bluuebunny/crossref_metadata_2025 huggingface dataset:
КЛІНІЧНИЙ ПЕРЕБІГ ПОЛОГІВ У ЖІНОК З НЕАЛКОГОЛЬНИМ СТЕАТОГЕПАТИТОМ НА ТЛІ ОЖИРІННЯ РІЗНОГО СТУПЕНЯ
Authors: Багній Л. В.
Published: February 2023

Мета дослідження – оцінити клінічний перебіг пологів у жінок з неалкогольним стеатогепатитом на тлі ожиріння різного ступеня.

Матеріали та методи. Було обстежено 98 вагітних жінок з неалкогольним стеатогепатитом у поєднанні з ожирінням. До контрольної групи ввійшли 30 практично здорових вагітних. Усіх вагітних поділили на 3 групи залежно від індексу маси тіла (ІМТ): ІА група – 26 вагітних з ІМТ 25,0–29,9 кг/м²; ІВ група – 48 вагітних з ІМТ 30,0–34,9 кг/м²; ІС група – 24 вагітних з ІМТ 35,0–39,9 кг/м². Для оцінки наявності й ступеня вираження стеатозу і стеатогепатиту проводили еластографію печінки зі стеатометрією та неінвазивний тест NASH-FibroTest.

Результати дослідження та їх обговорення. Під час аналізу перебігу пологової діяльності передчасні пологи спостерігали в IА групі в 1,7 раза, в ІВ групі – у 2,5 раза, в ІС групі – у 3,1 раза частіше, ніж у контрольній групі (p<0,05), первинна слабкість пологової діяльності виникала в ІА групі в 1,1 раза, в ІВ групі – у 3,1 раза, в ІС групі – у 3,7 раза частіше, ніж у вагітних контрольної групи (p<0,05). Післяпологова кровотеча розвивалася в пацієнток IА групи у 2,3 раза, IВ групи – у 3,7 раза, IС групи – в 5,0 разів більше, ніж у вагітних контрольної групи (p<0,05), а клінічно вузький таз діагностували в жінок з надмірною масою тіла у 3,8 раза, у вагітних з ожирінням І ступеня – у 6,2 раза, в пацієнток з ожирінням ІІ–ІІІ ступенів – у 8,3 раза частіше проти контрольної групи (p<0,05).

Висновки. Клінічний перебіг пологів у роділь з неалкогольним стеатогепатитом на тлі ожиріння супроводжується достовірно вищою частотою розвитку акушерських і перинатальних ускладнень, що позитивно корелюють із зростанням ІМТ та вказують на вагомість неалкогольного стеатогепатиту під час вагітності.
Вплив антибіотиків різних груп на перебіг позалікарняної пневмонії у дітей
Authors: Щербатюк Н. Ю. , Гаріян Т. В. , Мудрик У. М. , Чорномидз І. Б. , Горішній І. М.
Published: February 2023

Резюме. У статті наведено результати застосування захищених амінопеніцилінів та цефалоспоринів у лікуванні позалікарняної пневмонії у дітей в умовах стаціонару. Продемонстровано їх порівняльний вплив на перебіг пневмонії, динаміку симптомів, даних додаткових методів дослідження. Доведено значно більшу ефективність захищених пеніцилінів порівняно з цефалоспоринами.
Мета дослідження – вивчити порівняльну ефективність захищених амінопеніцилінів та цефалоспоринів у лікування позалікарняної пневмонії у дітей в умовах стаціонару.
Матеріали і методи. Обстежено 40 дітей від 3 місяців до 5 років із позалікарняними пневмоніями, 20 дітей отримували в лікуванні захищені амінопеніциліни, 20 дітей отримували в лікуванні цефалоспорини. Вивчався вплив антибактеріальної терапії на показники загального аналізу крові, динаміку змін на рентгенограмах органів грудної клітки, брались до уваги дані про зміни загального стану хворих дітей, динаміка при аускультації легень.
Результати. В обстежених дітей, які отримували захищені амінопеніциліни скарги на кашель, загальну слабкість, головний біль регресували на 7–8 день лікування, тоді коли в пацієнтів, які отримували цефалоспорини, скарги мали місце до 10 дня лікування. Аускультативні та рентгенографічні зміни, а також зниження запального синдрому в лабораторних обстеженнях в середньому на 30 % були більш динамічними під впливом лікування у пацієнтів, які отримували захищені амінопеніциліни.
Висновки. Дотримання рекомендацій ВООЗ (2017 р.) з антибактеріальної терапії сприяє більшій ефективності динаміки симптомів. При лікуванні необхідно надавати перевагу антибіотикам групи ACCESS (доступність), куди належать амоксицилін та амоксициліна/клавуланат над препаратами групи WATCH (спостереження), куди відносяться, у тому числі, цефалоспорини 3 покоління, які є препаратами вибору та резерву, так як їх застосування підвищує ризик розвитку резистентності.
Післядипломна освіта медичної сестри як одна із складових особистої освітньої траєкторії
Authors: Шульгай А. Г. , Теренда Н. О. , Литвинова О. Н. , Трущенкова Л. В. , Петрашик Ю. М.
Published: February 2023

Резюме. Безперервна освіта медичної сестри сприяє значному покращанню якості, доступності та економічності надання медичної допомоги населенню.
Мета дослідження – вивчити та порівняти аналіз післядипломної освіти медичних сестер в Україні та Польщі як складових особистої освітньої траєкторії.
Матеріали і методи. Проаналізовано нормативно-правову документацію щодо освіти в Україні та країнах Європейського Союзу.
Результати. У статті описано нормативно-правову базу форм та методів післядипломної освіти в Україні та країнах Європейського Союзу. Особлива увага приділяється питанням інформальної освіти. Найпоширенішим видом неформальної освіти для медичних сестер стане форма інформальної освіти: участь у фахових нарадах, семінарах, науково-практичних конференціях, симпозіумах, з’їздах, виставках, симуляційних тренінгах, майстер-класах, курсах з оволодіння практичними навичками, стажування у клініках інших країн, дистанційне навчання, у тому числі електронне через фахові інтернет-ресурси. Наведено порівняльний аналіз післядипломної освіти медичних сестер в Україні та Польщі як основи безперервного професійного розвитку та умов кар’єрного зростання. Досвід післядипломної освіти в Польщі вказує на позитивний ефект від формування особистого освітнього портфоліо медичного працівника, структурованого підходу до призначення на управлінські посади залежно від наявності ступеня бакалавра чи магістра. Запровадження в Україні цього позитивного досвіду сприятиме підвищенню зацікавленості медичних сестер у освоєнні нових практичних навичок, покращенні професійних компетентностей, здобутті вищої освіти.
Висновки. Впровадження інформальної освіти у процес набуття нових компетентностей та підвищення професійної майстерності молодших спеціалістів із медичною освітою є затребуваним напрямком у сучасній системі безперервного професійного розвитку фахівців у сфері охорони здоров’я.
Hate Crimes and Black College Student Enrollment
Authors: Baker Dominique J. , Britton Tolani
Published: February 2023

Reported hate crimes in the United States have increased rapidly in recent years, alongside an increase in general racial animus. Scholars have shown that the larger sociopolitical environment can directly impact the campus climate and experiences of all students, particularly students of color. However, little is known about how reports of hate crime incidents relate to college enrollment levels of students of color. This lack of evidence has especially troubling implications for Black people, the most frequent targets of reported hate crimes. This paper helps to fill in that gap by exploring the association between the number of reports of hate crimes within states and Black students’ college enrollment. We examine a comprehensive dataset of institutional enrollment and characteristics, reported hate crimes, and census data on state racial demographics from 2000 to 2017 using several techniques, including institution fixed effects. We find that a 1 standard deviation increase in reports of state-level hate crimes predicts a 17 to 22 percent increase in Black first-time student enrollment at historically Black colleges and universities. As the number of reported hate crimes is almost assuredly an undercount of the actual number of incidents, we explore the implications of what these results mean.
The artoriine wolf spiders of Australia: the new genus Kochosa and a key to genera (Araneae: Lycosidae)
Authors: FRAMENAU VOLKER W. , CASTANHEIRA PEDRO DE S. , YOO JUNG-SUN
Published: February 2023

A key to the six Australian genera of the wolf spider (Lycosidae Sundevall, 1833) subfamily Artoriinae Framenau, 2007 is provided, now including Artoria Thorell, 1877, Artoriopsis Framenau, 2007, Diahogna Roewer, 1960, Kangarosa Framenau, 2010, Kochosa gen. nov. and Tetralycosa Roewer, 1960. Kochosa gen. nov. is described to include 16 species: K. australia sp. nov. (type species; from New South Wales, Queensland, South Australia, Victoria, Western Australia), K. aero sp. nov. (Western Australia), K. asterix sp. nov. (New South Wales, Queensland, Tasmania and Victoria), K. confusa sp. nov. (Queensland), K. erratum sp. nov. (Queensland), K. fleurae sp. nov. (Victoria), K. mendum sp. nov. (Australian Capital Territory, New South Wales, Queensland), K. nigra sp. nov. (Queensland), K. obelix sp. nov. (Western Australia), K. queenslandica sp. nov. (Queensland), K. sharae sp. nov. (South Australia), K. tanakai sp. nov. (New South Wales, Queensland), K. tasmaniensis sp. nov. (Tasmania), K. timwintoni sp. nov. (Western Australia), K. tongiorgii sp. nov., (Queensland), and K. westralia sp. nov. (Western Australia). Kochosa gen. nov. differs distinctly from all other genera within the Artoriinae by somatic and genitalic morphology. Most conspicuous is a distinct off-white or yellowish-white cardiac mark on an otherwise generally uniformly dark abdomen. The cardiac mark is rendered by thick black setae, which are particularly dense posteriorly. The tegular apophysis of the male pedipalp is heavily reduced, generally forming a semi-transparent small lobe. In turn, the embolic division is often complex with a variety of apophyses. Kochosa gen. nov. generally inhabit mesic habitats such as temperate and tropical shrubs and forests along the eastern and south-eastern coast and in the south-western parts of Australia.
Taxonomic review of the Oiketicoides species (Lepidoptera: Psychidae: Oiketicinae: Acanthopsychini) from Anatolia, the Middle East and Central Asia
Authors: ARNSCHEID WILFRIED R. , SOBCZYK THOMAS
Published: February 2023

As already shown in previous papers (Arnscheid & Sobczyk 2020; Arnscheid et al., 2021 and Sobczyk & Arnscheid 2021) the genus Oiketicoides Heylaerts, 1881 is one of the most difficult assessable groups within the Psychidae as regards both taxonomy and bionomics. The previous articles dealt with the taxonomic relationship of the Oiketicoides species distributed in South-West Europe and North Africa. The present article treats the species of the Anatolian peninsula, the Near and Middle East and Central Asia. Sixteen species are listed and their diagnostic differences are presented. Five new species for science are described: Oiketicoides elegantis sp. nov., O. centralasiaticae sp. nov., O. hackeri sp. nov., O. defreinai sp. nov. and O. anatolica sp. nov. Ten species are removed from the genus Oiketicoides and are newly combined with Acanthopsyche Heylaerts, 1881. These are: Acanthopsyche orophila (Wehrli, 1928) comb. nov., Acanthopsyche grummi Heylaerts, 1887, stat. rev., Acanthopsyche demarcata (Kozhanshikov, 1956) comb. nov., Acanthopsyche heptatomica (Kozhanshikov, 1956) comb. nov., Acanthopsyche nigripilosa (Kozhanshikov, 1956) comb. nov., Acanthopsyche squamopilosa (Kozhanshikov, 1956) comb. nov., Acanthopsyche theodori (Kozhanshikov, 1956) comb. nov., Acanthopsyche saurica (Solyanikov, 1996) comb. nov., Acanthopsyche leoi (Kozhanshikov, 1956) comb. nov., Acanthopsyche staudingeri (Heylaerts, 1889) comb. nov. Canephora unicolorata (Kozhanshikov, 1956) comb. nov., syn. nov. is transferred from Oiketicoides to Canephora Hübner, 1822 and synonymized with Canephora hirsuta (Poda, 1761). In addition, the following synonymization acts are made: Amicta caucasica Bang-Haas, 1912 syn. nov. of Oiketicoides armena (Heylaerts, 1885), Amictoides borealis Kozhanshikov, 1956 syn. nov. of Oiketicoides armena (Heylaerts, 1885), Amictoides subgrisea Kozhanshikov, 1956 syn. nov. of Oiketicoides armena (Heylaerts, 1885).
First record of Archanara neurica (Hübner, 1808) from the Iberian Peninsula (Lepidoptera: Noctuidae) according to DNA barcoding and internal male genitalia
Authors: ORTIZ A. S. , RUBIO R. M. , RANKI T. , GUERRERO J. J. , YELA J. L.
Published: February 2023

Archanara neurica (Hübner, 1808) is recorded for the first time from the Iberian Peninsula. The Iberian population represent a link between central European, including French, and Moroccan populations. Male internal genitalia are comparatively described. DNA barcode is presented and compared with those of the other European Archanara, Lenisa and Globia species, formerly considered congeneric. An analysis based on the COI mitochondrial gene provisionally supports the morphologically proposed statement that recognize the three mentioned taxa at the generic level.
Unmet Need for Screening for Diabetes Mellitus, Hypertension, and Dyslipidemia in a Population That Is at Risk for NCDs; A Study Among Older Adults in Kottayam District, Kerala
Authors: Scaria Liss Maria
Published: February 2023

Background: More than half of the people in the geriatric age group have a history of at least one chronic illness, the majority of which are associated with the cardiovascular system. Hypertension, dyslipidemia, and diabetes mellitus are recognized risk factors for cardiovascular disease morbidity and mortality. The early detection of noncommunicable diseases (NCDs) has been found to reduce the disease burden and the associated complications. The study aims to assess the unmet need for screening of NCDs among older adults in the Kottayam district. Methods: A cross-sectional study was conducted among 420 older adults (60 years and above) in all 11 blocks of the Kottayam district using a structured interview schedule. Statistical analysis using proportions with appropriate stratification was undertaken using SPSS Version 26. Results: The unmet need for dyslipidemia screening (45.5%) was the highest among the screening. Employment status, socioeconomic status, and education were associated with the unmet need for dyslipidemia screening. Education, employment status, current means of sustenance, and socioeconomic status were associated with the unmet need for screening of diabetes mellitus. The unmet need for screening of only dyslipidemia was 22.4%. Among the participants with hypertension and diabetes mellitus, more than three-fourths (77.0%) had an unmet need for dyslipidemia screening. Conclusions: Unmet need for screening of dyslipidemia was the highest among all the 3 diseases. About one-eight of those aged 60 and above have not been screened appropriately for all the 3 diseases. Any programmatic effort needs to address this to reduce the burden of NCD morbidity among the elderly.
Prevalence of Oral Health Issues and Its Associated Risk Factors Among Post-COVID Patients in Kannur, Kerala: A Cross-Sectional Study
Authors: Radhakrishnan Athira , Dinesh Avani , Sreedevi Aswathy , Mathew Minu Maria
Published: February 2023

Background: The novel coronavirus has affected over 6.9 million people in over 200 nations in the world. As of May 2022, according to World Health Organization, India reported 43,107,689 confirmed cases of coronavirus disease (COVID-19). An Egyptian study reported 67.2% with oral manifestations where dry mouth was 39.7%, gustatory dysfunction as 34.5% loss of salt sensation, 29.3% loss of sweet sensation, and 25.9% altered food taste. The objective of this study was to estimate prevalence of oral health issues and associated factors among persons who had been diagnosed COVID positive in Kerala. Methods: In the cross-sectional study conducted among 63 post-COVID patients in Kannur district in Kerala, data was collected through online survey with semi-structured questionnaires. Results: Mean age of study participants was 43.96 ± 16.78 years. About three-fourth, 74.6% (95% confidence interval: 63.9, 85.3), of study participants suffered oral health issues. Most common oral health issues reported were dry mouth 37 (58.7%), altered taste sensation in 35 (55.6%), and teeth sensitivity among 32 (50.8%). Ayurvedic medications for COVID-19 (P value: .014), oral hygiene habits (P value: .001), irregular dental consultation (P value: .04), and treatment (P value: .033) were factors significantly associated with oral health issues. Conclusion: Our study reveals that post-COVID patients are a group which require better oral care and hence early diagnosis is encouraged to recognize and treat oral manifestations in them.
Assessment of Implementation and Awareness of Cigarettes and Other Tobacco Products Act in High Schools and Higher Secondary Schools of Kasaragod District, Kerala
Authors: Vasudevan Ganesh , Ajayakumar Aarathi , Ambatipudi Srikant
Published: February 2023

Background: Tobacco use remains the single largest preventable cause of mortality globally, accounting for 8 million premature deaths each year. Even after a decade of enactment of tobacco control laws in India, their acceptance and successful implementation remain challenging. This study was envisaged to assess the implementation of the Cigarettes and Other Tobacco Products Act (COTPA) in schools and the awareness levels of tobacco control laws among heads, teachers, and students of the schools in Kasaragod district. Methods: An institution-based cross-sectional survey was conducted to assess the awareness of selected provisions of the COTPA (Sections 4, 5, 6a, 6b, 21, and 25) among the heads of the institutions of 40 randomly selected high schools and higher secondary schools. Similarly, awareness of the COTPA provisions was assessed among teachers (n = 328) and students (n = 402) using self-administered questionnaires. In addition, schools were surveyed for inspecting the implementation level of selected provisions of the COTPA using an observational checklist. Results: The overall implementation of the COTPA was observed to be 35.5%. The overall self-reported awareness of the COTPA was 13.6%, 25.8%, and 13.1%, among the head of the institutions, teachers, and students, respectively. Government school students had better awareness than that in private schools (42.7% vs 25.2%), although violations of provisions are higher in government schools (OR = 6.0, 95% CI [1.11 to 32.28]). Conclusion: The overall implementation and awareness of the COTPA provisions was low in the schools of Kasaragod district. The implementation will improve if regular inspection of the schools is done. Increasing the frequency of comprehensive structured training programs for the head of the institution, teachers, and students, and coordinated efforts by stakeholders will help in better implementation of the COTPA.
Dietary Practices and Related Elements Among Patients With Type 2 Diabetes in Rural Kerala, India
Authors: Mannethodi Kamaruddeen , Sankar Uma V. , Prasad Varma Ravi
Published: February 2023

Background: Frequency of type 2 diabetes is very much elevated in Kerala in comparison with other states. Essential and effectual regulation of the illness could avert and thus delay complications. Good dietary practice is an important component in diabetes management. This study aims to assess the regimen applications and related elements among patients with type 2 diabetes in Malappuram district of Kerala. Methods: A cross-sectional survey was done among 304 patients with type 2 diabetes selected by cluster sampling from randomly chosen electoral divisions of Malappuram block panchayat of Kerala. A systematic interview was performed in order to evaluate the frequency and prevalence of quality regimen practices among patients distressed with type 2 diabetes and factors associated with it. Good dietary practice was a single composite outcome created out of 5 independent variables. Results: The prevalence of good dietary practice among patients with type 2 diabetes was 20.4%. Elements like self-announced hardness in following a healthy balanced regimen (adjusted odds ratio [AOR]: 0.19 [0.09-0.41]), physical help from a family member to follow good dietary practices (AOR: 2.89 [1.24-6.75]), companionship of peer or family member in practicing good dietary practice (AOR: 2.23 [1.07-4.66]), and regular blood sugar monitoring (AOR: 2.74 [1.27-5.94]) were remarkably linked with quality regimen practices. Conclusion: Prevalence of good dietary practices within patients with type 2 diabetes was found to be very low. Interventions for improvement in good dietary practices should include methods like regime counselling which can actually guide the patients to outgrow their recognized health issues. During difficult times like these, most of the patients desire great family assistance and help from others who would like to conduct good regimen practices with the patients.
Genomic selection models substantially improve the accuracy of genetic merit predictions for fillet yield and body weight in rainbow trout using a multi-trait model and multi-generation progeny testing
Authors: Garcia Andre , Tsuruta Shogo , Gao Guangtu , Palti Yniv , Lourenco Daniela , Leeds Tim
Published: February 2023

Background

In aquaculture, the proportion of edible meat (FY = fillet yield) is of major economic importance, and breeding animals of superior genetic merit for this trait can improve efficiency and profitability. Achieving genetic gains for fillet yield is possible using a pedigree-based best linear unbiased prediction (PBLUP) model with direct and indirect selection. To investigate the feasibility of using genomic selection (GS) to improve FY and body weight (BW) in rainbow trout, the prediction accuracy of GS models was compared to that of PBLUP. In addition, a genome-wide association study (GWAS) was conducted to identify quantitative trait loci (QTL) for the traits. All analyses were performed using a two-trait model with FY and BW, and variance components, heritability, and genetic correlations were estimated without genomic information. The data used included 14,165 fish in the pedigree, of which 2742 and 12,890 had FY and BW phenotypic records, respectively, and 2484 had genotypes from the 57K single nucleotide polymorphism (SNP) array.

Results

The heritabilities were moderate, at 0.41 and 0.33 for FY and BW, respectively. Both traits were lowly but positively correlated (genetic correlation; r = 0.24), which suggests potential favourable correlated genetic gains. GS models increased prediction accuracy compared to PBLUP by up to 50% for FY and 44% for BW. Evaluations were found to be biased when validation was performed on future performances but not when it was performed on future genomic estimated breeding values.

Conclusions

The low but positive genetic correlation between fillet yield and body weight indicates that some improvement in fillet yield may be achieved through indirect selection for body weight. Genomic information increases the prediction accuracy of breeding values and is an important tool to accelerate genetic progress for fillet yield and growth in the current rainbow trout population. No significant QTL were found for either trait, indicating that both traits are polygenic, and that marker-assisted selection will not be helpful to improve these traits in this population.
Higher anxiety and perceived trauma among COVID-19 patients: a prospective comparative study
Authors: Kordi Alireza , Sarabi-Jamab Atiyeh , Shariat Seyed Vahid , Rezaee Nastaran , Shariati Behnam , Faiz Seyed Hamid Reza , Mirfazeli Fatemeh Sadat
Published: February 2023

Background and purpose

Psychiatric disorders such as anxiety, depression, and traumatic stress are not rare during infectious outbreaks, as the COVID-19 pandemic has posed a great concern to the general population. In this study, we aimed to investigate whether experiencing psychiatric symptoms during COVID-19 is the result of the burden of carrying an illness or the COVID-19 itself.

Method

Two hundred ten subjects and three different groups of participants (COVID-19 patients, university staff, and orthopedic patients) were recruited. They answered a demographic questionnaire, Yale-Brown Obsessive–Compulsive Scale (YBOCS) test for OCD symptoms, Impact of Event Scale-Revised (IES-R) for perceived trauma, Beck Anxiety Inventory (BAI) for anxiety, and Beck Depression Inventory (BDI) for depression assessments using phone or face-to-face interviews.

Result

At least one OCD symptom was observed in 85.7% of the subjects. However, there was no significant difference between the 3 groups (p = 0.2194). Perceived trauma was significantly higher among COVID-19 patients followed by university staff and orthopedic patients (23.73, 16.21, 11.51 mean IES-R scores respectively, p = 8.449e−14). COVID-19 patients also showed higher anxiety (mean BAI score: 17.00) than the university staff and orthopedic patients’ group (9.22 and 5.56 respectively) (p = 6.175e−08). BDI score did not show much variation for depression, the mean score was 9.66, 9.49, and 6.7 for the COVID-19 patients, university staff, and orthopedic patients respectively, (p = 0.2735).

Conclusion

Perceived trauma and anxiety symptoms are significantly higher in COVID-19 patients and the symptoms of OCD and depression do not differ between COVID-19 and non-COVID-19 people, so the necessity of screening and following treatment of patients with COVID-19 should be kept in mind.

Trial registration

IR.IUMS.FMD.REC.1399.761.
Factors influencing infant feeding for Aboriginal and Torres Strait Islander women and their families: a systematic review of qualitative evidence
Authors: Mitchell Fiona , Walker Troy , Hill Karen , Browne Jennifer
Published: February 2023

Background

Breastfeeding provides all the necessary energy and nutrients for an infant and provides many benefits for mothers and babies. The effects of colonisation have contributed to reduced prevalence and duration of breastfeeding among Australian Aboriginal women and widespread use of infant formula as a substitute for breastmilk. This review aimed to synthesise qualitative evidence about the factors that influence breastfeeding and infant feeding practices of Aboriginal and Torres Strait Islander women and their families.

Methods

MEDLINE, CINAHL, Informit and Google Scholar were systematically searched for qualitative studies that included the perspective of Aboriginal and Torres Strait Islander women and their families about the factors influencing infant feeding decisions. Included studies were appraised using an Indigenous quality assessment tool and were synthesised via inductive thematic analysis informed by an ecological framework.

Results

The search identified 968 studies with 7 meeting the inclusion criteria. Key factors influencing breastfeeding and infant feeding practices of Aboriginal women included cultural practices, normalisation of bottle feeding, shame associated with breastfeeding in public, access to culturally safe nutrition education, support services and health professionals, family/partner support, knowledge of the benefits of breastfeeding, experiences with previous babies and concern that the baby was not getting enough milk.

Conclusion

The perspectives of Aboriginal and Torres Strait Islander women must be considered when providing breastfeeding and infant feeding advice. This can be achieved through Aboriginal and Torres Strait Islander people designing, implementing, and leading the delivery of education and information regarding breastfeeding and health infant feeding practices that have been influenced by the priorities of Aboriginal and Torres Strait Islander communities.
A qualitative process evaluation of universal free school meal provision in two London secondary schools
Authors: Jessiman Patricia E. , Carlisle Victoria R. , Breheny Katie , Campbell Rona , Jago Russell , Robinson Marcus , Strong Steve , Kidger Judi
Published: February 2023

Background

In the UK, one in five households with children experienced food insecurity in 2022, defined as a household-level economic and social condition of limited or uncertain access to adequate food. Free school meals are a public health intervention aimed at reducing food insecurity amongst children. The provision of universal free school meals (UFSM) to secondary school-aged children is a novel and untested intervention in the UK. This study is a process evaluation of a pilot of UFSM in two secondary schools in England. The aim was to understand the feasibility, acceptability, cost implications and lessons for the implementation of UFSM.

Methods

20 parents, 28 students and 8 school staff from two intervention schools participated in online qualitative interviews, as well as 4 staff from non-intervention schools. The Framework Method of thematic analysis was applied. These data were supplemented with student-led observations of school meal times, and school lunch uptake-data and cost information provided by the local authority delivering the pilot.

Results

UFSM in secondary schools is a feasible and acceptable intervention, with coherent goals of increased access to a healthy meal, reduced food insecurity and better nutrition. All participants perceived these goals were met. Acceptability was further enhanced by the perception that UFSM were supporting a greater proportion of low-income families than the national, targeted Free School Meal scheme, as well as being easier to implement. Potential barriers to implementation include limited school kitchen and dining infrastructure, meal quality and choice, and increased queuing times. Participants’ concerns that UFSM may benefit middle- and high- income families not in need were not as prevalent as the perception that UFSM was an effective way to support all families with secondary-aged children experiencing food insecurity.

Conclusion

This small-scale pilot study suggests that UFSM in secondary schools is feasible and acceptable, but more evidence is required from larger studies on the impact on long-term health, psychosocial and educational outcomes. Future, larger studies should also include detailed economic evaluations so this approach can be compared with other possible interventions.
Predictors of pulmonary hypertension in patients with hypersensitivity pneumonitis
Authors: Elnady Mohamed Abdelhakim , Elkorashy Reem , Nabil Afnan , Ibrahim Eman Kamal
Published: February 2023

Background

Hypersensitivity pneumonitis (HP) is an immunologically induced inflammation of the lung parenchyma that occurs in susceptible individuals in response to a variety of antigens. Repeated exposures to the causative antigens lead to chronic HP. The condition could be complicated with pulmonary hypertension (PH).

Methodology

60 patients with established diagnosis of HP were included, clinical examination, high resolution computed tomography (HRCT) of chest, arterial blood gases, six minute walking test (6MWT), desaturation index, spirometry, echocardiography were performed to all patients and right heart catheter was done for patients with high echo probability of PH.

Results

The mean age of patients was 41.67 ± 13.4 years with female predominance 83.3% of patients had history of raising birds. 71.7% of cases suffered from resting hypoxia with oxygen saturation 89 ± 11% with desaturation index 9% ± 8%, Echo probability of PH ranged from low to high 71.67, 21.67 and 6.67% respectively, mean pulmonary artery systolic pressure was 63.65 (18.48) mmHg. PH was diagnosed in 17 (28.33%) patients. HP with PH patients were significantly more symptomatic with predominant fibrotic pattern in HRCT chest P < 0.001, 82% of them had hypoxia P < 0.001 with significant desaturation after 6MWT P = 0.001. Predictors of PH in study group were fibrotic pattern in HRCT chest and hypoxia OR = 62.22, P < 0.001; 49.2, P < 0.001 respectively.

Conclusion

PH was prevalent in 28.33% of patients with HP, predictors of development of PH were fibrotic pattern in HRCT chest and hypoxia.

Trial registration: Retrospectively registered, registration number is NCT05458635, date of registration 07/12/2022.
Pedicle morphometry analysis of main thoracic apex adolescent idiopathic scoliosis
Authors: Sakti Yudha Mathan , Lanodiyu Zikrina Abyanti , Ichsantyaridha Mahardhika , Wijanarko Sonny , Filza Muhammad Riyad , Taufan Taufan , Susanto Dwi Budhi , Tampubolon Yunus Oksikimbawan , Baskara Anak Agung Ngurah Nata , Nurshal Aidil Akbar , Mustofa Fuad Dheni , Rosfadilla Annissa , Magetsari Rahadyan , Rukmoyo Tedjo
Published: February 2023

Introduction

Screw insertion during scoliosis surgery uses free-hand pedicle screw insertion methods. However, there is a wide variation in pedicle shapes, sizes, and morphometry, especially in scoliosis patients. CT scan pedicle measurements in main thoracic Lenke type 1 adolescent idiopathic scoliosis can help visualize this diversity. This study aimed to highlight the features of pedicle morphometry on the concave and convex sides, including pedicle diameter (width in axial and height in the sagittal plane), the depth to the anterior cortex, and Watanabe Pedicle classification in patients with main thoracic apex adolescent idiopathic scoliosis.

Materials and methods

This study was a cross-sectional observational study of Adolescent Idiopathic Scoliosis (AIS) patients whose apex in the main thoracic patient underwent deformity correction procedures. We used a three-dimensional CT scan to evaluate pedicle morphometry on the apex vertebrae, three consecutive vertebrae above and below the apex.

Results

A total of 6 patients with apex main thoracic AIS with 84 pedicles consisting of 42 pedicles from each concave and convex curve were analyzed. All of the samples were female, with the mean age at the procedure being 21.2 ± 5.56. The mean cobb angle was 62° ± 23°, with the main apex between VT8-VT10. The size of the pedicle was bigger from upper to lower vertebrae. The mean pedicle depth, pedicle width, and pedicle height for the concave side were 36.06 ± 4.31 mm, 3.91 ± 0.66 mm, and 9.16 ± 1.52 mm, respectively. Meanwhile, the convex side is 37.52 ± 1.84 mm, 5.20 ± 0.55 mm, and 11.05 ± 0.70 mm, respectively. We found a significant difference between the concave and convex sides for the pedicle width and height. The concave and convex sides were mainly classified as type C (38%) and type A (50%) Watanabe pedicle.

Conclusion

Pedicle width and pedicle height are significantly different between the concave and the convex side with convex side has better Watanabe pedicle classification. Pre-operative CT evaluation is essential for planning proper pedicle screw placement in AIS patients.
Perceptions, barriers and enablers of salt reduction in Malaysian out-of-home sectors (MySaltOH): from the point of view of policy-makers and food industries
Authors: Harun Zaliha , Shahar Suzana , You Yee Xing , Manaf Zahara Abdul , Majid Hazreen Abdul , Chia Yook Chin , Haron Hasnah , Michael Viola , Sukiman Noor Shahida , Taib Aida Farzana Mohamad , He Feng J. , Brown Mhairi K.
Published: February 2023

Background

High salt intake is a major cause of hypertension and cardiovascular diseases. The out-of-home sectors have been identified as one of the contributors of high salt intake in the population. The National Salt Reduction Policy of Malaysia was initiated in 2015; however, out-of-home sectors are yet to be emphasized and perception by policy-makers and the food industries towards salt reduction are yet unknown. This study aimed to determine the perceptions, barriers and enablers towards salt reduction in the out-of-home sector in Malaysia, as well as among policy-makers and the food industries.

Methods

This is a qualitative study via semi-structured in-depth interviews (IDI) and focus group discussions (FGD) involving several stakeholders consisting of policy-makers from five ministries, five nongovernment organizations (NGOs) and food science/food technology researchers from five regions (West, North, East, and South Peninsular and East Malaysia/Borneo), as well as the food industries. The IDI and FGD sessions were recorded, transcribed verbatim and analysed thematically using Nvivo software version 12.

Results

All participants agreed that salt intake in Malaysia is high and leads to hypertension and cardiovascular diseases. Lack of awareness, poor eating culture and behaviour and frequent eating out were among the causes of high salt intake. Awareness campaigns and education, sodium content labelling and product reformulation were strategies that have been implemented by the government; whilst for the food industries, some of them have tried to reduce salt and labelled the sodium content on their food products. However, there were several barriers including perceived poor consumer acceptance, lack of knowledge and resources, and challenges in reformulation, as well as unavailability of guidelines and salt targets. Hence, several enablers have been suggested, which include prioritizing the salt reduction strategy, creating more awareness, collaboration and engagement, research and technology particularly for reformulation and shelf-life stability, incentives and salt tax.

Conclusions

Salt reduction efforts of the out-of-home sector in Malaysia could be achieved through several measures or enablers that can overcome the barriers currently faced by stakeholders, especially policy-makers, food industries and the consumers themselves. This study will benefit the policy-makers to improve the salt reduction policy of out-of-home sectors and highlight the concerns among the food industries on the policy.
Role of noncoding RNAs in orthodontic tooth movement: new insights into periodontium remodeling
Authors: Chen Yuming , Zhang Chao
Published: February 2023

Orthodontic tooth movement (OTM) is biologically based on the spatiotemporal remodeling process in periodontium, the mechanisms of which remain obscure. Noncoding RNAs (ncRNAs), especially microRNAs and long noncoding RNAs, play a pivotal role in maintaining periodontal homeostasis at the transcriptional, post-transcriptional, and epigenetic levels. Under force stimuli, mechanosensitive ncRNAs with altered expression levels transduce mechanical load to modulate intracellular genes. These ncRNAs regulate the biomechanical responses of periodontium in the catabolic, anabolic, and coupling phases throughout OTM. To achieve this, down or upregulated ncRNAs actively participate in cell proliferation, differentiation, autophagy, inflammatory, immune, and neurovascular responses. This review highlights the regulatory mechanism of fine-tuning ncRNAs in periodontium remodeling during OTM, laying the foundation for safe, precise, and personalized orthodontic treatment.
Affordable drug resistance genotyping of HIV-1 reverse transcriptase, protease and integrase genes, for resource limited settings
Authors: Manyana Sontaga , Pillay Melendhran , Gounder Lilishia , Khan Aabida , Moodley Pravi , Naidoo Kogieleum , Chimukangara Benjamin
Published: February 2023

Background

As use of dolutegravir (DTG) becomes more common in resource limited settings (RLS), the demand for integrase resistance testing is increasing. Affordable methods for genotyping all relevant HIV-1 pol genes (i.e., protease (PR), reverse transcriptase (RT) and integrase (IN)) are required to guide choice of future antiretroviral therapy (ART). We designed an in-house HIV-1 drug resistance (HIVDR) genotyping method that is affordable and suitable for use in RLS.

Methods

We obtained remnant plasma samples from CAPRISA 103 study and amplified HIV-1 PR, RT and IN genes, using an innovative PCR assay. We validated the assay using remnant plasma samples from an external quality assessment (EQA) programme. We genotyped samples by Sanger sequencing and assessed HIVDR mutations using the Stanford HIV drug resistance database. We compared drug resistance mutations with previous genotypes and calculated method cost-estimates.

Results

From 96 samples processed, we obtained sequence data for 78 (81%), of which 75 (96%) had a least one HIVDR mutation, with no major-IN mutations observed. Only one sample had an E157Q INSTI-accessory mutation. When compared to previous genotypes, 18/78 (23%) had at least one discordant mutation, but only 2/78 (3%) resulted in different phenotypic predictions that could affect choice of subsequent regimen. All CAPRISA 103 study sequences were HIV-1C as confirmed by phylogenetic analysis. Of the 7 EQA samples, 4 were HIV-1C, 2 were HIV-1D, and 1 was HIV-1A. Genotypic resistance data generated using the IDR method were 100% concordant with EQA panel results. Overall genotyping cost per sample was estimated at ~ US$43–$US49, with a processing time of ~ 2 working days.

Conclusions

We successfully designed an in-house HIVDR method that is suitable for genotyping HIV-1 PR, RT and IN genes, at an affordable cost and shorter turnaround time. This HIVDR genotyping method accommodates changes in ART regimens and will help to guide HIV-1 treatment decisions in RLS.
Pilot and feasibility studies: extending the conceptual framework
Authors: Bond Christine , Lancaster Gillian A. , Campbell Mike , Chan Claire , Eddy Saskia , Hopewell Sally , Mellor Katie , Thabane Lehana , Eldridge Sandra
Published: February 2023

In 2016, we published a conceptual framework outlining the conclusions of our work in defining pilot and feasibility studies. Since then, the CONSORT extension to randomised pilot and feasibility trials has been published and there have been further developments in the pilot study landscape. In this paper, we revisit and extend our framework to incorporate the various feasibility pathways open to researchers, which include internal pilot studies. We consider, with examples, when different approaches to feasibility and pilot studies are more effective and efficient, taking into account the pragmatic decisions that may need to be made. The ethical issues involved in pilot studies are discussed. We end with a consideration of the funders’ perspective in making difficult resource decisions to include feasibility work and the policy implications of these; throughout, we provide examples of the uncertainties and compromises that researchers have to navigate to make progress in the most efficient way.
Sialylation of chitosan to mitigate Aβ toxicity
Authors: Dhavale Dhruva , Lai Hy K. , Warwick Paityn , Henry James E.
Published: February 2023

Background

Amyloid beta peptide (Aβ) is the main component of plaques and is known to play a role in the development of Alzheimer's disease (AD). As a result, structures that can trap Aβ or disrupt the interaction between Aβ and cells have been researched as a way to lessen the pathological effects of Aβ. Particularly, sialylated compounds that exhibit clustering effects could be advantageous.

Results

Through the use of 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide chemistry, sialic acid (N-acetylneuraminic acid) was used to decorate a chitosan backbone. The compounds were characterized using Fourier-transform infrared spectroscopy (FTIR) and colorimetric assays. Using the model neuroblastoma cell line SH-SY5Y, the ability of these compounds to lessen the toxicity of Aβ was examined in vitro. Successful in vitro mitigation of Aβ toxicity was found to be critically dependent on the degree of sialylation. In particular, a balance between the degree of sialylation and molecular flexibility was determined to be the criteria as it allows for natural clustering. Additionally, chitosan alone demonstrated low levels of cellular toxicity with moderate levels of toxicity mitigation (comparable to low degrees of labelling).

Conclusions

Compounds were successfully produced, and they varied in their effectiveness in reducing Aβ's toxicity to cells in culture. The effect of molecular flexibility and clustering on toxicity mitigation is explained in this work. This shows the potential of polymeric sugars for the creation of AD treatments.
Spinal anesthesia is a grossly underutilized gold standard in primary total joint arthroplasty: propensity-matched analysis of a national surgical quality database
Authors: Ferreira Andre C. , Hung Chun Wai , Ghanta Ramesh B. , Harrington Melvyn A. , Halawi Mohamad J.
Published: February 2023

Background

There is currently no consensus regarding the optimal anesthetic technique for total hip and knee arthroplasty (THA, TKA). This study aimed to compare the utilization rates and safety of spinal vs. general anesthesia in contemporary THA/TKA practice.

Methods

Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), a retrospective review of 307,076 patients undergoing total hip or knee arthroplasty under either spinal or general anesthesia between January 2015 and December 2018 was performed. Propensity matching was used to compare differences in operative times, hospital length of stay, discharge destination, and 30-day adverse events. The annual utilization rates for both techniques between 2011 and 2018 were also assessed.

Results

Patients receiving spinal anesthesia had a shorter length of stay (P < 0.001) for TKA while no statistical differences in length of stay were observed for THA. Patients were also less likely to experience any 30-day complication (OR = 0.82, P <0.001 and OR = 0.92, P < 0.001 for THA and TKA, respectively) while being more likely to be discharged to home (OR = 1.46, P < 0.001 and OR = 1.44, P < 0.001 for THA and TKA, respectively). Between 2011 and 2018, spinal anesthesia utilization only increased by 1.4% for THA (P < 0.001) and decreased by 0.2% for TKA (P < 0.001), reaching 38.1% and 40.3%, respectively.

Conclusion

Spinal anesthesia remains a grossly underutilized tool despite providing better perioperative outcomes compared to general anesthesia. As orthopedic surgeons navigate the challenges of value-based care, spinal anesthesia represents an invaluable tool that should be considered the gold standard in elective, primary total hip and knee arthroplasty.
Diagnostic accuracy of ultrasound and alpha-fetoprotein measurement for hepatocellular carcinoma surveillance: a retrospective comparative study
Authors: Abduljabbar Ahmed Haitham
Published: February 2023

Background

Liver cirrhosis and chronic infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) are major risk factors for hepatocellular carcinoma (HCC). International societies guidelines recommend HCC surveillance in patients with cirrhosis and chronic hepatitis. However, the ideal surveillance strategy is still controversial. The aim of this study is to assess and compare the diagnostic accuracy of ultrasound (US) AND alpha-fetoprotein (AFP) measurement in HCC surveillance.

Results

All patients with cirrhosis and/or infection with HBV and HVC, who received HCC surveillance through US and AFP measurement between January 2013 and January 2016, were retrospectively evaluated. The performance of surveillance using AFP, US, and both in HCC detection was compared. After exclusion, a final cohort of 335 patients were included. Thirty-five patients (10.3%) developed HCCs. US showed no focal lesions in 259 patients, 9 benign lesions (3 cysts, 5 hemangiomas, and 1 focal fat), 16 HCCs and 51 indeterminate findings. All indeterminate findings were worked up by CT and/or MRI. For HCC detection, the area under the receiver operator characteristic (ROC) curve for US surveillance was 0.924 (95% confidence interval: 0.866–0.983, P < 0.001). For surveillance, AFP was 0.829 (95% confidence interval: 0.756– 0.902, P < 0.001) and for combined US and AFP was 0.897 (95% confidence interval: 0.854– 0.941, P < 0.001). When the traditional cutoff value of 20 ng/ml was used, the sensitivity and specificity of AFP were 63% and 88.7%, respectively. ROC curve results for AFP levels demonstrated that using 5.6 ng/ml as a cutoff, AFP will have a 77% sensitivity and 78% specificity for HCC detection. US exhibited a sensitivity and specificity of 45.7% and 100%, respectively. When indeterminate findings were considered as positive surveillance test, US exhibited a sensitivity and specificity of 91.4% and 88.3%, respectively. A combination of US and AFP exhibited a sensitivity and specificity of 97% and 87.3%, respectively.

Conclusions

US has better accuracy compared to AFP in HCC surveillance. Combined use of US and AFP improves the sensitivity for HCC detection.