomocysteinemia is an emerging risk factor causing early-onset cardiovascular events. The objective of the study was to assess serum homocysteine levels in newly diagnosed young persons (age < 30 years) with abnormal glucose tolerance.

Methodology:

This cross-sectional study included 40 young participants with newly diagnosed abnormal glucose tolerance (including prediabetes and diabetes mellitus) and an equal number of young persons with normal glucose tolerance (normal glucose tolerance vs prediabetes vs. diabetes mellitus-age (years): 25.0 (22.0, 28.0) vs 25.50 (21.50, 27.0) vs 28.0 (25.0, 29.0), median (interquartile range)). Glycemic status was diagnosed by American Diabetes Association, 2021 criteria. After taking clinical information, fasting blood was collected to measure homocysteine by chemiluminescent immunoassay.

Results:

Homocysteine level was different across the spectrum of glycemic status (normal glucose tolerance vs. prediabetes vs. diabetes mellitus: 15.57 (13.89–20.71) vs 13.19 (11.40–18.11) vs 12.27 (9.97–14.42) µmol/L; median (interquartile range); p = 0.006). Serum homocysteine was significantly elevated in participants with normal glucose tolerance than diabetes mellitus ( p = 0.006) but statistically similar in prediabetes in comparison to both normal glucose tolerance and diabetes mellitus ( p = NS for both). Homocysteine level was above the normal level in 47.5% of participants with normal glucose tolerance and in 22.5% with abnormal glucose tolerance ( p = 0.019).

Conclusions:

Patients under 30 years with diabetes mellitus had lower homocysteine levels than those with normal glucose tolerance.
Medication Assisted Treatment Program Policies: Opinions of People in Treatment
Authors: Carter Martha , Boyd Jennifer , Bennett Trey , Baus Adam
Published: August 2023

Introduction:

Medication assisted treatment (MAT) for opioid use disorder (OUD) saves lives and enhances quality of life for people in recovery. However, only a small percentage of people eligible for MAT in the United States receive treatment, and among those who do seek treatment, retention is a challenge. This study aims to understand factors that help individuals enter and stay in MAT from the perspective of those in recovery. The patient perspective is vital in efforts to improve care delivery and best support individuals in treatment.

Methods:

Survey development was driven by a review of current peer-reviewed literature plus information gained through 3 semi-structured interviews and follow-up discussions with 5 individuals who have lived experience in MAT, termed Participant Advisors. Survey questions focused in part on MAT participants’ opinions relating to program policies such as drug testing, relapse protocols, duration of treatment, participant use of anti-anxiety medications and marijuana, and requirements for attendance in peer recovery groups such as Narcotics Anonymous and Alcoholics Anonymous. Responses were collected from West Virginia-based MAT programs from February through August 2021, with 1700 surveys distributed to 21 MAT programs.

Results:

At the close of data collection, 225 survey responses, including over 500 free-text comments, were received (13.2% response rate). Most (n = 207, 95%) were currently in a MAT program and most (n = 187, 88.6%) reported using buprenorphine/naloxone for MAT, though participants reported having used other medications for treatment of OUD as well. Questions about how long a person should have MAT prescribed, how long they should be able to stay in treatment, whether they can use marijuana or anti-anxiety drugs while in treatment, and whether they should use a 12-step program generated mixed opinions. Findings strongly support consideration of individual situations and shared decision-making with providers.
Investigating the Associations Between Socioeconomic Factors and Unhealthy Days among Adults Using Zero-inflated Negative Binomial Regression
Authors: Liu Jin , Jiang Ning , Fan Amy Z. , Thompson William W. , Ding Ruyi , Ni Shiguang
Published: August 2023

Poor social and economic circumstances affect the health of individuals throughout the life cycle. The purpose of the study was to examine whether state-level and individual-level socioeconomic factors are associated with mentally or physically unhealthy days in the general U.S. population of adults. The Behavioral Risk Factor Surveillance System and the American Community Survey in 2016 were used to examine state-level social determinants of health and the number of self-reported mentally unhealthy days in the last 30 days using Zero-Inflated Negative Binomial (ZINB) regression models. Men, older individuals, minorities, persons with higher educational attainment levels, persons who were employed, persons who were married, or with a partner, and persons with one or zero chronic condition were more likely to report excessive zeros for responses to the mentally, and physically unhealthy days. The negative binomial regression results indicated that higher state-level poverty rates, higher income inequity, lower median income, and higher unemployment rates were related to the higher number of reported mentally, and physically unhealthy days. Persons with higher educational attainment, and who were employed reported lower mentally, and physically unhealthy days. The findings show significant relationships between socioeconomic contexts and general health status. Health planners and policymakers may use the results to allocate resources and guide public policies and programs.
Can Equity Incentives Restrain Defensive Behaviors in Corporate Cash Holding Decisions?
Authors: Liao Feimei , Zhang Jiaqing , Ye Songqin
Published: August 2023

The present study aims to explore the effect of equity incentive intensity on defensive behavior in enterprise cash holding decision-making using ordinary least squares, System GMM, and Heckman tests. This study finds that the higher the intensity of equity incentives, the lower the level of corporate excess cash holdings. The intensity of equity incentives inhibits defensive behavior in corporate cash holding decisions. A substitute relationship is observed between equity incentive intensity and product market competition in the inhibition of management defensive behavior in cash holding decision. Our further research finds that the inhibitory effect of equity incentive intensity on the defensive behavior of cash holding decisions mainly exists in the case of ineffective supervision by large shareholders and creditors. For theoretical contribution, this paper tries to explore the governance effect of equity incentive on the management defensive behavior in a company’s cash holding decision making. It also reveals the substitute relationship between the intensity of equity incentive and the product market competition in suppressing the management defensive behavior in the cash holding decision of enterprises. Moreover, it provides new evidence for the governance effect of equity incentive in the institutional environment and expands the literature on equity incentive effects.
Jeddah Retinopathy of Prematurity (JED-ROP) Screening Algorithm
Authors: Raffa Lina , Alamri Aliaa , Alosaimi Amal , Alessa Sara , AlHarbi Suzan , AlNowaiser Sara , Ahmedhussein Huda , Almarzouki Hashem , Al Qurashi Mansour
Published: August 2023

Background. The Jeddah retinopathy of prematurity (JED-ROP) algorithm, which is more specific to the population in Saudi Arabia, was established to decrease the number of infants screened without missing type 1 ROP cases. Methods. The data reviewed were birth weight (BW), gestational age (GA), weekly postnatal weight gain (PWG), and relevant perinatal risk factors. The sensitivities and specificities for detecting type 1 ROP were calculated. Results. Of the 502 infants included in the study, 148 developed ROP. The JED-ROP algorithm demonstrated 100% sensitivity and 38.9% specificity for recommending the screening of infants with GA ≤30 weeks and BW <1501 g and blood transfused <6 weeks and/or 3-week PWG <100 g in the type 1 ROP group. Conclusion. The JED-ROP algorithm can reduce the number of infants requiring ROP screening by 35.7% without missing type 1 ROP. The algorithm can be an adjunct to current national screening guidelines.
Insider and Outsider Knowledge: Etic and Emic Perspectives on Empirical Missiological Research and Its Consequences for Theological Education
Authors: Schuckert Tobias
Published: August 2023

This article discusses the need for a distinction between an outsider’s and an insider’s perspective in missiological research. It uses the concept of etic and emic that has been developed by the linguist Kenneth Pike, demonstrating the need from the historical example of the representation of Indian life and religion in Europe as well as some epistemological questions that evolve from the topic. Here, an outsider’s perspective led to a misunderstanding of Hinduism that has persisted to the present day. This contribution introduces recent research examples that illustrate the integrating etic and emic perspectives in research. After some practical considerations, the article concludes with consequences for theological education for missions.
Lived Poetics as a Contemplative Stance of Christian Witness: The Case from Australia for a World in Crisis
Authors: Yang Xiaoli
Published: August 2023

This paper evokes reflections on “lived poetics” as a contemplative stance of Christian witness during the recent pandemic in the context of multicultural Australia “Down Under.” Following an explanation of lived poetics, this paper articulates how deep listening, imagination, and participation are encompassed during periods of lockdown. By amplifying the author’s own and other Australian poetic voices, it seeks to demonstrate the power of lived poetics rooted in lived experience is both inspirational and transformative. It argues that this aesthetic epistemological path to make a beautiful and meaningful life is an effective contemplative stance of Christian witness in a broken world. It offers a new spiritual horizon of beauty that may save the world from decay and ashes, a new way of being and becoming fully alive.
Surface and crack effects on longitudinal vibration of thick nanorods with various boundary conditions
Authors: Shokrollahi Hassan , Nazemnezhad Reza
Published: August 2023

Considering the effect of surface parameters and crack on the longitudinal vibration of nanorods is the aim of this study. The nanorod is assumed to be thick, and it is modeled based on Bishop theory of rods. In thick nanorods, the effects of the inertia of lateral motions and the shear stiffness are considered in the kinetic energy and the strain energy of the nanorod, respectively. In the present study, the crack is modeled as a linear spring in which its stiffness is related to the crack severity. The surface parameters considered are the surface Lamé constants, the surface density, and the surface stress. Considering all surface parameters causes inhomogeneity of governing equations and boundary conditions. After converting inhomogeneous equations to homogeneous ones, the resulted equations are solved numerically. All possible boundary conditions are introduced but only natural frequencies of nanorod with fixed-fixed and fixed-free are reported. In addition to considering the effect of type of boundary conditions on the natural frequencies, the effect of geometrical parameters like radius and length, and mode number is also considered. The results are presented for both thin and thick nanorods to compare the effect of various parameters especially surface parameters on longitudinal frequencies.
Place of death from dementia as an underlying cause during the COVID-19 pandemic in Japan: a cross-sectional study from national death certificates
Authors: Nakanishi Miharu , Yamasaki Syudo , Sakai Mai , Yoshii Hatsumi , Ogawa Asao , Nishida Atsushi
Published: August 2023

Background:

The coronavirus disease (COVID-19) pandemic has challenged palliative end-of-life care for people with dementia. The site of death can be considered as an end-of-life care quality indicator. Most people with dementia prefer to die at nursing or private homes; however, in Japan, they are often hospitalized in psychiatric hospitals for management of neuropsychiatric symptoms. As palliative end-of-life care for older adults with Alzheimer’s disease and related dementias has been further challenged by the COVID-19 pandemic, little is known about its effects on the place of death in patients with dementia.

Objectives:

This study aimed to investigate the shifts in place of death from dementia during the COVID-19 pandemic in Japan. Changes throughout the pandemic were compared between deaths from dementia and from senility.

Design:

Cross-sectional.

Methods:

Death certificate data of individuals aged 65 years or older who died in Japan between 1 January 2018, and 31 December 2021, were used to extract the cause and place of death. Differences in place of death between the periods were estimated using multinomial logistic analysis with reference to death in private homes.

Results:

Deaths from dementia mostly occurred in hospitals (59%), while deaths from senility were most frequent in nursing homes (37%). After adjusting for patient characteristics, the likelihood of hospital deaths significantly increased for patients with dementia during the pandemic. Meanwhile, the likelihood of senility deaths decreased in hospitals but increased in nursing homes during the pandemic.

Conclusion:

The shift to hospital deaths since the onset of the COVID-19 pandemic was uniquely observed in deaths from dementia. This hospital shift likely involved increased transfers from nursing and private homes to psychiatric hospitals. Further investigation is needed to examine the association between the pandemic-related change in long-term care workforce and palliative care practice in people with dementia.
Developing a compassionate community: a Canadian conceptual model for community capacity development
Authors: Kelley Mary Lou
Published: August 2023

The purpose of this article is to share a Canadian model called Developing a Compassionate Community (DCC) in which aging, dying, caregiving, and grieving are everyone’s responsibility. The model provides a research-informed practice guide for people who choose to adopt a community capacity development approach to developing a compassionate community. Based on 30 years of Canadian research by the author in rural, urban, First Nations communities, and long-term care homes, the DCC model offers a practice theory and practical tool. The model incorporates the principles of community capacity development which are as follows: change is incremental and in phases, but nonlinear and dynamic; the change process takes time; development is essentially about developing people; development builds on existing resources (assets); development cannot be imposed from the outside; and development is ongoing (never-ending). Community capacity development starts with citizens who want to make positive changes in their lives and their community. They become empowered by gaining the knowledge, skills, and resources they need. The community mobilizes around finding solutions rather than discussing problems. Passion propels their action and commitment drives the process. The strategy for change is engaging, empowering, and educating community members to act on their own behalf. It requires mobilizing networks of families, friends, and neighbors across the community, wherever people live, work, or play. Community networks are encouraged to prepare for later life, and for giving and getting help among themselves. This Canadian model offers communities one approach to developing a compassionate community and is a resource for implementing a public health approach to end-of-life care in Canada. The model is also available to be evaluated for its applicability beyond Canada and is designed to be adapted to new contexts if desired.
Rare Case of Infraorbital Desmoplastic Fibroma in a 10-Year-Old: Challenging Diagnosis, Unusual Location and Multidisciplinary Management: A Case Report
Authors: Krishna Venkata Rajesh Varma Chundru , Mohapatra Devi Prasad , Jyothy Surendran Amrutha , Badhe Bhawana Ashok
Published: August 2023

Desmoplastic fibroma is a rare benign bone tumor primarily seen in long bones and mandible. Our case was of a 10-year-old with painless infra orbital swelling for which she underwent excision under general anesthesia and reconstruction with orbital plating and iliac crest bone grafting. By its unique clinical presentation and diagnostic challenges encountered in managing this condition, this case report expands our understanding of the disease’s presentation and management, it guides future therapeutic decision-making in similar pediatric cases.
The China International Commercial Court: Establishment and Development in a Global Context
Authors: Sun Xiangzhuang
Published: August 2023

International commercial courts have proliferated in the past 20 years. In 2018, China established specialized international commercial courts in Shenzhen and Xi’an. They are the two branches of the China International Commercial Court (CICC). Since then there has been a proliferation of literature on the CICC. This article provides insights into the recent development of the CICC. The first part of the article explores the background against which the CICC was established. The second part narrates its recent development. The challenges the CICC faces to improve its attractiveness and competitiveness are discussed in the third part and the fourth part considers possible competition between international commercial courts in different jurisdictions. The article closes with a few concluding remarks on the place of the CICC in the global transnational commercial dispute resolution community.
Impact of COVID-19 on pediatric emergency fellowship training in Saudi Arabia
Authors: Khobrani Ahmad , Kentab Osama , Algarni Abdulaziz , Ibrahim Ahmad AAl , Bhat Javid Ahmad , Abdulmajeed Ammar , Homaida Wafa , Basheer Sara El , Akkam Abdullah , Aljahany Muna
Published: August 2023

Objectives

To assess the impact of the COVID-19 pandemic on the academic and clinical processes of pediatric emergency medicine (PEM) fellowship training held by the Saudi Commission for Health Specialties (SCHS).

Methods

A cross-sectional, nationwide, survey-based study was conducted between June and December 2020. PEM program directors as well as fellowship trainees were eligible. The collected data were under the following domains: (1) sociodemographic and work-related characteristics; (2) impact of the COVID-19 pandemic on patient flow and PEM procedures; (3) impact on emergency skills and competence; (4) impact on academic performance; and (5) attitudes toward PEM practice and potential solutions. Monthly reports of PEM visits and procedures were also collected from program directors.

Results

A total of 11 PEM program directors and 42 fellows responded. During the pandemic, the number of total ED visits decreased by 70.1%, ED inpatient admissions fell by 57.3%, and the number of intraosseous need insertion and lumbar puncture procedures fell by 76.7% and 62.3%, respectively; the temporal differences in the median frequencies were statistically significant. The pandemic has influenced the knowledge acquisition and leadership skills of one-third of program directors (36.4% and 27.3%, respectively) and the skills and competence of fellows (31.0%). The majority of directors and fellows showed that online classes/webinars were useful (100% and 95.2%, respectively), and there was no need to extend the current fellowship training to compensate for learning deficits (62.7% and 78.6%, respectively). The importance of dedicated modalities to fill in the training gap increased by 62.5% of program directors and 35.7% of fellows.

Conclusion

The COVID-19 pandemic had significant effects on clinical procedures and academic activities in the PEM fellowship program. The impact was consistently perceived across PEM program directors and fellows. Technology-driven solutions are warranted to mitigate the expected learning and clinical deficits due to reduced clinical exposure.
Floristic composition and plant community distribution along environmental gradients in Guard dry Afromontane forest of Northwestern Ethiopia
Authors: Dagne Yitayih , Birhanu Liyew
Published: August 2023

Background

Dry evergreen montane forests of Ethiopia provide economic and ecological services for the community but it is under several threats of natural and anthropogenic disturbances. The study aimed to investigate the floristic composition, species diversity, and plant community distribution of Guard forest along environmental gradients.

Methods

A systematic sampling technique was used to collect vegetation and environmental data. Fifty eight plots each with 400 m2 (20 m X 20 m) were established for trees and shrubs and 2 m x2m (4 m2) for herbs along eleven transect lines. Shannon Weiner diversity index and evenness were used to assess the species diversity and richness. The similarities among plant communities were computed using Sorenson’s similarity index. The plant community types and vegetation-environment relationships were analyzed using hierarchical cluster analysis and Canonical correspondence analysis (CCA) in R software, respectively.

Results

A total of 137 plant species belonging to 111 genera and 55 families were identified. The most dominant families in the study area were Fabaceae and Asteraceae. Among the total plant species documented in the forest, 42(30.65%) were trees, 36 (26.28%) were shrubs, 48(35.04%) were herbs, and 11 (8.03%) were climbers. Of the total species, 14(10.22%) species are endemic to Ethiopia and Eritrea. Three plant community types were identified by cluster analysis. The Shannon-Weiner Diversity Index was 3.39 and evenness was 0.87 for the forest. The pattern of plant species distribution was significantly influenced by altitude, pH, BD, slope, and charcoal (P < 0.05).

Conclusion

Guard forest has good species diversity and richness, and supports different endemic plant species that show the potential of the area to support useful but some of the characteristics species are not found in the forest and others are rare in their existence due to the presence of disturbances and need immediate conservation to ensure sustainable use and management of the forest.
Attrition one year after starting antiretroviral therapy before and after the programmatic implementation of HIV “Treat All” in Sub-Saharan Africa: a systematic review and meta-analysis
Authors: Makurumidze Richard , Decroo Tom , Jacobs Bart K. M. , Rusakaniko Simbarashe , Van Damme Wim , Lynen Lutgarde , Gils Tinne
Published: August 2023

Introduction

Evidence on the real-world effects of “Treat All” on attrition has not been systematically reviewed. We aimed to review existing literature to compare attrition 12 months after antiretroviral therapy (ART) initiation, before and after “Treat All” was implemented in Sub-Saharan Africa and describe predictors of attrition.

Methods

We searched Embase, Google Scholar, PubMed, and Web of Science in July 2020 and created alerts up to the end of June 2023. We also searched for preprints and conference abstracts. Two co-authors screened and selected the articles. Risk of bias was assessed using the modified Newcastle–Ottawa Scale. We extracted and tabulated data on study characteristics, attrition 12 months after ART initiation, and predictors of attrition. We calculated a pooled risk ratio for attrition using random-effects meta-analysis.

Results

Eight articles and one conference abstract (nine studies) out of 8179 screened records were included in the meta-analysis. The random-effects adjusted pooled risk ratio (RR) comparing attrition before and after “Treat All” 12 months after ART initiation was not significant [RR = 1.07 (95% Confidence interval (CI): 0.91–1.24)], with 92% heterogeneity (I2). Being a pregnant or breastfeeding woman, starting ART with advanced HIV, and starting ART within the same week were reported as risk factors for attrition both before and after “Treat All”.

Conclusions

We found no significant difference in attrition before and after “Treat All” one year after ART initiation. While “Treat All” is being implemented widely, differentiated approaches to enhance retention should be prioritised for those subgroups at risk of attrition.

PROSPERO number

CRD42020191582.
A novel likely pathogenic CLCN5 variant in Dent’s disease
Authors: Hayward S , Norton J , Bownass L , Platt C ,   Genomics England Research Consortium, Ambrose J. C. , Arumugam P , Bevers R. , Bleda M. , Boardman-Pretty F. , Boustred C. R. , Brittain H. , Brown M. A. , Caulfield M. J. , Chan G. C. , Giess A. , Griffin J. N. , Hamblin A. , Henderson S. , Hubbard T. J. P. , Jackson R. , Jones L. J. , Kasperaviciute D. , Kayikci M. , Kousathanas A. , Lahnstein L. , Lakey A , Leigh S. E. A. , Leong I. U. S. , Lopez F. J. , Maleady-Crowe F. , McEntagart M. , Minneci F. , Mitchell J. , Moutsianas L. , Mueller M. , Murugaesu N. , Need A. C. , O‘Donovan P. , Odhams C. A. , Patch C. , Perez-Gil D. , Pereira M. B. , Pullinger J. , Rahim T. , Rendon A. , Rogers T. , Savage K. , Sawant K. , Scott R. H. , Siddiq A. , Sieghart A. , Smith S. C. , Sosinsky A. , Stuckey A. , Tanguy M. , Taylor Tavares A. L. , Thomas E. R. A. , Thompson S. R. , Tucci A. , Welland M. J. , Williams E. , Witkowska K. , Wood S. M. , Zarowiecki M. , Campbell H , Watson E , Forrester N , Smithson S , Menon A
Published: August 2023

Background

The majority of cases of Dent’s disease are caused by pathogenic variants in the CLCN5 gene, which encodes a voltage-gated chloride ion channel (ClC-5), resulting in proximal tubular dysfunction. We present three members of the same family and one unrelated paediatric patient with the same insertion-deletion CLCN5 variant. The identification of these patients and positive familial segregation led to the re-classification of this variant from one of unknown significance to one of likely pathogenicity.

Case presentation

A 41 year old male presented with end stage kidney failure, proteinuria and haematuria. Whole genome sequencing identified an insertion-deletion variant in CLCN5, resulting in a missense change (c.1744_1745delinsAA p.(Ala582Lys)). His brother and nephew, who both exhibited renal impairment, haematuria, proteinuria, glycosuria and nephrocalcinosis, were found to have the same variant. In addition, genetic testing of an unrelated paediatric patient who presented with proteinuria and hypercalciuria, demonstrated the same variant.

Conclusions

The identification of this novel variant in four individuals with features of Dent’s disease, has led to the re-classification of the variant to one of likely pathogenicity.

As a result, our patients and any future patients with the same variant can be offered a likely diagnosis, without the need for kidney biopsy, and their family members can be offered genetic screening.
Epidemiological characteristics of leukemia in China, 2005–2017: a log-linear regression and age-period-cohort analysis
Authors: Lin Kangqian , Jia Huaimiao , Cao Miao , Xu Tongtong , Chen Zuhai , Song Xi , Miao Yingfang , Yao Teng , Dong Chenxian , Shao Jianjiang , Guo Heng , Hu Yunhua , Yan Yizhong
Published: August 2023

Background

Leukemia is a threat to human health, and there are relatively few studies on the incidence, mortality and disease burden analysis of leukemia in China. This study aimed to analyze the incidence and mortality rates of leukemia in China from 2005 to 2017 and estimate their age-period-cohort effects, it is an important prerequisite for effective prevention and control of leukemia.

Methods

Leukemia incidence and mortality data from 2005 to 2017 were collected from the Chinese Cancer Registry Annual Report. Joinpoint regression model was used to estimate the average annual percentage change (AAPC) and annual percentage change (APC) response time trend. Age-period-cohort model was constructed to analyze the effects of age, period and cohort.

Results

The age-standardized incidence rate of leukemia was 4.54/100,000 from 2005 to 2017, showed an increasing trend with AAPC of 1.9% (95% CI: 1.3%, 2.5%). The age-standardized mortality rate was 2.91/100,000, showed an increasing trend from 2005 to 2012 with APC of 2.1% (95%CI: 0.4%, 3.9%) and then a decreasing trend from 2012 to 2017 with APC of -2.5% (95%CI: -5.3%, 0.3%). The age-standardized incidence (mortality) rates of leukemia were not only higher in males than that in females, but also increased more rapidly. The incidence of leukemia in rural areas was lower than in urban areas, but the AAPC was 2.2 times higher than urban areas. Children aged 0–4 years were at higher risk of leukemia. The risk of leukemia incidence and mortality increased with age. The period effect of leukemia mortality risk showed a decreasing trend, while the cohort effect showed an increasing and then decreasing trend with the turning point of 1955–1959.

Conclusions

The age-standardized incidence rate of leukemia in China showed an increasing trend from 2005 to 2017, while the age-standardized mortality rate increased first and then decreased in 2012 as a turning point. Differences existed by gender and region. The risk of leukemia incidence and mortality increased accordingly with age. The risk of mortality due to leukemia gradually decreased from 2005 to 2017. Leukemia remains a public health problem that requires continuous attention.
Assessment of healthcare workers' knowledge and attitude on Ebola virus disease in Somalia: a multicenter nationwide survey
Authors: Mohamud Abdirahman Khalif , Ali Ikran Abdulkadir , Ali Ahmed Isse , Dirie Najib Isse , Inchon Pamornsri , Ahmed Omar Abdullahi , Mohamud Abdulrahman Ahmed
Published: August 2023

Background

In September 2022, a new Ebola outbreak was reported in Uganda, East Africa, and 142 confirmed cases, including 19 Healthcare workers (HCWs) reported. Ebola is not endemic in Somalia, but the country is at a reasonable risk of the virus being introduced due to the direct connection with daily flights from Uganda without border health control and prevention activities. Therefore, evaluating HCWs' Knowledge and attitude is crucial since this is the first time being evaluated in Somalia. The study's objective is to evaluate the HCWs' Knowledge and attitude toward the Ebola virus disease in Somalia.

Method

An online self-administrated cross-sectional survey was conducted among HCWs (n = 1103) in all six federal member states of Somalia using a validated, reliable, well-structured questionnaire. Data we analyzed using descriptive statistics and Logistic regression were used to determine sociodemographic characteristics associated with poor Knowledge and negative attitude.

Result

Over one-third (37.3%) of HCWs had poor Knowledge; the mean knowledge score was 7.97 SD ± 2.15. Almost 40.1% of the HCWs had a negative attitude; the mean attitude was 27.81 SD ± 8.06. Low-income HCWs (AOR = 2.06, 95%CI:1.01–4.19), Married HCWs (AOR = 1.39, 95%CI: 1.110–1.963), Midwives (AOR = 2.76, 95%CI: 1.74–4.39), Lab technicians (AOR = 2.43, 95%CI: 1.43–4.14), HCWs work in Jubaland state of Somalia (AOR = 3.69, 95%CI: 2.39–5.70), Galmudug state (AOR = 8.50, 95%CI: 4.59–15.77), Hirshabelle state (AOR = 3.18, 95%CI: 2.15–4.71) were more likely to have poor Knowledge compared to their counterparts. HCWs who work in Hirshabelle state (AOR = 5.44,95%CI: 3.58–8.27), Jubaland state (AOR = 8.47, 95%CI: 4.69–15.29), and Galmudug state (AOR = 4.43, 95%CI: 3.03–6.48) was more likely to have a negative attitude than those working in the Banadir region administration.

Conclusion

Most Somali healthcare workers showed good Knowledge and a positive attitude toward the Ebola virus. The implementation to enhance Knowledge and attitude must specifically focus on low-income HCWs, Midwives, Lab technicalities, and those who work in Hirshabelle, Jubaland, and Galmudug states of Somalia.
The association of serum Klotho concentrations with hyperlipidemia prevalence and lipid levels among US adults: a cross-sectional study
Authors: Jiang Shunli , Wang Yongxin , Wang Zengliang , Zhang Lu , Jin Feng , Li Bo
Published: August 2023

Background

Klotho has anti-oxidative and anti-inflammatory properties. However, little is known about whether high Klotho concentrations were associated with reduced hyperlipidemia risk and improved plasma lipid levels.

Methods

Participants with complete data on serum Klotho and plasma lipid concentrations from the 2007–2016 National Health and Nutrition Examination Survey were included. Weighted regression models were fitted to explore the association of Klotho concentrations with hyperlipidemia risk and plasma lipid levels while restricted cubic spline models were applied to explore the dose–response relationship. Additionally, we assessed the mediating effects of C-reaction protein (CRP) on the foregoing association.

Results

Individuals in the fourth and fifth quintile of serum Klotho had an adjusted odds ratio (OR) of 0.77 (95%CI: 0.65, 0.93) and 0.67 (95%CI: 0.65, 0.93) for hyperlipidemia. Doubling of serum Klotho concentrations was associated with decreased hyperlipidemia risk (OR = 0.81; 95%CI: 0.68, 0.95) and triglyceride levels (13.25 mg/dL; 95%CI: 4.02, 22.47), with a monotonic dose–response relationship. Individuals in the fourth and fifth quintile of serum Klotho had a 0.07 (95%CI: 0.002, 0.13), 0.08 (95%CI: 0.02, 0.15) and 0.05 (95%CI: –0.03, 0.12) mg/dL decreased CRP levels, with a marginally significant trend (Ptrend = 0.05).

Conclusions

Higher Klotho concentrations were associated with reduced hyperlipidemia risk and triglyceride levels. Klotho supplementation maybe a promising method to intervene and prevent hyperlipidemia, but the underlying mechanism should be further explored.
A systematic review of the measurement properties of self-care scales in nurses
Authors: Rajai Nahid , Ebadi Abbas , Karimi Leila , Sajadi Seyedeh Azam , Parandeh Akram
Published: August 2023

Background

Self-care is a necessary measure against occupational injuries of nurses and improves nursing performance at the bedside. Nurses have different scales to measure self-care, and researchers are confused about choosing valid and reliable scales. This systematic review aimed to evaluate the measurement properties of self-care scales in nurses to identify the best available scales.

Methods

Four databases (PubMed, Web of Science, SCOPUS, and ProQuest) were systematically searched, with no date limiters, until 9 Jun 2023. A manual search was performed with Google Scholar and the reference list of articles to complete the search. Studies aiming to develop or determine the measurement properties of self-care in nurses were included. Based on Consensus-Based Standards for the Selection of Health Measurement Instruments, the methodological quality of the studies was determined, and the result of each study on a measurement property was rated (sufficient, insufficient, or indeterminate). The quality of the evidence was graded using a modified Grading of Recommendations Assessment, Development, and Evaluation approach (high, moderate, low, or very low). These processes were used to make recommendations and identify the best scale to assess self-care in nurses.

Results

Out of 8601 articles, six articles with five different scales were included. Only internal consistency was reported across all scales. Criterion validity, measurement error, responsiveness, feasibility, and interpretability, were not reported in any of them. Content validity was reported only in two studies with inconsistent results and low-quality evidence. None of the scales had methodological quality with a rating of very good and sufficient high-quality evidence for all measurement properties.

Conclusions

None of the scales is strongly recommended to measure self-care in nurses. Only the Professional self-care scale is temporarily recommended until their quality is assessed in future studies. Considering that the content of the examined scales does not meet all the professional self-care needs of nurses, designing a valid, reliable, and specialized scale for nurses is needed.
Design and validation of the presenteeism scale in nursing
Authors: Mohammadi Mohammad Mehdi , Nayeri Nahid Dehghan , Varaei Shokoh , Rasti Arezoo
Published: August 2023

Background

The instruments used to measure presenteeism are all flawed and only incompletely measure the concept of presenteeism in employees of the general population. As a result, the concept of presenteeism is not measured, and in most of these instruments, the population for which the instrument has been developed differs from the nursing population. The present research was conducted to design and validate the instrument for evaluating presenteeism in nursing.

Methods

The present study was part of an exploratory sequential mixed study. In this study, the instrument for measuring the level of presenteeism among nurses was developed and validated based on the results of the qualitative stage. To this end, the instrument’s psychometric properties were investigated using face, content, and construct validity, as well as reliability through internal consistency and stability.

Results

In this study, an instrument containing 17 items and three dimensions (imperfect cognitive presence, imperfect emotional presence, and imperfect movement presence) with favorable validation characteristics was developed. Therefore, the instrument was able to explain 56.375% of the total variance. Furthermore, Cronbach’s alpha and McDonald’s omega coefficients were 0.881 and 0.815, respectively. The intra-cluster correlation coefficient (ICC) was also reported as 0.972 for the entire instrument, with a 95% confidence interval of 0.941 to 0.987.

Conclusion

Based this study, it was possible to measure the level of nurses’ presenteeism through an instrument with favorable psychometric properties. This study helps health managers lay the groundwork for designing a system for measuring presenteeism among Iranian nurses using the developed instrument.