bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Engagement and Disaffection With the Student Engagement Instrument
Authors: O’Donnell Kayleigh C. , Reschly Amy L. , Appleton James J.
Published: August 2023

Research suggests the need to assess both positive and negative forms of student engagement. The purpose of this study was to pilot disaffection items with the Student Engagement Instrument (SEI) with a sample of middle school students from a rural area in the Southeastern U.S. This study explored the factor structure of the piloted items alongside the SEI, measurement invariance, and associations between student engagement and disaffection with educational outcomes such as mathematics and reading test scores, discipline referrals, and absences. Results hold implications for our theoretical understanding of engagement, suggesting that engagement and disaffection dimensions are theoretically and psychometrically distinct.
The healthcare cyberpandemic: It’s time for an intervention
Authors: Hartman Ryan
Published: August 2023

The healthcare sector is in crisis as Internet-based actors attack the digital infrastructure necessary for operations. The growing complexity of systems and events on the world stage have given rise to a dynamic threat landscape that includes nation-states affiliates. Challenging even private industry, healthcare systems and budgets already strained by COVID-19 are struggling to cope. A pandemic style response with new investment and legislation is needed.
Design and characterization of electro-active soft actuator based on phase transition of microencapsulated silicon-ethanol composite
Authors: Ebrahimi Amir Hossein , Zamyad Hojjat , Safaei Javad , Sahebian Samaneh
Published: August 2023

In this study, we demonstrate the development of a fast-response soft composite actuator fabricated by mechanical mixing of silicone elastomer (matrix) and ethanol (as phase-change fluid). Joule heating generated by electrical actuation causes a liquid-vapor transition of ethanol embedded in silicone microcapsules; provides the required pressure for mimicking the natural movements. We discuss the critical design variables to improve the temperature response, chemical composition, mechanical properties, force generated, and microstructure of soft actuator. Our soft actuator produces a high load-to-weight ratio (1000 times greater than its own) using a low-voltage source (˂20V). The stability of the soft actuator under multiple working cycles would bring the application to different robotic areas. The actuator using the mechanism presented here is easy to manufacture, automate, and recyclable. It can be used in a range of robotic applications.
Stakeholders Inform an LGBTQIA+ Health Best Practices Learning Module for Nursing Students
Authors: Cassidy Brenda , Fischl Andrea , Fasone Alexa , Braxter Betty
Published: August 2023

Introduction:

The American Association of Colleges of Nursing (AACN) summons nurse educators to address health care inequities by preparing leaders who advocate for vulnerable groups. A lack of academic guidelines promoting cultural competence in nursing with lesbian, gay, bisexual, transgender, queer and/or questioning, intersex, and asexual and/or aromantic (LGBTQIA+) individuals exist. The purpose of this study was to develop a learning module for health care providers about best practices in LGBTQIA+ health informed by key stakeholders.

Methods:

Exploratory qualitative design utilized focus group methodology obtaining stakeholder’s views on LGBTQIA+ health, with a convenience sample recruited from a large public university. Focus group thematic analysis informed development of the learning module.

Results:

Three overarching themes emerged from focus group discussions ( n = 31): appropriate terminology, health disparities, and respectful communication.

Discussion:

This project addresses an educational gap in nursing curriculum using an interactive online module, introducing key concepts about LGBTQIA+ health. Future research focused on the development of standards of care for LGBTQIA+ individuals can support inclusion and reduce discrimination in health care settings.
Clinical and Pathological Characteristics of Patients With Papillary Thyroid Carcinoma Coexisting With Hashimoto’s Thyroiditis: A Retrospective Cohort Study
Authors: Yang Ye , Liu Jun , Shi Xiaoqin , Wang Min
Published: August 2023

Background

Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid carcinoma, and Hashimoto’s thyroiditis (HT) has been postulated to have a relationship with PTC. This study aims to assess clinical and pathological characteristics of patients with papillary thyroid carcinoma coexisting with Hashimoto’s thyroiditis.

Methods

A retrospective study was conducted in a cohort of patients with thyroid carcinoma at the Department of Surgery, Shanghai General Hospital from January 2017 to December 2018. Medical records of patients who had PTC with or without HT were reviewed and clinical and histopathological characteristics of these patients were analyzed.

Results

A total of 632 patients with thyroid carcinoma were identified. Among them, 614 (97.15%) had PTC and 120/614 (19.0%) harbored PTC together with HT. PTC was significantly associated with HT, as compared with other histological subtypes ( P < .001). Patients with coexisting PTC and HT (PTC + HT group) were significantly younger than patients with PTC alone (PTC group) ( P = .008). There were more women in the PTC + HT group than in the PTC group (88.3% vs. 73.1%, P < .001). TSH, TGAb, and TPOAb levels were significantly higher in the PTC + HT group than in the PTC group ( P ≤ .001). In addition, tumor diameter was smaller in the PTC + HT group than in the PTC group ( P = .034). The PTC + HT group showed a significant better recurrence-free survival than the PTC group. Furthermore, immunohistochemical analysis revealed that patients in the PTC + HT group had a higher positive rate and higher expression intensity of Ki67 than patients in the PTC group.

Conclusions

Our study revealed that patients with coexisting PTC and HT were younger, had smaller tumor diameters, a better prognosis, and higher positive rates and expression intensity of Ki67, than did patients with PTC alone.
Stop (to Work) and Go (to Recover) During Mandatory Work From Home: A Three-Wave Study
Authors: Molino Monica , Dolce Valentina , Cortese Claudio Giovanni , Sanseverino Domenico , Ghislieri Chiara
Published: August 2023

During the COVID-19 pandemic, many workers have been forced to work from home. In this situation, the boundaries between work and private life have become particularly blurred, and recovering from work was even more difficult than in traditional times, with negative consequences for workers’ health. Among the psychological experiences that might underlie the recovery process, mastery played a crucial role as people sought new stimuli and challenging situations. However, there are few articles that have explored the role of this specific recovery experience, its antecedents, and the health consequences under conditions of work from home. Therefore, in this multiwave study, we aimed to investigate the role of mastery as a mediator between supervisor support and insomnia problems. The study was conducted during the COVID-19 pandemic in Italy and had a three-wave design. A convenience sample of 130 employees (67% women) completed an online questionnaire. Hypotheses were tested using a three-wave autoregressive cross-lagged panel model. According to the results, supervisor support at Time 1 was positively related to mastery at Time 2, which in turn showed a negative association with insomnia at Time 3. The results demonstrated that mastery experiences have played a crucial role during COVID-19 mandatory work from home, which points to some potential implications for workers’ health in the adoption of teleworking beyond the emergency situation.
Equity in virtual care: A mixed methods study of perspectives from physicians
Authors: Guetterman Timothy C , Koptyra Emily , Ritchie Olivia , Marquis Liz B , Kadri Reema , Laurie Anna , Vydiswaran VG Vinod , Li Jiazhao , Brown Lindsay K , Veinot Tiffany C , Buis Lorraine R
Published: August 2023

Background

Virtual care expanded rapidly during the COVID-19 pandemic, and how this shift affected healthcare disparities among subgroups of patients is of concern. Racial and ethnic minorities, older adults, individuals with less education, and lower-income households have lower rates of home broadband, smartphone ownership, and patient portal adoption, which may directly affect access to virtual care. Because primary care is a major access point to healthcare, perspectives of primary care providers are critical to inform the implementation of equitable virtual care.

Objective

The aim of this mixed methods study was to explore primary care physician experiences and perceptions of barriers and facilitators to equitable virtual care.

Design

We used an explanatory sequential mixed methods design, which consists of first collecting and analyzing quantitative survey data, then using those results to inform a qualitative follow-up phase to explain and expand on results.

Participants

Primary care physicians in a family medicine department at an academic medical center responded to surveys ( n = 38) and participated in interviews ( n = 16).

Approach

Participants completed a survey concerning frequency and preferences about video visits, pros and cons of video visits, communication aspects, and sufficiency of the technology. A purposeful sample of participants completed semi-structured interviews about their virtual care experiences with a focus on equity for subpopulations.

Key Results

The results indicated that physicians have observed equity issues for unique patient populations. The results add to the understanding of nuanced ways in which virtual care can increase and decrease healthcare access for unique populations. Patients with limited English proficiency were particularly affected by inequity in virtual care access.

Conclusion

Additional research and interventions are needed to improve portal access for those with limited English proficiency. Improvements should focus on health system interventions that expand access without requiring increased patient burden.
Equality before the law and the recognition of same-sex foreign marriages in Namibia: Digashu and another v GRN and others; Seiler-Lilles and another v GRN and others [2023] NASC 14
Authors: Mujuzi Jamil Ddamulira
Published: August 2023

Article 10(1) of the Constitution of Namibian provides for the right to equality before the law. Article 10(2) prohibits discrimination on several grounds. The Constitution of Namibia, unlike that of South Africa (1996), does not prohibit discrimination on the ground of sexual orientation. However, unlike the Constitutions of some African countries such as Uganda, Seychelles, Kenya and Zimbabwe, the Constitution of Namibia does not prohibit same-sex marriages. Namibian law does not expressly prohibit same-sex marriages. However, in Immigration Selection Board v Frank (2001), the Namibian Supreme Court held that same-sex marriages were not allowed in Namibia. In Digashu and Another v GRN and Others; Seiler-Lilles and Another v GRN and Others, dated 16 May 2023, the Supreme Court, by majority, invoked Article 10(1) and common law to overrule its decision in Immigration Selection Board v Frank and to hold that Namibian law should recognise same-sex marriages entered into abroad. However, the court declined to express its opinion on whether discrimination on the ground of sexual-orientation is prohibited in Namibia. In this note, the author argues, inter alia, that the list of grounds under Article 10(2) is closed and that explains why the court did not rule that the appellants had been discriminated against based on their sexual orientation; it was unlikely for the government to succeed had it relied on the argument of public policy as the basis for its refusal to recognise foreign same-sex marriages; and that the court unconsciously developed common law on the issue of foreign marriages.
Digital transformation and the new combinations in tourism: A systematic literature review
Authors: Gutierriz Ives , Ferreira João J , Fernandes Paula O
Published: August 2023

This study aims to analyse the research involving the evolution and development of digital transformation and the new combinations in tourism development. To this end, a systematic literature review was conducted in the Scopus and Web of Science databases, which gathered 167 studies published between 1997 and 2023, representing the final sample analysed in this review. The results allow the identification of three main findings: i) there are four thematic groups - Digital Marketing, Digital Economy, Education and Hospitality and Free Digital; ii) there is a growing interest in the research of this topic and the use of available technologies for the development of tourism companies and their businesses and the respective wider economy; and, iii) digital transformation tends to be a positive factor when applied to the tourism sector. This research further proposes a framework that provides a detailed description of these studies with key issues and contributions from the available literature.
“Connecting to themselves and the world”: Engaging young children in read-alouds with social-emotional learning
Authors: Bennett Susan V , Gunn AnnMarie Alberton , Peterson Barbara J , Bellara Aarti P
Published: August 2023

As educators, we anticipated the social-emotional learning (SEL) of the children from the neighboring community would be greatly impacted due to the lack of social interaction necessary for human development during COVID. As literacy experts, we thought we could support these children through read-alouds focused on SEL. Our goal was to provide children the opportunity to participate in read-alouds of multicultural texts that incorporated SEL content and measured changes in their SEL development and vocabulary. We utilized the Collaborative for Academic, Social, and Emotional Learning (CASEL) framework, which categorizes SEL into five competencies or domains, and Culturally Sustaining Pedagogy to guide our research. We used a convergent parallel mixedmethod design in this pilot study in which 20 children from a community afterschool center and three adult volunteers participated. We found no statistical significance between administrations in children’s SEL as measured by the SEL web-based assessment, yet there was a statistically significant difference in SEL vocabulary scores between administrations. Supporting vocabulary scores, we identified four major themes: instructional practices, development of social-emotional learning, volunteers’ personal highlights, and challenges. This study has the potential to impact curriculum used in school and afterschool programs and could possibly make a positive impact on both socialemotional growth and vocabulary.
An alter-centric perspective on status disparity and newcomer additions in multiparty syndicates
Authors: Gray Steven M , Boumgarden Peter , Ranganathan Ram , Huang Laura
Published: August 2023

Status dynamics play a critical role in venture capital (VC) syndication. Prior research on multiparty syndicates has shown how status differences among current syndicate members affect how the syndicate searches for new investors in later investment rounds. However, it is unclear how potential newcomers evaluate whether or not to join a syndicate based on the degree of status disparity among current syndicate members. We adopt an alter-centric approach by examining how an existing syndicate’s status disparity affects a potential newcomer’s willingness to join. For potential newcomers, we contend that syndicate status disparity is a double-edged sword, both deterring newcomers due to low perceptions of syndicate trust while simultaneously attracting newcomers at the prospect of accessing diverse future investment opportunities. Whether the perceived costs of syndicate status disparity outweigh the perceived benefits for newcomers depends upon the degree of risk associated with the venture deal. Across two studies—a field experiment of 193 institutional investors and an archival study of 3644 multiparty syndicates—we found that newcomers are attracted to syndicate status disparity when deal risk is low but deterred from syndicate status disparity when deal risk is high. Our article highlights how newcomer additions to multiparty syndicates entail a complex interplay between features of co-investors and features of the venture deal.
Cell death signaling in Anopheles gambiae initiated by Bacillus thuringiensis Cry4B toxin involves Na+/K+ ATPase
Authors: Liu Li , Bulla Lee A
Published: August 2023

Identifying the mechanisms by which bacterial pathogens kill host cells is fundamental to understanding how to control and prevent human and animal disease. In the case of Bacillus thuringiensis (Bt), such knowledge is critical to using the bacterium to kill insect vectors that transmit human and animal disease. For the Cry4B toxin produced by Bt, its capacity to kill Anopheles gambiae, the primary mosquito vector of malaria, is the consequence of a variety of signaling activities. We show here that Cry4B, acting as first messenger, binds specifically to the bitopic cadherin BT-R3 G-protein-coupled receptor (GPCR) localized in the midgut of A. gambiae, activating the downstream second messenger cyclic adenosine monophosphate (cAMP). The direct result of the Cry4B–BT-R3 binding is the release of αs from the heterotrimeric αβγ-G-protein complex and its activation of adenylyl cyclase (AC). The upshot is an increased level of cAMP, which activates protein kinase A (PKA). The functional impact of cAMP–PKA signaling is the stimulation of Na+/K+-ATPase (NKA) which serves as an Na+/K+ pump to maintain proper gradients of extracellular Na+ and intracellular K+. Increased level of cAMP amplifies NKA and upsets normal ion concentration gradients. NKA, as a scaffolding protein, accelerates the first messenger signal to the nucleus, generating additional BT-R3 molecules and promoting their exocytotic trafficking to the cell membrane. Accumulation of BT-R3 on the cell surface facilitates recruitment of additional toxin molecules which, in turn, amplify the original signal in a cascade-like manner. This report provides the first evidence of a bacterial toxin using NKA via AC/PKA signaling to execute cell death.
Acute Type B Aortic Dissection Complicated With Spinal Cord Ischemia and Paraplegia Treated With Endovascular Scissor Technique
Authors: Catasta Alexandra , Freyrie Antonio , Bramucci Alberto , Bianchini Massoni Claudio , Perini Paolo
Published: August 2023

Spinal cord ischemia leading to paraplegia is a rare, life-limiting complication of acute type B aortic dissection. We report a case of spinal cord ischemia occurred in a young woman treated with endovascular scissor technique in urgent setting. The patient had an uneventful post-procedural course. After 4 months, computed tomography angiography confirmed false lumen reperfusion and major symptoms were regressed. In selected cases, this procedure is a tool to improve false lumen perfusion in type B dissections, and demonstrated to be helpful in our case of spinal cord ischaemia.
Understanding Collective Intelligence: Investigating the Role of Collective Memory, Attention, and Reasoning Processes
Authors: Woolley Anita Williams , Gupta Pranav
Published: August 2023

As society has come to rely on groups and technology to address many of its most challenging problems, there is a growing need to understand how technology-enabled, distributed, and dynamic collectives can be designed to solve a wide range of problems over time in the face of complex and changing environmental conditions—an ability we define as “collective intelligence.” We describe recent research on the Transaction Systems Model of Collective Intelligence (TSM-CI) that integrates literature from diverse areas of psychology to conceptualize the underpinnings of collective intelligence. The TSM-CI articulates the development and mutual adaptation of transactive memory, transactive attention, and transactive reasoning systems that together support the emergence and maintenance of collective intelligence. We also review related research on computational indicators of transactive-system functioning based on collaborative process behaviors that enable agent-based teammates to diagnose and potentially intervene to address developing issues. We conclude by discussing future directions in developing the TSM-CI to support research on developing collective human-machine intelligence and to identify ways to design technology to enhance it.
Discrepancies in the Definition and Measurement of Human Interoception: A Comprehensive Discussion and Suggested Ways Forward
Authors: Desmedt Olivier , Luminet Olivier , Maurage Pierre , Corneille Olivier
Published: August 2023

Interoception has been the subject of renewed interest over the past 2 decades. The involvement of interoception in a variety of fundamental human abilities (e.g., decision-making and emotional regulation) has led to the hypothesis that interoception is a central transdiagnostic process that causes and maintains mental disorders and physical diseases. However, interoception has been inconsistently defined and conceptualized. In the first part of this article, we argue that the widespread practice of defining interoception as the processing of signals originating from within the body and limiting it to specific physiological pathways (lamina I spinothalamic afferents) is problematic. This is because, in humans, the processing of internal states is underpinned by other physiological pathways generally assigned to the somatosensory system. In the second part, we explain that the consensual dimensions of interoception are empirically detached from existing measures, the latter of which capture loosely related phenomena. This is detrimental to the replicability of findings across measures and the validity of interpretations. In the general discussion, we discuss the main insights of the current analysis and suggest a more refined way to define interoception in humans and conceptualize its underlying dimensions.
Incomparability and Incommensurability in Choice: No Common Currency of Value?
Authors: Walasek Lukasz , Brown Gordon D. A.
Published: August 2023

Models of decision-making typically assume the existence of some common currency of value, such as utility, happiness, or inclusive fitness. This common currency is taken to allow comparison of options and to underpin everyday choice. Here we suggest instead that there is no universal value scale, that incommensurable values pervade everyday choice, and hence that most existing models of decision-making in both economics and psychology are fundamentally limited. We propose that choice objects can be compared only with reference to specific but nonuniversal “covering values.” These covering values may reflect decision-makers’ goals, motivations, or current states. A complete model of choice must accommodate the range of possible covering values. We show that abandoning the common-currency assumption in models of judgment and decision-making necessitates rank-based and “simple heuristics” models that contrast radically with conventional utility-based approaches. We note that if there is no universal value scale, then Arrow’s impossibility theorem places severe bounds on the rationality of individual decision-making and hence that there is a deep link between the incommensurability of value, inconsistencies in human decision-making, and rank-based coding of value. More generally, incommensurability raises the question of whether it will ever be possible to develop single-quantity-maximizing models of decision-making.
Culturally Responsive Programming in the Orchestra Classroom: A Survey of Ensemble Teachers
Authors: Davis Susan A. , Dean Kara Eaton
Published: August 2023

The purpose of this study was to examine the factors that influence orchestra teachers when selecting repertoire for performance ensembles and to better understand the extent of culturally relevant and responsive programming in elementary and secondary orchestra classrooms across the United States. In March of 2020, the authors undertook a survey regarding concert programming practices of school orchestra teachers who were active members of the American String Teachers Association. Results indicated that the level of difficulty was the most important consideration while availability for easy download was the least important one. Sociocultural considerations were generally rated lower than administrative and pedagogical considerations. Repertoire from the Western European canon was programmed most frequently, followed by folk and fiddle music, and pop and rock music. More than 80% of participants indicated they had never programmed a piece to teach about matters related to gender, sexual identity, or the Black Lives Matter movement, whereas 76.5% had programmed a piece to teach about multicultural awareness. Implications for orchestra teachers, music educator preparation programs, and future research are explored.
Valuating Words: Semantic Practices in Web Search Advertising
Authors: Jobin Anna
Published: August 2023

Much like in traditional media contexts, advertising is a key source of revenue in digital media industries. One popular form is web search advertising, which is targeted based on words. But there has been little critical empirical research into how web search advertising is achieved in practice. Based on in-depth interviews with web search advertising professionals, this article examines how these professionals make sense of Google’s “linguistic capitalism.” It identifies three salient contextual factors that influence the valuation of words (locality, semantic footprints, and governance) and four semantic practices that advertising professionals mobilize to grapple with the meaning of words when (e)valuating them (attaching meaning, ascribing intention, algorithmic association, and measuring relevance). It also reveals the importance of semantic practices for the commodification of words, which depends on, and ultimately reaffirms, Google’s semantic power. Overall, this article contributes to the critical literature on web search and meaning-making in algorithmic media.
Determinants of Online Purchase Intention Toward Life Insurance in Malaysia: Moderating Role of Trust
Authors: Hanaysha Jalal Rajeh , Chen Cheah Lee , Rahim Noor Fareen Abdul , Salamzadeh Yashar , Hasouneh Lana Omar
Published: August 2023

This article focuses on examining the impact of web skills, perceived usefulness, subjective norms, perceived web security, and perceived ease of use on online purchase intention. It was also designed to verify the moderating effect of trust among them. Required data was gathered from customers of insurance companies in Malaysia via an online questionnaire. SmartPLS was used to conduct statistical analyses and verify research hypotheses. The findings showed that subjective norms, perceived usefulness, perceived ease of use, and perceived web security are positively associated with online purchase intention. However, the effect of web skills on online purchase intention was not supported. In other words, customers tend to purchase an online life insurance if they believe the process will be easy, safe, and convenient for them. The results also showed that trust moderates the association among subjective norms and intent to buy life insurance online.
The Mediating Effect of Dynamic Marketing Capabilities on the Relationship Between Customer Knowledge Management and Organizational Innovation
Authors: Alani Emad , Alrubaiee Laith , Shojaei Alieza Shabani , Naji Laith , OweeKowang Tan
Published: August 2023

Today’s competitive business environment has made organizational innovation (OI) a central strategy for most firms. Not only does OI lead to obtaining new customers and market segments but it also enables firms to develop a reputation for being innovative. To ensure a sustained level of OI, firms need to enhance their customer knowledge management (CKM) as well as their dynamic marketing capabilities (DMCs). This study focuses on investigating the mediating effect of DMCs on the relationship between CKM and OI. To this end, a set of hypotheses were developed to analyse these relationships employing structural equation modelling. The data were collected from a total of 242 top management of firms in the pharmaceutical and healthcare industries in Jordan. The findings showed that knowledge for customer and knowledge about customer had strong and positive effects on the OI levels of the firms considered in this study. It was also revealed that knowledge from customer has no significant effect on OI. Moreover, the results indicated that DMCs have a mediating effect on the relationship between CKM and OI.
Associations of water, sanitation, and hygiene with typhoid fever in case–control studies: a systematic review and meta-analysis
Authors: Kim Chaelin , Goucher Gerard R. , Tadesse Birkneh Tilahun , Lee Woojoo , Abbas Kaja , Kim Jong-Hoon
Published: August 2023

Background

Water, sanitation, and hygiene (WASH) play a pivotal role in controlling typhoid fever, as it is primarily transmitted through oral-fecal pathways. Given our constrained resources, staying current with the most recent research is crucial. This ensures we remain informed about practical insights regarding effective typhoid fever control strategies across various WASH components. We conducted a systematic review and meta-analysis of case-control studies to estimate the associations of water, sanitation, and hygiene exposures with typhoid fever.

Methods

We updated the previous review conducted by Brockett et al. We included new findings published between June 2018 and October 2022 in Web of Science, Embase, and PubMed. We used the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool for risk of bias (ROB) assessment. We classified WASH exposures according to the classification provided by the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation, and Hygiene (JMP) update in 2015. We conducted the meta-analyses by only including studies that did not have a critical ROB in both Bayesian and frequentist random-effects models.

Results

We identified 8 new studies and analyzed 27 studies in total. Our analyses showed that while the general insights on the protective (or harmful) impact of improved (or unimproved) WASH remain the same, the pooled estimates of OR differed. Pooled estimates of limited hygiene (OR = 2.26, 95% CrI: 1.38 to 3.64), untreated water (OR = 1.96, 95% CrI: 1.28 to 3.27) and surface water (OR = 2.14, 95% CrI: 1.03 to 4.06) showed 3% increase, 18% decrease, and 16% increase, respectively, from the existing estimates. On the other hand, improved WASH reduced the odds of typhoid fever with pooled estimates for improved water source (OR = 0.54, 95% CrI: 0.31 to 1.08), basic hygiene (OR = 0.6, 95% CrI: 0.38 to 0.97) and treated water (OR = 0.54, 95% CrI: 0.36 to 0.8) showing 26% decrease, 15% increase, and 8% decrease, respectively, from the existing estimates.

Conclusions

The updated pooled estimates of ORs for the association of WASH with typhoid fever showed clear changes from the existing estimates. Our study affirms that relatively low-cost WASH strategies such as basic hygiene or water treatment can be an effective tool to provide protection against typhoid fever in addition to other resource-intensive ways to improve WASH.

Trial registration

PROSPERO 2021 CRD42021271881.
Immunogenicity and safety of inactivated quadrivalent influenza vaccine compared with the trivalent vaccine for influenza infection: an overview of systematic reviews
Authors: Carregaro Rodrigo Luiz , Roscani Alessandra N. C. P. , Raimundo Augusto Cesar Sousa , Ferreira Larissa , Vanni Tazio , da Graça Salomão Maria , Probst Livia Fernandes , Viscondi Juliana Yukari K.
Published: August 2023

Background

Influenza infection is a highly preventable transmissible viral disease associated with mild upper respiratory symptoms and more severe conditions such as lethal pneumonia. Studies have shown that a broader spectrum influenza vaccine could reduce influenza’s burden of disease in low- and middle-income countries. A considerable number of systematic reviews reported that quadrivalent influenza vaccines are considered more effective compared to trivalent vaccines, hence, there is a need for an overview in order to synthesize the current evidence pertaining to the comparison between quadrivalent and trivalent inactivated influenza vaccines. Objective: The aim was to summarize the evidence from systematic reviews that investigated the immunogenicity and safety of the Influenza’s inactivated quadrivalent vaccine (QIV) compared to the trivalent vaccine (TIV), in the general population.

Methods

We searched articles up to December 2022 at: Web of Science, EMBASE, MEDLINE, Cochrane Library, and SCOPUS. The search strategy was conducted following the PICO model. We included systematic reviews comparing the primary outcomes of immunogenicity (seroprotection rate and seroconversion rate) and adverse events using risk ratios. The AMSTAR 2 and ROBIS were used for quality assessments, and GRADE was used for evidence certainty assessments.

Findings

We included five systematic reviews, totalling 47,740 participants. The Quadrivalent Inactivated Influenza Vaccine (QIV) exhibited enhanced immunogenicity in the context of B-lineage mismatch when compared to the Trivalent Inactivated Influenza Vaccine (TIV). While the safety profile of QIV was found to be comparable to that of TIV, the QIV showed a higher incidence of solicited local pain among children and adolescents, as well as an increased frequency of local adverse events within the adult population.

Conclusion

Our findings suggest that the QIV provides a superior immunogenicity response compared to the TIV in all age groups evaluated, especially when a lineage mismatch occurred. The safety of QIV was considered similar to the TIV, with no serious or systemic solicited or unsolicited adverse events; tough pain at the injection site was greater for QIV. We recommend caution owing to the high risk of bias in the selection process and no protocol registration.
BRCA genes as candidates for colorectal cancer genetic testing panel: systematic review and meta-analysis
Authors: Feng Zhewen , Yang Xiaobao , Tian Mingwei , Zeng Na , Bai Zhigang , Deng Wei , Zhao Yanyan , Guo Jianru , Yang Yingchi , Zhang Zhongtao , Yang Yun
Published: August 2023

Background

Breast cancer susceptibility gene (BRCA) mutation carriers are at an increased risk for breast, ovarian, prostate and pancreatic cancers. However, the role of BRCA is unclear in colorectal cancer; the results regarding the association between BRCA gene mutations and colorectal cancer risk are inconsistent and even controversial. This study aimed to investigate whether BRCA1 and BRCA2 gene mutations are associated with colorectal cancer risk.

Methods

In this systematic review, we searched PubMed/MEDLINE, Embase and Cochrane Library databases, adhering to PRISMA guidelines. Study quality was assessed using the Newcastle–Ottawa Scale (NOS). Unadjusted odds ratios (ORs) were used to estimate the probability of Breast Cancer Type 1 Susceptibility gene (BRCA1) and Breast Cancer Type 2 Susceptibility gene (BRCA2) mutations in colorectal cancer patients. The associations were evaluated using fixed effect models.

Results

Fourteen studies were included in the systematic review. Twelve studies, including seven case–control and five cohort studies, were included in the meta-analysis. A significant increase in the frequency of BRCA1 and BRCA2 mutations was observed in patients with colorectal cancer [OR = 1.34, 95% confidence interval (CI) = 1.02–1.76, P = 0.04]. In subgroup analysis, colorectal cancer patients had an increased odds of BRCA1 (OR = 1.48, 95% CI = 1.10–2.01, P = 0.01) and BRCA2 (OR = 1.56, 95% CI = 1.06–2.30, P = 0.02) mutations.

Conclusions

BRCA genes are one of the genes that may increase the risk of developing colorectal cancer. Thus, BRCA genes could be potential candidates that may be included in the colorectal cancer genetic testing panel.
Association between vitamin D deficiency and lipid profiles in overweight and obese adults: a systematic review and meta-analysis
Authors: Huang Xiao , Yang Yan , Jiang Yingling , Zhou Zhiguang , Zhang Jingjing
Published: August 2023

Objective

The association between vitamin D deficiency and lipid profiles in adults with overweight or obesity remains unclear and inconsistent. The aim of our study was to determine the relationship between lipid profiles and vitamin D deficiency in the overweight and obese adults.

Methods

Four databases, including PubMed, the Web of Science, EMBASE and the Cochrane Library, were used to identify all studies on vitamin D status and lipid levels, including the serum levels of triglycerides (TGs), total cholesterol (TC), low-density lipoprotein cholesterol (LDL), and high-density lipoprotein cholesterol (HDL). The Weighted mean difference (WMD) with 95% confidence intervals (CIs) using random-effects models was used to assess the association between the lipid profile and vitamin D deficiency.

Results

Twenty-one articles that included a total of 7952 adults with overweight or obesity (BMI ≥ 25 kg/m2) were included. The overall results revealed that compared with the controls, individuals with vitamin D deficiency showed higher levels of TG (WMD = 15.01; 95%CI, 2.51–27.52) and TC (WMD = 8.61; 95%CI, 1.31–15.92). Moreover, vitamin D deficiency was related to an increased level of LDL (WMD = 6.12; 95%CI, 0.02–12.23). HDL level was inversely associated with the vitamin D deficiency status (WMD = -2.57; 95%CI, -4.26, -0.88).

Conclusions

Among the adults with overweight or obesity, the vitamin D deficient group displayed impaired lipid profiles, including increased TG, TC and LDL levels and reduced HDL level.
Applying the Delphi Approach to Prioritize Social Factors Affecting the Development of Children Under Six Years
Authors: Sadrkhanlou Mitra , Maher Ali , Alimohammadzadeh Khalil , Jafari Mehrnoosh , Bahadori Mohammadkarim
Published: August 2023

Background

Social determinants of health have a key role in the growth and development of children, particularly in early childhood which is mentioned from infancy to the age of six years old. These factors might cause disparities in living conditions and consequently bring about inequities regarding different aspects of development such as emotional, psychological, social, psychological, and intellectual. This research aimed to provide a model for prioritizing social factors affecting the development of children under six years.

Methods

We used quantitative–qualitative (mixed) method to perform data analysis. The statistical population included 12 medical experts and professionals in the field of children’s development and social determinants of health that were selected using the snowball method. In the quantitative section, a Delphi technique was applied to screen the extracted indicators. Then through applying a decision-making trial and evaluation laboratory (DEMATEL) method, the cause-and-effect interactions among main social determinants were identified. To analyze data, super decision software was used.

Results

According to literature review and the results obtained from focus group discussions, five dimensions including individual factors, family factors, environmental factors, governance, and global factors were identified. Based on the study findings, the criterion of “family factors” was mentioned as the most important priority affecting childhood development. Furthermore, the sub-criterion of “International Programs and Policies” received the greatest priority among other sub-criteria with a profound impact on children's healthy growth and development.

Conclusion

Despite the current knowledge about social determinants of health, it is required to identify the most influential socioeconomic factors on childhood development. In such a manner, political strategies for improving the health condition of children can be implemented based on scientific evidence. Due to the crucial role of family factors, environmental factors and other socio-economic conditions, health policy makers and public health practitioners should be informed of the importance of these factors in shaping the health condition of children.
The influence of immigrant background and parental education on overweight and obesity in 8-year-old children in Norway
Authors: Øvrebø B. , Kjøllesdal M. , Stea T. H. , Wills A. K. , Bere E. , Magnus P. , Juliusson P. B. , Bergh I. H.
Published: August 2023

Background

Little is known about the prevalence of overweight/obesity and socio-economic position (SEP) in children with immigrant background in Scandinavia. The purpose of this study is to examine the prevalence of overweight/obesity by immigrant background among children in Norway and to explore the role of SEP in explaining differences in weight status.

Methods

Anthropometric data from 8,858 children (age 8.3 years) from the population-based Norwegian Childhood Growth Study were used. Information about immigrant background, country of origin, and parental education (used as an indicator of SEP) were provided by Statistics Norway. For children with immigrant background, regional background was determined based on country of origin. Prevalence ratios (PR) were estimated for overweight/obesity and weight-to-height-ratio (WHtR) ≥ 0.5 by immigration and regional background, using generalized estimating equation log-binominal models adjusting for sex, age, survey year (model 1), residential area, population density (model 2) and parental education (model 3).

Results

Children with immigrant background had a higher prevalence of overweight/obesity and WHtR ≥ 0.5 than non-immigrant background children. Adjusted for parental education, children with an immigrant background from Southern and Eastern Europe, Asia except South-Asia, and Africa had a higher prevalence of overweight/obesity [PR: 1.37 (95% confidence interval (CI): 1.10–1.72), 1.28 (1.05–1.57), 1.47 (1.13–1.91), respectively] than children with a non-immigrant background. Children originating from Asia except South-Asia had a higher prevalence of WHtR ≥ 0.5 (PR: 1.64, CI: 1.25–2.15) compared to non-immigrant background children. The adjustment for parental education did not substantially change the results.

Conclusion

Children with immigrant background had higher prevalence of overweight/obesity than non-immigrant background children. The difference varied according to region of origin but not substantially according to parental education. There is a need for culturally acceptable preventative measures targeting the parents of immigrant background children.
Health literacy in individuals with knee pain—a mixed methods study
Authors: Sylwander Charlotte , Wahl Astrid Klopstad , Andersson Maria L.E , Haglund Emma , Larsson Ingrid
Published: August 2023

Background

Low health literacy is associated with worse pain and poorer self-management. This study (1) examined the level of health literacy and associations with lifestyle habits, health status, chronic pain, and radiographic knee osteoarthritis; and (2) explored experiences illuminating health literacy among individuals with knee pain.

Methods

A convergent parallel mixed-methods design was used, including 221 individuals. Health literacy was assessed by HLS-EU-Q16 and eHEALS. The questionnaire included questions on lifestyle habits, health status, and pain distribution. Radiographic knee osteoarthritis was assessed with x-rays. Associations were analysed using logistic regression analyses. Individual semi-structured interviews were conducted (n = 19) and analysed with qualitative content analysis.

Results

The result showed that 71% reported sufficient health literacy. Higher education, healthy lifestyle habits, better general health, and absence of widespread pain were associated with sufficient health literacy. Experiences regarding health literacy influencing the decision-making process toward a decision on action comprised: (1) searching for information actively or passively; (2) processing of the information included being informed, critical, and interpretive; and (3) taking a stand on the information based on trustfulness and motivation.

Conclusion

Seven out of 10 reported sufficient health literacy. Despite this, unhealthy lifestyles were common, suggesting that having sufficient HL is not enough for a behavioural change and the decision-making process, including different phases such as searching, processing, and taking a stand on health information is important to consider. More research on health literacy is needed to gain knowledge of how best to develop health promotion in individuals with knee pain.
Musculoskeletal pain during and after SARS-CoV-2 infection and healthcare utilization: a cross-sectional study
Authors: de Oliveira Soares Junior Abelardo , dos Santos Afonso Max , Vieira Yohana Pereira , Rocha Juliana Quadros Santos , Dumith Samuel , Neves Rosália Garcia , da Silva Carine Nascimento , Duro Suele Manjourany Silva , de Oliveira Saes Mirelle
Published: August 2023

Background

The COVID-19 pandemic necessitated the reorganization of health services to cater to the needs of individuals affected by the virus.

Objective

This study aimed to examine the association between musculoskeletal pain during and after SARS-CoV-2 infection and the utilization of health services among adults in southern Brazil. 

Methods

A cross-sectional study was conducted with individuals aged 18 years and older, who were diagnosed with COVID-19 between December 2020 and March 2021. Questionnaires were electronically collected using tablets through the REDCap platform via phone calls. The health service utilization outcomes assessed included Primary Health Care, general practitioners, private emergency care, and specialized services. The exposure variable was the presence of musculoskeletal pain during and after SARS-CoV-2 infection in different regions, such as cervical, upper limbs, thoracic, lumbar, and lower limbs. Poisson regression analysis was employed to assess the relationship between health service utilization during and after SARS-CoV-2 infection and musculoskeletal pain during and after the infection with SARS-CoV-2 among adults in southern Brazil. Data were analyzed using the Stata 16.1 statistical package. 

Results

A total of 2,919 individuals were interviewed. Overall, individuals with musculoskeletal pain were found to utilize health services approximately 15 percentage points higher when compared to those without musculoskeletal pain. In adjusted analysis, individuals who reported musculoskeletal pain during and after SARS-CoV-2 infection were up to twice as likely to use health services. Among them, the emergency care unit was the most frequently used service, particularly in those with pain in the lower limbs (RP=2.19, 95% CI 1.66-2.87) and thoracic region (RP=2.04, 95% CI 1.47-2.84). Notably, the highest magnitudes of association were observed with emergency care units, specialist doctors, and specialized services, especially neurologists, who were two to three times more likely to be sought, followed by pulmonologists. 

Conclusion

Health service utilization was significantly associated with musculoskeletal pain during and after SARS-CoV-2 infection. All regions, except for the cervical region, showed a correlation with the use of Primary Health Care. The thoracic region featured an association with pulmonologists and emergency room utilization. Additionally, health services like emergency care units, specialist doctors, and specialized services, including cardiologists and neurologists, were commonly utilized across all regions in southern Brazil.