bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrative data of a novel ciliate (Alveolata, Ciliophora) propose the establishment of Heterodeviata nantongensis nov. sp.
Authors: Liao Lijian , Jiang Limin , Hu Xiaozhong
Published: January 2024

Background

As unicellular eukaryotes, ciliates are an indispensable component of micro-ecosystems that play the role of intermediate nutrition link between bacteria or algae and meiofauna. Recent faunistic studies have revealed many new taxa of hypotrich ciliates, indicating their diversity is greater than previously thought. Here we document an undescribed form isolated from an artificial brackish water pond in East China. Examination of its morphology, ontogenesis and molecular phylogeny suggests that it represents a new species.

Results

The morphology and morphogenesis of the new brackish-water deviatid ciliate,Heterodeviata nantongensisnov. sp., isolated from Nantong, China, were investigated using live observations and protargol staining. The diagnostic traits of the new species include three frontal cirri, one buccal cirrus, one or two parabuccal cirri, an inconspicuous frontoventral cirral row of four to six frontoventral cirri derived from two anlagen, three left and two right marginal rows, two dorsal kineties, dorsal kinety 1 with 9–14 dikinetids and dorsal kinety 2 with only two dikinetids, and one to three caudal cirri at the rear end of dorsal kinety 1. Its main morphogenetic features are: (i) the old oral apparatus is completely inherited by the proter except undulating membranes, which are reorganized in situ; (ii) anlagen for marginal rows and the left dorsal kinety develop intrakinetally in both proter and opisthe; (iii) dorsal kinety 2 is generated dorsomarginally; (iv) five cirral anlagen are formed in both proter and opisthe; (v) in the proter, anlagen I and II very likely originate from the parental undulating membranes and the buccal cirrus, respectively, anlage III from anterior parabuccal cirrus, anlage IV originates from the parental frontoventral cirri and anlage V from the innermost parental right marginal row; and (vi) anlagen I–IV of the opisthe are all generated from oral primordium, anlage V from the innermost parental right marginal row. Phylogenetic analyses based on SSU rRNA gene sequence data were performed to determine the systematic position of the new taxon.

Conclusions

The study on the morphology, and ontogenesis of a new brackish-water taxon increases the overall knowledge about the biodiversity of this ciliate group. It also adds to the genetic data available and further provides a reliable reference for environmental monitoring and resource investigations.
Perinatal outcome of emergency cesarean section under neuraxial anesthesia versus general anesthesia: a seven-year retrospective analysis
Authors: Shi Xueduo , Xu Chenyang , Wen Yazhou , Jiang Ming , Yu Huiling , Wang Xian , Yuan Hongmei , Feng Shanwu
Published: January 2024

Objective

An emergency cesarean section (CS), which is extremely life-threatening to the mother or fetus, seems to be performed within an adequate time horizon to avoid negative fetal-maternal denouement. An effective and vigilant technique for anesthesia remains vital for emergency cesarean delivery. Therefore, this study aimed to validate the impact of various anesthesia tactics on maternal and neonatal outcomes.

Method

This was a retrospective cohort study of parturient patients who were selected for emergency CS with the assistance of general or neuraxial anesthesia between January 2015 and July 2021 at our institution. The 5-min Apgar score was documented as the primary outcome. Secondary outcomes, including the 1 min Apgar score, decision-to-delivery interval (DDI), onset of anesthesia to incision interval (OAII), decision to incision interval (DII), duration of operation, length of hospitalization, height and weight of the newborn, use of vasopressors, blood loss, neonatal resuscitation rate, admission to neonatal intensive care unit (NICU), duration of NICU and complications, were also measured.

Results

Of the 539 patients included in the analysis, 337 CSs were performed under general anesthesia (GA), 137 under epidural anesthesia (EA) and 65 under combined spinal-epidural anesthesia (CSEA). The Apgar scores at 1 min and 5 min in newborns receiving GA were lower than those receiving intraspinal anesthesia, and no difference was found between those receiving EA and those receiving CSEA. The DDI of parturients under GA, EA, and CSE were 7[6,7], 6[6,7], and 14[11.5,20.5], respectively. The DDI and DII of GA and EA were shorter than those of CSE, and the DDI and DII were similar between GA and EA. Compared to that in the GA group, the OAII in the intraspinal anesthesia group was significantly greater. GA administration correlated with more frequent resuscitative interventions, increased admission rates to NICU, and a greater incidence of neonatal respiratory distress syndrome (NRDS). Nevertheless, the duration of NICU stay and the incidence rates of neonatal hypoxic ischemic encephalopathy (HIE) and pneumonia did not significantly differ based on the type of anesthesia performed.

Conclusion

Compared with general anesthesia, epidural anesthesia may not be associated with a negative impact on neonatal or maternal outcomes and could be utilized as an alternative to general anesthesia in our selected patient population following emergency cesarean section; In addition, a comparably short DDI was achieved for emergency cesarean delivery under epidural anesthesia when compared to general anesthesia in our study. However, the possibility that selection bias related to the retrospective study design may have influenced the results cannot be excluded.
Walking capacity and its association with quality of life among children with down syndrome in Saudi Arabia
Authors: Alhammad Saad A. , Alqahtani Amani S. , Alwadeai Khalid S. , Algabbani Maha F. , Alhusaini Adel A.
Published: January 2024

Background

Walking ability, which has been connected to better health and independence, is one of the daily activities that is negatively impacted by Down syndrome. Thus, the objective of this study was to examine the walking capacity and its association with the quality of life of children who have Down syndrome compared to those who do not have Down syndrome in Saudi Arabia.

Methods

For this cross-sectional study, we recruited 68 Arabic-speaking children aged 6 to 12 using a convenience sampling method from August to November 2021. Children were divided into two groups: those who do not have Down syndrome (n = 38) and those who have Down syndrome (n = 30). Children in the Riyadh region of Saudi Arabia who do not have Down syndrome were chosen randomly from two schools. Children who have Down syndrome were selected from multiple associations and centers in the same region. A 6-minute walk test was used to measure the child’s walking capacity. The Arabic version of the Pediatric Quality of Life Inventory scale was used to assess the child’s or parent’s perceptions of the child’s quality of life and its physical, emotional, social, and school functioning domains.

Results

The difference in the mean 6-minute walk test scores between children who have and who do not have Down syndrome was statistically significant, with a mean difference = 105.6, 95% confidence limit = 57.2—154.0, p < .0001. The linear regression analysis after adjusting for age, height, weight, and body mass index revealed that walking capacity was found to be significantly associated with the worst score on the Pediatric Quality of Life Inventory scale (β = −2.71, SE = 0.49, p < .0001) and its domains of physical, social, and school functioning (β = −2.29, SE = 0.54, p < .0001; β = −2.40, SE = 0.58; p = .001; β = −3.71, SE = 0.56, p = .002, respectively) in children who have Down syndrome, but they had better emotional functioning than children who do not have Down syndrome.

Conclusions

Children who have Down syndrome were less able to walk and were highly associated with the worst possible quality of life, which included the lowest levels of physical, social, and school functioning. Early interventions with techniques must be developed to improve the quality of life for these children.
The first case of intellectual disability caused by novel compound heterozygosity for NUDT2 variants
Authors: Bi Bo , Chen Xiaohong , Huang Shan , Peng Min , Gu Weiyue , Zhu Hongmin , Ming Yangcan
Published: January 2024

NUDT2 is an enzyme important for maintaining the intracellular level of the diadenosine tetraphosphate (Ap4A). Bi-allelic loss of function variants in NUDT2 has recently been reported as a rare cause of intellectual disability (ID). Herein, we describe a Chinese girl with ID, attention deficit hyperactivity disorder (ADHD), and motor delays with abnormal walking posture and difficulty climbing stairs, who bears compound heterozygous variants c.34 C > T (p.R12*) and c.194T > G (p.I65R) in NUDT2. Homozygous variants c.34 C > T (p.R12*) or c.186del (p.A63Qfs*3) in NUDT2 were previously reported to cause ID. This is the first patient with ID due to compound heterozygous variants in NUDT2 and p.I65R is a novel missense variant. This study enriched the genotype and phenotype of NUDT2-related ID and supported the critical developmental involvement of NUDT2.
Metabolic syndrome increases osteoarthritis risk: findings from the UK Biobank prospective cohort study
Authors: Zhang Shiyong , Wang Danni , Zhao Jinyu , Zhao Haitong , Xie Peng , Zheng Linli , Sheng Puyi , Yuan Jinqiu , Xia Bin , Wei Fuxin , Zhang Ziji
Published: January 2024

Objective

The association between Metabolic Syndrome (MetS), its components, and the risk of osteoarthritis (OA) has been a topic of conflicting evidence in different studies. The aim of this present study is to investigate the association between MetS, its components, and the risk of OA using data from the UK Biobank.

Methods

A prospective cohort study was conducted in the UK Biobank to assess the risk of osteoarthritis (OA) related to MetS. MetS was defined according to the criteria set by the International Diabetes Federation (IDF). Additionally, lifestyle factors, medications, and the inflammatory marker C-reactive protein (CRP) were included in the model. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI). The cumulative risk of OA was analyzed using Kaplan–Meier curves and log-rank tests. To explore potential nonlinear associations between MetS components and OA risk, a restricted cubic splines (RCS) model was employed. In addition, the polygenic risk score (PRS) of OA was calculated to characterize individual genetic risk.

Results

A total of 45,581 cases of OA were identified among 370,311 participants, with a median follow-up time of 12.48 years. The study found that individuals with MetS had a 15% higher risk of developing OA (HR = 1.15, 95%CI:1.12–1.19). Additionally, central obesity was associated with a 58% increased risk of OA (HR = 1.58, 95%CI:1.5–1.66), while hyperglycemia was linked to a 13% higher risk (HR = 1.13, 95%CI:1.1–1.15). Dyslipidemia, specifically in triglycerides (HR = 1.07, 95%CI:1.05–1.09) and high-density lipoprotein (HR = 1.05, 95%CI:1.02–1.07), was also found to be slightly associated with OA risk. When stratified by PRS, those in the high PRS group had a significantly higher risk of OA compared to those with a low PRS, whereas no interaction was found between MetS and PRS on OA risks. Furthermore, the presence of MetS significantly increased the risk of OA by up to 35% in individuals with elevated CRP levels (HR = 1.35, 95% CI:1.3–1.4).

Conclusion

MetS and its components have been found to be associated with an increased risk of OA, particularly in individuals with elevated levels of CRP. These findings highlight the significance of managing MetS as a preventive and intervention measure for OA.
Determinants of health insurance coverage among women in Mauritania: a multilevel analysis
Authors: Dowou Robert Kokou , Atanuriba Gideon Awenabisa , Adzigbli Leticia Akua , Balame Samuel Kwaku , Tahidu Issifu , Aggrey-Korsah Juliet , Aboagye Richard Gyan
Published: January 2024

Background

Health insurance has been documented as one of the primary methods of financing healthcare for Sustainable Development Goals (SDGs) by 2030. Yet, there is a dearth of evidence on the determinants of health insurance coverage among women in Mauritania. We examine the factors associated with health insurance coverage among women in Mauritania using a nationally representative survey dataset.

Methods

We analyzed secondary data from the 2019–2021 Mauritania Demographic and Health Survey. A weighted sample of 15,714 women of reproductive age (15–49 years) was included in the study. Multilevel regression analysis was used to examined the factors associated with health insurance coverage. The results were presented using an adjusted odds ratio (aOR) with a 95% confidence interval (CI).

Results

The coverage of health insurance among women was 8.7%. The majority of the women subscribed to social security health insurance (7.6%). Women aged 35 years and above [aOR = 1.54; 95% CI = 1.24, 1.92] were more likely to be covered by health insurance relative to those aged 15–24. The likelihood of being covered by health insurance increased with increasing level of education with the highest odds among women with higher education [aOR = 6.09; 95% CI = 3.93, 9.42]. Women in the richest wealth index households [aOR = 22.12; 95% CI = 9.52, 51.41] and those with grand parity [aOR = 2.16; 95% CI = 1.62, 2.87] had the highest odds of being covered by health insurance. Women who were working, those who watched television, and those who used the internet were more likely to be covered by health insurance relative to their counterparts who were not working, those who did not watch television, and those who did not use the internet. Women residing in Tiris zemour et Inchiri [aOR = 3.60; 95%CI = 1.60, 8.10], Tagant (aOR = 3.74; 95% CI = 1.61, 8.68], and Adrar [aOR = 2.76; 95% CI = 1.36, 5.61] regions were more likely to be covered by health insurance compared with those from Hodh Echargui.

Conclusion

Health insurance coverage among the women in our study was low. Achieving the SDG targets of ensuring universal health coverage and lowering maternal mortality to less than 70 deaths per 100,000 live births requires the implementation of interventions to increase health insurance coverage, taking into consideration the identified factors in the study. We recommend effective public education and awareness creation on the importance of being covered by health insurance by leveraging television and internet platforms. Also, interventions to increase health insurance coverage should consider younger women and those in rural areas.
Cross-sectional and longitudinal associations between the 24-hour movement behaviours, including muscle and bone strengthening activity, with bone and lean mass from childhood to adolescence
Authors: Skinner Annie M. , Barker Alan R. , Moore Sarah A. , Soininen Sonja , Haapala Eero A. , Väistö Juuso , Westgate Kate , Brage Soren , Lakka Timo A. , Vlachopoulos Dimitris
Published: January 2024

Background

This study aimed to assess whether moderate-to-vigorous physical activity (MVPA), sport and exercise as a proxy measure of muscle and bone strengthening activity, sedentary behaviour, and sleep were associated with total-body-less-head (TBLH) bone mineral content (BMC) and TBLH lean mass cross-sectionally and longitudinally from age 6 to 9 years and age 9 to 11 years to age 15 to 17 years.

Methods

We used longitudinal data from a population sample of Finnish children from the Physical Activity and Nutrition in Children study (age 6 to 9 years: n = 478, 229 females; age 9 to 11 years: n = 384, 197 females; age 15 to 17 years: n = 222, 103 females). Linear regression analysed the cross-sectional and longitudinal associations between accelerometer-assessed MVPA, sedentary time and sleep, and questionnaire-assessed sport and exercise participation and screen time with dual-energy X-ray absorptiometry-assessed TBLH BMC and lean mass.

Results

In females, MVPA at age 6 to 9 years was positively associated with TBLH BMC at age 15 to 17 years (β = 0.008, p = 0.010). Sport and exercise at age 9 to 11 years was positively associated with TBLH BMC (β = 0.020, p = 0.002) and lean mass (β = 0.343, p = 0.040) at age 15 to 17 years. MVPA at age 9 to 11 years was positively associated with TBLH lean mass (β = 0.272, p = 0.004) at age 15 to 17 years. In males, sleep at age 6 to 9 years was positively associated with TBLH lean mass (β = 0.382, p = 0.003) at age 15 to 17 years. Sport and exercise at age 9 to 11 years was positively associated with TBLH BMC (β = 0.027, p = 0.012) and lean mass (β = 0.721, p < 0.001) at age 15 to 17 years.

Conclusions

Promoting engagement in the 24-hour movement behaviours in childhood, particularly sport and exercise to strengthen muscle and bone, is important in supporting bone and lean mass development in adolescence.

Trial registration

NCT01803776; first trial registration date: 04/03/2013.
Outcomes of ECMO support with polypropylene membrane during pandemic times: a retrospective cohort study
Authors: Valenzuela-Faccini Natalia , Poveda-Henao Claudia , Flórez-Navas Catalina , Pérez-Garzón Michel , Boada-Becerra Natalia , Mercado-Diaz Mario , Salcedo Patricia , Robayo-Amortegui Henry
Published: January 2024

Background

The SARS-CoV-2 pandemic resulted in shortages of supplies, which limited the use of extracorporeal membrane oxygenation (ECMO) support. As a contingency strategy, polypropylene (PP) oxygenation membranes were used. This study describes the clinical outcomes in patients on ECMO with PP compared to poly-methylpentene (PMP) oxygenation membranes.

Methods

Retrospective cohort of patients in ECMO support admitted between 2020 and 2021.

Results

A total of 152 patients with ECMO support were included, 71.05% were men with an average age of 42 (SD 9.91) years. Veno-venous configuration was performed in 75.6% of cases. The PP oxygenation membranes required more changes 22 (63.1%), than the PMP Sorin® 24 (32,8%) and Euroset® 15 (31,9%) (p.0.022). The main indication for membrane change was low oxygen transfer for PP at 56.2%, Sorin® at 50%, and Euroset® at 14.8%. Renal replacement therapy was the most frequent complication with PP membrane in 22 patients (68.7%) Sorin® 25 patients (34.2%), and Euroset® 15 patients (31.9%) (p 0.001) without statistically significant differences in mortality.

Conclusion

PP oxygenation membranes was a useful and feasible strategy. It allowed a greater disponibility of ECMO support for critically ill in a situation of great adversity during the SARS-CoV-2 pandemic.
Application of ultrasound-guided medical thoracoscopy in patients with small amounts or without pleural effusion
Authors: Yang Linhui , Wang Kaige , Hou Wang , Liu Dan , Li Weimin
Published: January 2024

Background

Pleural disease is a common clinical condition, and some patients present with a small amount of pleural effusion or no pleural effusion. It is difficult to diagnose such patients in clinical practice. Medical thoracoscopy is the gold standard for the diagnosis of pleural effusion with unknown origin, and guidelines recommend that pneumothorax should be induced in such patients before medical thoracoscopy examination. However, the process of inducing pneumothorax is tedious and has many complications. Our study was conducted to clarify the value of thoracic ultrasound combined with medical thoracoscopy in patients with small amounts or without pleural effusion to simplify the process of medical thoracoscopy examination.

Methods

In this retrospective study, we included patients who were assigned to complete medical thoracoscopy. Successful completion of medical thoracoscopy in patients was regarded as letting the endoscope get into the pleural cavity and completion of the biopsy. Finally, we analyzed the value of preoperative ultrasound in patients without or with small amounts of pleural effusion.

Results

Seventy-two patients were finally included in the study. Among them, 68 patients who underwent ultrasound positioning of the access site successfully completed the examination and four patients failed the examination. Fifty-one cases showed no fluid sonolucent area at the access site, of which 48 cases had pleural sliding signs at the access site, and 47 patients successfully completed the examination; 3 cases without pleural sliding signs at the access site failed to complete thoracoscopy. In 21 cases, the fluid sonolucent area was selected as the access site, and all of them successfully completed thoracoscopy.

Conclusion

Medical thoracoscopy is one of the methods to confirm the diagnosis in patients with pleural disease with small amounts or without pleural effusion. The application of thoracic ultrasound before medical thoracoscopy can be used for the selection of the access site. It is possible to replace pneumothorax induction before medical thoracoscopy.
Histological evaluation of the regenerative potential of a novel photocrosslinkable gelatin-treated dentin matrix hydrogel in direct pulp capping: an animal study
Authors: Sedek Eman M. , Abdelkader Sally , Fahmy Amal E. , Kamoun Elbadawy A. , Nouh Samir R. , Khalil Nesma Mohamed
Published: January 2024

Background

To assess histologically the success of the pulp capping approach performed in traumatically exposed dogs’ teeth using a novel injectable gelatin-treated dentin matrix light cured hydrogel (LCG-TDM) compared with LCG, MTA and TheraCal LC.

Methods

Sixty-four dogs’ teeth were divided into two groups (each including 32 teeth) based on the post-treatment evaluation period: group I: 2 weeks and group II: 8 weeks. Each group was further subdivided according to the pulp capping material into four subgroups (n = 8), with subgroup A (light-cured gelatin hydrogel) as the control subgroup, subgroup B (LCG-TDM), subgroup C (TheraCal LC), and subgroup D (MTA). Pulps were mechanically exposed in the middle of the cavity floor and capped with different materials. An assessment of periapical response was performed preoperatively and at 8 weeks. After 2 and 8-week intervals, the dogs were sacrificed, and the teeth were stained with hematoxylin-eosin and graded by using a histologic scoring system. Statistical analysis was performed using the chi-square and Kruskal-Wallis tests (p = 0.05).

Results

All subgroups showed mild inflammation with normal pulp tissue at 2 weeks with no significant differences between subgroups (p ≤ 0.05), except for the TheraCal LC subgroup, which exhibited moderate inflammation (62.5%). Absence of a complete calcified bridge was reported in all subgroups at 2 weeks, while at 8 weeks, the majority of samples in the LCG-TDM and MTA-Angelus subgroups showed complete dentin bridge formation and absence of inflammatory pulp response with no significant differences between them (p ≤ 0.05). However, the formed dentin in the LCG-TDM group was significantly thicker, with layers of ordered odontoblasts identified to create a homogeneous tubular structure and numerous dentinal tubule lines suggesting a favourable trend towards dentin regeneration. TheraCal LC samples revealed a reasonably thick dentin bridge with moderate inflammation (50%) and LCG showed heavily fibrous tissue infiltrates with areas of degenerated pulp with no signs of hard tissue formation.

Conclusions

LCG-TDM, as an extracellular matrix-based material, has the potential to regenerate dentin and preserve pulp vitality, making it a viable natural alternative to silicate-based cements for healing in vivo dentin defects in direct pulp-capping procedures.
Predicting students’ academic progress and related attributes in first-year medical students: an analysis with artificial neural networks and Naïve Bayes
Authors: Monteverde-Suárez Diego , González-Flores Patricia , Santos-Solórzano Roberto , García-Minjares Manuel , Zavala-Sierra Irma , de la Luz Verónica Luna , Sánchez-Mendiola Melchor
Published: January 2024

Background

Dropout and poor academic performance are persistent problems in medical schools in emerging economies. Identifying at-risk students early and knowing the factors that contribute to their success would be useful for designing educational interventions. Educational Data Mining (EDM) methods can identify students at risk of poor academic progress and dropping out. The main goal of this study was to use machine learning models, Artificial Neural Networks (ANN) and Naïve Bayes (NB), to identify first year medical students that succeed academically, using sociodemographic data and academic history.

Methods

Data from seven cohorts (2011 to 2017) of admitted medical students to the National Autonomous University of Mexico (UNAM) Faculty of Medicine in Mexico City were analysed. Data from 7,976 students (2011 to 2017 cohorts) of the program were included. Information from admission diagnostic exam results, academic history, sociodemographic characteristics and family environment was used. The main dataset included 48 variables. The study followed the general knowledge discovery process: pre-processing, data analysis, and validation. Artificial Neural Networks (ANN) and Naïve Bayes (NB) models were used for data mining analysis.

Results

ANNs models had slightly better performance in accuracy, sensitivity, and specificity. Both models had better sensitivity when classifying regular students and better specificity when classifying irregular students. Of the 25 variables with highest predictive value in the Naïve Bayes model, percentage of correct answers in the diagnostic exam was the best variable.

Conclusions

Both ANN and Naïve Bayes methods can be useful for predicting medical students’ academic achievement in an undergraduate program, based on information of their prior knowledge and socio-demographic factors. Although ANN offered slightly superior results, Naïve Bayes made it possible to obtain an in-depth analysis of how the different variables influenced the model. The use of educational data mining techniques and machine learning classification techniques have potential in medical education.
What influences newly graduated registered nurses’ intention to leave the nursing profession? An integrative review
Authors: Lyu Xiao-Chen , Huang Shuang-Shuang , Ye Xiao-Ming , Zhang Lu-Yu , Zhang Peng , Wang Ya-Juan
Published: January 2024

Background

Newly graduated registered nurses leaving the nursing profession in the early stages of their career have enormous financial and time implications for nursing organizations and affect the quality of nursing care.

Objective

To identify the factors influencing newly graduated registered nurses’ intention to leave the nursing profession over the past 10 years.

Methods

The framework developed by Whittemore and Knafl was used to conduct this integrative review. An electronic search was conducted for English articles to identify research studies published between 2011-2022 using the following databases of PubMed, MEDLINE, CINAHL, PsycINFO, and Scopus. Eligible publications were critically reviewed and scored using the Critical Appraisal Skills Program Checklist and the Center for Evidence-Based Management appraisal.

Results

Twenty-one studies were analyzed. The main factors affecting newly graduated registered nurses’ intention to leave the nursing profession included demographic factors (age, educational level, year of experience, professional title, employment status, health status, shift, hospital location and size), supervisor and peer support, challenges in the workplace, cognitive and affective response to work, work environment (collegial nurse-physician relations, insufficient staffing level, person-work environment fit), gender stereotypes, autonomous motivation, role models, and resilience.

Conclusions

The factors affecting newly graduated registered nurses’ intention to leave the nursing profession are multifaceted and should receive continuous attention from nurse managers. The findings provide more comprehensive for nurse administrators to develop intervention strategies to mitigate newly graduated registered nurses’ turnover intention.
Subtypes of nursing students' volunteer motivation in COVID-19: a latent profile analysis
Authors: He Fupei , Lin Beilei , Liu Xueting , Mei Yongxia , Wang Wenna , Zhang Zhenxiang , Wang Mingxu
Published: January 2024

Background

One factor that influences nursing students' decision to engage in volunteer activities is volunteer motivation. It is important to understand the motivations of nursing students to volunteer. However, the majority of current studies have concentrated on the present level of nursing students' motivation to volunteer.

Objectives

To identify subgroups of nursing students' volunteer motivation and its influential factors.

Methods

From January to February 2022, a cross-sectional online study was conducted, and 2569 nursing students from 10 provinces in China were recruited. Participants completed the General Information Questionnaire, Volunteer Functional Inventory (VFI), Perceived Stress Scale (PSS) and Perceived Social Support Scale (PSSS). We explore the categories and characteristics of volunteer motivation using latent profile analysis. Then, we determined factors that affect undergraduate nursing students' volunteer motivation using multinomial logistic regression.

Results

The volunteer motivation score of the nursing students was 77.65 (15.22). The study found that volunteer motivation could be divided into three categories: low-low protective volunteer motivation group (9.3%), general-high career values volunteer motivation group (37.5%), and high volunteer motivation group (53.2%). Perceived social support scale score, perceived stress scale score, gender, and grade significantly influenced the volunteer motivation of nursing students in different categories (bothP < 0.05). Women were more likely to have higher motivation to volunteer than men, and fourth-year nursing students were more likely to be in general-high career values volunteer motivation group.

Conclusions

The study highlights the significant heterogeneity in volunteer motivation among nursing students. Higher volunteer motivation was associated with higher perceived social support and lower perceived stress. In addition, gender and academic year were significant influencing factors. Nursing educators should develop targeted volunteer management plans based on the typological characteristics of the population to motivate nursing students to volunteer and promote the development of individual physical and mental health and social well-being.

Trial registration

The survey was approved by the Biomedical Ethics Committee of the Department of Medicine, Xi’an Jiaotong University (No. 2022–0006).
Validation and cross-cultural adaptation of the six-dimension scale of nursing performance- arabic version
Authors: Ta’an Wafa’a F. , Rababah Jehad A. , Al-Hammouri Mohammed M. , Yousef Jumana , Mukattash Tareq Lewis , Williams Brett
Published: January 2024

Background

Nursing performance is a key indicator of patients’ care quality and safety. Most healthcare research tools are available in the English language; however, nurses around the world can employ these tools if rigorously adapted and cross-culturally validated.

Aims and objectives

This study aims to provide a cross-cultural adaptation and validation of the six-dimension scale of nursing performance to be used among Arabic-speaking nurses.

Design

The study employed a descriptive, correlational design with a cross-sectional approach.

Methods

A five-step cross-cultural adaptation process was adopted. The scale was administered to 216 Jordanian nurses between January 2022 to April 2022. SPSS and AMOS were used for descriptive and correlation analyses and testing the six-dimension model through structural equation modeling (SEM).

Results

The current study produced a valid, reliable, culturally adapted Arabic language version of the six-dimension scale of nursing performance. The internal consistency of the tool was supported by a Cronbach Alpha’s value of 0.99. The model’s goodness of fit indices were: CFI = 0.96, RMSEA = 0.048, and CMIN/df = 1.49. The exploratory factor analysis (EFA) of the scale identified three factors with eigenvalues greater than 1.00., explaining 75.22% of the variance. A subsequent EFA, specifying six factors, yielded 79.79% explained variance. All item factor loadings exceeded 0.30, confirming the scale’s robust factor structure.

Conclusions

This study proved that following a robust cross-cultural adaptation process results in a reliable and valid measure of nursing performance to be used among Arabic-speaking nurses. The study supports the dimensionality of nursing performance as evidenced by the SEM results. Therefore, the findings have the potential to considerably enhance studying nursing performance in healthcare fields in Arabic-speaking nurses.

Relevance to clinical practice

The validation and cross-cultural adaptation of the Arabic version of the Six-Dimension Scale of Nursing Performance have direct implications for improving the quality of nursing services, enhancing patient safety, promoting cultural competence, and supporting the professional growth of Arabic-speaking nurses.
Assembling a population health management maturity index using a Delphi method
Authors: van Ede A. F. T. M. , Stein K. V. , Bruijnzeels M. A.
Published: January 2024

Background

Although local initiatives commonly express a wish to improve population health and wellbeing using a population health management (PHM) approach, implementation is challenging and existing tools have either a narrow focus or lack transparency. This has created demand for practice-oriented guidance concerning the introduction and requirements of PHM.

Methods

Existing knowledge from scientific literature was combined with expert opinion obtained using an adjusted RAND UCLA appropriateness method, which consisted of six Dutch panels in three Delphi rounds, followed by two rounds of validation by an international panel.

Results

The Dutch panels identified 36 items relevant to PHM, in addition to the 97 items across six elements of PHM derived from scientific literature. Of these 133 items, 101 were considered important and 32 ambiguous. The international panel awarded similar scores for 128 of 133 items, with only 5 items remaining unvalidated. Combining literature and expert opinion gave extra weight and validity to the items.

Discussion

In developing a maturity index to help assess the use and progress of PHM in health regions, input from experts counterbalanced a previous skewedness of item distribution across the PHM elements and the Rainbow Model of Integrated Care (RMIC). Participant expertise also improved our understanding of successful PHM implementation, as well as how the six PHM elements are best constituted in a first iteration of a maturity index. Limitations included the number of participants in some panels and ambiguity of language. Further development should focus on item clarity, adoption in practice and item interconnectedness.

Conclusion

By employing scientific literature enriched with expert opinion, this study provides new insight for both science and practice concerning the composition of PHM elements that influence PHM implementation. This will help guide practices in their quest to implement PHM.
Full quantitative resource utilization of raw mustard waste through integrating a comprehensive approach for producing hydrogen and soil amendments
Authors: Zhou Ling , Sun JiaZhen , Xu XiaoJun , Ma MingXia , Li YongZhi , Chen Qiao , Su HaiFeng
Published: January 2024

Background

Pickled mustard, the largest cultivated vegetable in China, generates substantial waste annually, leading to significant environmental pollution due to challenges in timely disposal, leading to decomposition and sewage issues. Consequently, the imperative to address this concern centers on the reduction and comprehensive resource utilization of raw mustard waste (RMW). To achieve complete and quantitative resource utilization of RMW, this study employs novel technology integration for optimizing its higher-value applications.

Results

Initially, subcritical hydrothermal technology was applied for rapid decomposition, with subsequent ammonia nitrogen removal via zeolite. Thereafter, photosynthetic bacteria, Rhodopseudomonas palustris, were employed to maximize hydrogen and methane gas production using various fermentation enhancement agents. Subsequent solid-liquid separation yielded liquid fertilizer from the fermented liquid and soil amendment from solid fermentation remnants. Results indicate that the highest glucose yield (29.6 ± 0.14) was achieved at 165–173℃, with a total sugar content of 50.2 g/L and 64% glucose proportion. Optimal ammonia nitrogen removal occurred with 8 g/L zeolite and strain stable growth at 32℃, with the highest OD600 reaching 2.7. Several fermentation promoters, including FeSO4, Neutral red, Na2S, flavin mononucleotide, Nickel titanate, Nickel oxide, and Mixture C, were evaluated for hydrogen production. Notably, Mixture C resulted in the maximum hydrogen production (756 mL), a production rate of 14 mL/h, and a 5-day stable hydrogen production period. Composting experiments enhanced humic acid content and organic matter (OM) by 17% and 15%, respectively.

Conclusions

This innovative technology not only expedites RMW treatment and hydrogen yield but also substantially enriches soil fertility. Consequently, it offers a novel approach for low-carbon, zero-pollution RMW management. The study’s double outcomes extend to large-scale RMW treatment based on the aim of full quantitative resource utilization of RMW. Our method provides a valuable reference for waste management in similar perishable vegetable plantations.
Post hospital admission blood lactate measurements are associated with mortality but not neurologic morbidity in children with cerebral malaria
Authors: Olowojesiku Ronke , Sherman Meredith G. , Mukadam Amina M. , Imam Rami , Chastang Kennedy M. , Seydel Karl B. , Liomba Alice M. , Barber John R. , O’Brien Nicole F. , Postels Douglas G.
Published: January 2024

Background

In children with cerebral malaria (CM) admission blood lactate has previously guided intravenous fluid therapy and been validated as a prognostic biomarker associated with death. The usefulness of post-admission measurements of blood lactate in children with CM is less clear. The strength of association between blood lactate and neurological sequelae in CM survivors, as well as the optimal duration of post-admission measurements of blood lactate to identify children at higher risk of adverse outcomes is unknown.

Methods

A retrospective cohort study of 1674 Malawian children with CM hospitalized from 2000 to 2018 who had blood lactate measurements every 6 h for the first 24 h after admission was performed. The strength of association between admission lactate or values measured at any time point in the first 24 h post-admission and outcomes (mortality and neurological morbidity in survivors) was estimated. The duration of time after admission that lactate remained a valid prognostic biomarker was assessed.

Results

When lactate is analysed as a continuous variable, children with CM who have higher values at admission have a 1.05-fold higher odds (95% CI 0.99–1.11) of death compared to those with lower lactate values. Children with higher blood lactate at 6 h have 1.16-fold higher odds (95% CI 1.09–1.23) of death, compared to those with lower values. If lactate levels are dichotomized into hyperlactataemic (lactate > 5.0 mmol/L) or not, the strength of association between admission lactate and mortality increases (OR = 2.49, 95% CI 1.47–4.22). Blood lactate levels obtained after 18 h post-admission are not associated with outcomes. Similarly, the change in lactate concentrations through time during the first 24 h of hospital admission is not associated with outcomes. Blood lactate during hospitalization is not associated with adverse neurologic outcomes in CM survivors.

Conclusions

In children with CM, blood lactate is associated with death but not neurologic morbidity in survivors. To comprehensively estimate prognosis, blood lactate in children with CM should be assessed at admission and for 18 h afterwards.
The CHANGE (Climate Health ANalysis Grading Evaluation) tool for weight of evidence reviews on climate change and health research
Authors: Sprague Nadav L. , Uong Stephen P. , Zonnevylle Hannah , Chatterjee Trinish , Hernández Diana , Rundle Andrew G. , Ekenga Christine C.
Published: January 2024

Background

Climate change has been identified as one of the biggest threats to human health. Despite this claim, there are no standardized tools that assess the rigor of published literature for use in weight of evidence (WOE) reviews. Standardized assessment tools are essential for creating clear and comparable WOE reviews. As such, we developed a standardized tool for evaluating the quality of climate change and health studies focused on evaluating studies that quantify exposure-response relationships and studies that implement and/or evaluate adaptation interventions.

Methods

The authors explored systematic-review methodology to enhance transparency and increase efficiency in summarizing and synthesizing findings from studies on climate change and health research. The authors adapted and extended existing WOE methods to develop the CHANGE (Climate Health ANalysis Grading Evaluation) tool. The resulting assessment tool has been refined through application and subsequent team input.

Results

The CHANGE tool is a two-step standardized tool for systematic review of climate change and health studies of exposure-response relationships and adaptation intervention studies. Step one of the CHANGE tool aims to classify studies included in weight-of-evidence reviews and step two assesses the quality and presence of bias in the climate change and health studies.

Conclusion

The application of the CHANGE tool in WOE reviews of climate change and health will lead to increased comparability, objectivity, and transparency within this research area.
Predictors of concurrent heroin use among patients on opioid maintenance treatment in France: a multilevel study over 11 years
Authors: Janssen Eric , Vuolo Mike , Spilka Stanislas , Airagnes Guillaume
Published: January 2024

Background

Consistent reports from health professionals suggest that heroin is commonly used by patients undergoing opioid maintenance treatment (OMT) in France, potentially jeopardizing their recovery process. However, there has been no formal epidemiological assessment on the matter.

Methods

We use a yearly updated compendium retrieving information on patients admitted in treatment centres in France between 2010 and 2020. Given the hierarchical nature of the data collection, we conduct 2-level modified Poisson regressions to estimate the risks of past month heroin use among patients on OMT.

Results

Despite an overall decreasing trend over time, heroin use among patients on OMT is indeed common, with half of patients declaring concurrent use. Our study unveils differentiated risks of heroin use vary according to the type of OMT, with patients on methadone more likely to use heroin compared to those on buprenorphine. The use of multilevel-related measures also uncovers high heterogeneity among patients’ profiles, reflecting different stages in the treatment process, as well as differentiated practices across treatment centres.

Conclusion

Opioid maintenance treatment is associated with heroin use, in particular when methadone is involved. The heterogeneity among patients on OMT should be given particular attention, as it underscores the need for tailored interventions.
Drug preparation, injection-related infections, and harm reduction practices among a national sample of individuals entering treatment for opioid use disorder
Authors: Marks Laura R. , Durkin Michael J. , Ayres Kelly , Ellis Matthew
Published: January 2024

Background

The rise in injection drug use in the USA has led to an increase in injection site infections. We performed a national survey of people who use drugs to evaluate common drug use preparation, harm reduction practices, and experiences with injection site infections.

Methods

A survey was disseminated to members of the Survey of Key Informants’ Patients Program from 2021 to 2022 and distributed to patients 18 years or older newly entering one of 68 substance use disorder treatment programs across the USA with a primary diagnosis of an opioid use disorder. Participants were surveyed about practices when preparing and using drugs, along with self-reported infections and drug use complications.

Results

1289 participants responded to the survey. Sexually transmitted infections were common, with 37.6% reporting ever having had any sexually transmitted infection. Injection-associated infections had affected 63.4% of participants who had ever used injection drugs. Many respondents reported not seeking professional medical assistance for infection management, including 29% draining abscesses without seeking medical care and 22.8% obtaining antibiotics through non-healthcare sources. Non-sterile injection practices included sharing needles with others who were febrile or ill (18%), using needles previously used to drain wounds/abscesses (9.9%) for subsequent injection drug use, and licking needles (21.2%).

Conclusion

Patients entering treatment for opioid use disorder reported a high burden of infectious diseases. A number of easily-modifiable high risk behaviors for developing injection-related infections were identified. Efforts are needed to disseminate targeted harm reduction education to PWID on how to reduce their risks for injection-related infections.
Perceptions regarding the concept and definition of patient-reported outcomes among healthcare stakeholders in Japan with relation to quality of life: a cross-sectional study
Authors: Kaneyasu Takako , Saito Shinya , Miyazaki Kikuko , Suzukamo Yoshimi , Naito Mariko , Kawaguchi Takashi , Nakajima Takako Eguchi , Yamaguchi Takuhiro , Shimozuma Kojiro
Published: January 2024

Patient-reported outcomes (PROs) are frequently used in a variety of settings, including clinical trials and clinical practice. The definition of PRO and quality of life (QOL) and their relationship have been concluded through discussions among experts that has been the premise of PRO guidelines are not clearly stated in the guidelines. Therefore, the definition of PRO, especially in relation to QOL, is sometimes explained simply, as “PRO includes QOL,” but this complicated matters. This study investigated the perceptions of PRO among various stakeholders (including patients and their families, the industry, clinicians, regulatory or health technology assessment personnel, and academic researchers) in Japan to clarify its definitions and that of QOL, including their relationship.

We conducted a two-step survey: a qualitative interview survey and a web-based survey to ensure the validity of the survey. During the interviews, eight stakeholders described their perceptions and thoughts on PRO and its relationship to QOL, and their experience of using PRO. Overall 253 clinicians, 249 company employees, and 494 patients participated in the web survey to confirm how the findings of the interview survey supported the results.

In the interview survey, patient advocates described various perspectives of PRO and QOL, including unexpected dynamic relationships, while the most other stakeholders explained PRO and QOL with the language used in the guidelines, but their responses were split. The web-based survey revealed that all stakeholders had a lower awareness of PRO than QOL. The most common perception of PRO, especially in the relationship to QOL, was “they did not fully overlap.” Although there were differences in perceptions of the relationship between PRO and QOL among clinicians, company employees, and patients, all perceived PRO as a tool to facilitate communication in clinical practice.

The present results are inconsistent with the simplified explanation of PRO, but consistent with the original PRO guideline definitions, which also considered the role of PRO in clinical practice. To make PRO a more potent tool, all stakeholders using PRO should confirm its definition and how it differs from QOL, have a unified recognition in each PRO use, and avoid miscommunication.