bluuebunny/crossref_metadata_2025 huggingface dataset:
Gaps in Knowledge and Practice in Treating Tobacco Use Among Non-physician Healthcare Professionals and Lay Health Workers in Chicago, Illinois
Authors: Tan Marcia M. , Veluz-Wilkins Anna , Styrczula Paulina , McBrayer Shambreia
Published: May 2022

Objective

To conduct a needs assessment for lay health workers and non-physician healthcare professionals [i.e., community health workers (CHW) and lung health professionals who spend more time face-to-face with tobacco-related disparity populations] to describe current gaps in tobacco cessation practices and knowledge.

Methods

A 46-item needs assessment survey was developed to understand knowledge, practices, and confidence about tobacco cessation among non-physician health professionals in a large, urban city in the U.S. Participants, recruited from local community-based organizations and email listservs, completed the online or paper survey, which included a 10-item investigator-initiated tobacco knowledge questionnaire.

Results

About 61.5% of participants (N = 53) asked each client/patient about tobacco use at initial visit, 41.8% reported extreme likelihood of discussing tobacco during a visit, and 43.1% reported addressing tobacco use directly. Despite assisting with cessation, tobacco-related knowledge and confidence was low, with respondents scoring an average of 4.08 out of 10 (SD = 2.21) on the tobacco knowledge questionnaire.

Conclusion

There was a clear lack of knowledge about tobacco cessation in the U.S. among non-physician healthcare professionals. These professionals could benefit from trainings that are relevant to their model of care and better equip them to assist the disparity populations that they serve.
On the non-linear dynamics of vehicle shimmy coupled with handling motions: modelling, bifurcation analysis, and validations
Authors: Lu Hangyu , Lu Jianwei , Wei Heng , Shi Lei , Ye Shenyong
Published: May 2022

A novel vehicle dynamic model considering the coupling mechanism between the front wheel shimmy and the vehicle lateral handling motions is established to investigate the interacting effect between the steering shimmy instability and the general motion instability, that focuses especially on the influence of the tyre force saturation induced by lateral-longitudinal coupling when different degrees and allocation strategy of braking force are applied. The typical 3-degree-of-freedom front wheel shimmy structure of dependent suspension is dynamically modelled by using the Lagrange method, alongside the equations for plane vehicle handling motions introduced. The stretched-string-based tyre kinematic equations, that describe the transient tyre-road contact status, are proposed by analytically deriving the coupling relations between the angular shimmy variables and vehicle motion status. A theoretically approximated linear tyre model, based on the coupling between vertical, longitudinal, and lateral directional forces, is analytically derived for stability analysis. Meanwhile, a complete PAC-2002 tyre model, with experimentally identified parameters, is employed for simulation verification. The stability chart of linear stability analysis shows the variation of the system bifurcation curves and stable parameter region under different parametric configurations, which gives that the degrees and allocations of braking force largely affect the stable parameter domain and the global stability. The variations of the system characteristic roots indicate that both Hopf and S-N bifurcation could happen due to shimmy oscillations and destabilization of motion, respectively, and their co-existence at certain parameter domains make the dynamic behaviour further unpredictable and complex. Numerical simulation verifies the dynamical characteristics of shimmy, and further analysis shows that three types of vehicle motion instability which coexisted with shimmy instability could be triggered by the coupling effect. In addition, the variation law of limit-cycle amplitude under varying vehicle driving inputs is summarized, and finally, a preliminary experiment is conducted for validations.
Dynamic calculation and optimization design of arbitrary planar branch piping system
Authors: Cao Yin-hang , Liu Gong-min , Hu Zhi
Published: May 2022

The absorbing transfer matrix method (ATMM) is applied to dynamics calculation and optimization design of planar branch piping systems combined with the response surface model or method (RSM) and a new proposed hybrid RSM (HRSM). A main path is chosen to absorb the influences of sub-branches, and the branch point transfer matrix in the main transfer path is established and proved by the ANSYS simulation and experimental results. It shows that the errors between the ATMM and the finite element method are less than 0.36% in the calculation of the natural frequencies of the two-branch piping system, and the ATMM also agrees well with the dynamics response experimental results of the cross-branch piping system. Then, based on the initial design model of a double-branch piping system, first order natural frequency analysis samples are selected for the branch point positions optimization using the uniform design method (UD) and calculated by the ATMM; the minimum value of the RSM, obtained by fitting the samples with a second-order polynomial (SOP) function, is solved as the best design scheme using the genetic algorithm (GA). Finally, for the problem of supporting positions optimization of a T-branch piping system, a HRSM using the SOP function to fit the variation law with different supporting positions in the samples of the dynamics response optimization target, which is the total x-directional vibration acceleration level (TAC) of three supporting points in the frequency 1–300 Hz and the Fourier basis function to fit the relationship of SOP function error with independent variables is proposed combining the Minimize Prediction (MP) adding point criterion to gradually update the samples, until the HRSM reaches stability and obtains the wanted design solution.
“Progressive” Public-Private Partnerships: Are They Reformative or Regressive!?
Authors: Casady Carter B. , Garvin Michael J.
Published: May 2022

In North America, public-private partnerships (P3s) are increasingly using pre-development agreements to enhance collaboration between the public and private sectors. Known colloquially as “progressive P3s”, these agreements allow the private sector to help scope and shape the structure of projects at the front end. However, concerns about their efficacy persist. Our Commentary contextualizes this ongoing debate by outlining the potential benefits and pitfalls of this new approach to P3s. We conclude that both practitioners and academics have a crucial role to play in our experience with and understanding of the progressive P3 experiment.
Customer Emotions in Service Robot Encounters: A Hybrid Machine-Human Intelligence Approach
Authors: Filieri Raffaele , Lin Zhibin , Li Yulei , Lu Xiaoqian , Yang Xingwei
Published: May 2022

Understanding consumer emotions arising from robot-customers encounters and shared through online reviews is critical for forecasting consumers’ intention to adopt service robots. Qualitative analysis has the advantage of generating rich insights from data, but it requires intensive manual work. Scholars have emphasized the benefits of using algorithms for recognizing and differentiating among emotions. This study critically addresses the advantages and disadvantages of qualitative analysis and machine learning methods by adopting a hybrid machine-human intelligence approach. We extracted a sample of 9707 customers reviews from two major social media platforms (Ctrip and TripAdvisor), encompassing 412 hotels in 8 countries. The results show that the customer experience with service robots is overwhelmingly positive, revealing that interacting with robots triggers emotions of joy, love, surprise, interest, and excitement. Discontent is mainly expressed when customers cannot use service robots due to malfunctioning. Service robots trigger more emotions when they move. The findings further reveal the potential moderation effect of culture on customer emotional reactions to service robots. The study highlights that the hybrid approach can take advantage of the scalability and efficiency of machine learning algorithms while overcoming its shortcomings, such as poor interpretative capacity and limited emotion categories.
Investigation of nozzle flow in high altitude test facility
Authors: Prashana ANL Kavin , Sundararaj Aldin Justin , Khan Mukit Azad
Published: May 2022

A high altitude test facility was developed for the experimental studies on nozzles for various levels of vacuum. The current study is focused on the performance of the nozzle under various altitude condition and to characterized the high altitude test facility. A supersonic nozzle designed for Mach 2.5 is used for the study. Compressed air is taped from the high pressure plenum having a pressure of 20 bar and is regulated and expanded through the nozzle. The inlet pressures for the study is varied from 4.5 to 10 bar. The nozzle is within the enclosure which is evacuated to 0.7–0.02 bar. Schlieren is used to view the flow condition at the end of the nozzle. A nozzle for 2.5 Mach is designed and tested in HAT facility. The nozzle design is validated with the CFD for various NPR. The high altitude test facility is characterized for various NPR and is found to be optimum flow at 14 NPR for 33 s at an inlet pressure of 4.5.
Validation of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in ANA-positive Chinese patients
Authors: Chung Yuen Kwan , Ho Ling Yin , Lee Carolyn , To Chi Hung , Mok Chi Chiu
Published: May 2022

Background:

The aim of this study was to validate the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for systemic lupus erythematosus (SLE) in antinuclear antibody (ANA)-positive Chinese patients.

Methods:

Medical records of all adult patients who attended the rheumatology out-patient clinics between May and September 2019 were reviewed. Patients with ever ANA positive (titre ⩾1:80) were included and evaluated for the fulfilment of the 2019 EULAR/ACR, 2012 Systemic Lupus International Collaborating Clinics (SLICC) and 1997 ACR criteria for SLE classification. The performance of these criteria in predicting a clinical diagnosis of SLE as judged by an independent panel of rheumatologists was studied and compared in different subgroups.

Results:

A total of 1533 patients (88.2% women; age at first clinic attendance 45.5 ± 15.6 years) were studied and 562 patients were judged to be clinical SLE. The sensitivity and specificity of the EULAR/ACR (⩾10 points), SLICC and ACR criteria for a clinical diagnosis of SLE was 96.1%, 97.9% and 86.1%; and 85.8%, 86.3% and 94.3%, respectively. Applying the attribution rule to the non-SLE controls, the specificity of the three criteria increased to 95.0%, 92.5% and 98.8%, respectively. The specificity of the EULAR/ACR criteria was higher in male patients (97.9%), those aged >50 years (97.0%) and disease duration of ⩽3 years (97.6%). Using a cut-off of 12 points, the specificity of the EULAR/ACR criteria was further increased (96.6%) while a high sensitivity (95.0%) was maintained.

Conclusion:

In Chinese patients with a positive ANA, the EULAR/ACR criteria for clinical SLE perform equally well to the SLICC criteria. Both the EULAR/ACR and SLICC are more sensitive but less specific than the ACR criteria. The specificity of all the three criteria is enhanced by applying the attribution rule to controls. The specificity of the EULAR/ACR criteria is higher in certain patient subgroups or when the cut-off score is raised.
Pelvic retroperitoneal pleomorphic hyalinizing angiectatic tumor: A case report and review of literature
Authors: Salehipour Mehdi , Anbardar Mohammad Hossein , Geramizadeh Bita , Jafari Hamed , Zare Ali , Adib Ali
Published: May 2022

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare tumor of the soft tissue, usually located in lower extremities. There are rarely tumors reported in other anatomic locations. Herein, we report retroperitoneal PHAT in a male patient. A 41-year-old man was referred to our clinic due to an incidentally found retroperitoneal mass. Computed tomography (CT) scan showed a solid hypoechoic lesion containing fat component and calcified elements measuring about 80*72*45 mm in the right lower quadrant (RLQ) of the abdomen. Magnetic resonance imaging (MRI) showed circumscribe lesion measuring about 60 x 48 mm with partial enhancement and fat component. In pelvic exploration, a large mass was found that had encased the right external iliac artery and vein. Therefore, the mass and its surrounding iliac vessels were excised and removed en block. Then, the external iliac vessels were reconstructed with Gortex graft. No recurrence was found in 1 month and 3 months post-operation follow up. We report a pelvic retroperitoneal PHAT as a rare location of this tumor. It seems that PHAT must be considered in differential diagnosis in patients with soft tissue tumors in the pelvic cavity.
Experimental study on the effect of Cordia africana’s and Austria pine’s wood species on the performance of wood plastic composite
Authors: Murad Abraham , Sirahbizu Belete
Published: May 2022

With its market demand expansion and increased application areas, products of wood-plastic composite (WPC) have been developing and growing rapidly in many countries over the last decades. This paper attempts to investigate the effect of wood species that are waste from the furniture industries on the performance of wood-plastic composites (WPCs). The samples were prepared by varying the wood flour species at 30wt% mixed with 70wt% HDPE (High Density polyethylene). The wood species used for samples preparation are Cordia africana’s /wanza/ wood flour, Austria pine’s wood flour, and the mixture of both wood species flour in 15wt% of each wood species and the resulted composites tensile and impact properties determined. Morphological and water absorption characteristics of these composites were also determined. The composite from the mixture of wood species exhibited best interfacial bonding between matrix and reinforcement that resulted in providing the best water absorption property, and the maximum tensile strength of the composite which is, 15.465 MPa. Compared with the pure HDPE, the reduction of impact strength with the addition of wood was also observed. Wood species in wood-plastic composites are an essential factor for the performance of WPCs.
The prevalence and predictors of cardiovascular diseases in Kherameh cohort study: a population-based study on 10,663 people in southern Iran
Authors: Baeradeh Najibullah , Ghoddusi Johari Masoumeh , Moftakhar Leila , Rezaeianzadeh Ramin , Hosseini Seyed Vahid , Rezaianzadeh Abbas
Published: May 2022

Background

The prevalence of cardiovascular disease (CVD) is rapidly increasing in the world. The present study aimed to assess the prevalence and Predictors factors of CVD based on the data of Kherameh cohort study.

Methods

The present cross-sectional, analytical study was done based on the data of Kherameh cohort study, as a branch of the Prospective Epidemiological Studies in Iran (PERSIAN). The participants consisted of 10,663 people aged 40–70 years. CVD was defined as suffering from ischemic heart diseases including heart failure, angina, and myocardial infarction. Logistic regression was used to model and predict the factors related to CVD. Additionally, the age-standardized prevalence rate (ASPR) of CVD was determined using the standard Asian population.

Results

The ASPR of CVD was 10.39% in males (95% CI 10.2–10.6%) and 10.21% in females (95% CI 9.9–10.4%). The prevalence of CVD was higher among the individuals with high blood pressure (58.3%, p < 0.001) as well as among those who smoked (28.3%, p = 0.018), used opium (18.2%, p = 0.039), had high triglyceride levels (31.6%, p = 0.011), were overweight and obese (66.2%, p < 0.001), were unmarried (83.9%, p < 0.001), were illiterate (64.2%, p < 0.001), were unemployed (60.9%, p < 0.001), and suffered from diabetes mellitus (28.1%, p < 0.001). The results of multivariable logistic regression analysis showed that the odds of having CVD was 2.25 times higher among the individuals aged 50–60 years compared to those aged 40–50 years, 1.66 folds higher in opium users than in non-opium users, 1.37 times higher in smokers compared to non-smokers, 2.03 folds higher in regular users of sleeping pills than in non-consumers, and 4.02 times higher in hypertensive individuals than in normotensive ones.

Conclusion

The prevalence of CVD was found to be relatively higher in Kherameh (southern Iran) compared to other places. Moreover, old age, obesity, taking sleeping pills, hypertension, drug use, and chronic obstructive pulmonary disease had the highest odds ratios of CVD.
National Emergency Resuscitation Airway Audit (NERAA): a pilot multicentre analysis of emergency intubations in Irish emergency departments
Authors: Umana Etimbuk , Foley James , Grossi Irene , Deasy Conor , O’Keeffe Francis ,   and on behalf of Irish Trainee Emergency Research Network (ITERN) Collaborators, Patton Andrew , Jee Marcus , Mulcaire Jeffery , Ahmed Ahmed Al Rasheed , Vecchia Claudio Dalla , Vainberg Nikita , O’ Reilly Hugh , Daly Joseph , de Buitléir Cathal , Prendergast Conor , Ibrahim Randa , Kukaswadia Shane
Published: May 2022

Background

There is paucity of literature on why and how patients are intubated, and by whom, in Irish Emergency Departments (EDs). The aim of this pilot study was to characterise emergency airway management (EAM) of critically unwell patients presenting to Irish EDs.

Methods

A multisite prospective pilot study was undertaken from February 10 to May 10, 2020. This project was facilitated through the Irish Trainee Emergency Research Network (ITERN). All patients over 16 years of age requiring EAM were included. Eleven EDs participated in the project. Data recorded included patients’ demographics, indication for intubation, technique of airway management, medications used to facilitate intubation, level of training and specialty of the intubating clinician, number of attempts, success/complications rates and variation across centres.

Results

Over a 3-month period, 118 patients underwent 131 intubation attempts across 11 EDs. The median age was 57 years (IQR: 40–70). Medical indications were reported in 83% of patients compared to 17% for trauma. Of the 118 patients intubated, Emergency Medicine (EM) doctors performed 54% of initial intubations, while anaesthesiology/intensive care medicine (ICM) doctors performed 46%. The majority (90%) of intubating clinicians were at registrar level. Emergency intubation check lists, video laryngoscopy and bougie were used in 55, 53 and 64% of first attempts, respectively. The first pass success rate was 89%. Intubation complications occurred in 19% of patients. EM doctors undertook a greater proportion of intubations in EDs with > 50,000 attendance (65%) compared to EDs with < 50,000 attendances (16%) (p < 0.000).

Conclusion

This is the first study to describe EAM in Irish EDs, and demonstrates comparable first pass success and complication rates to international studies. This study highlights the need for continuous EAM surveillance and could provide a vector for developing national standards for EAM and EAM training in Irish EDs.
Association of triglyceride glucose index with all-cause and cause-specific mortality among middle age and elderly US population
Authors: Sun Min , Guo Hongmei , Wang Yi , Ma Dongchao
Published: May 2022

Aims

To investigate the association between the triglyceride glucose (TyG) index and all-cause and cause-specific mortality in middle age and elderly population.

Methods and results

A total of 9,254 participants with age ≥ 45 years were enrolled from the National Health and Nutrition Examination Survey cycle of 1999–2014. The TyG index was determined as ln [fasting triglycerides (mg/dL) x fasting glucose (mg/dL)/2]. Primary outcomes were all-cause mortality and cause-specific mortality (cardiovascular diseases and malignant neoplasms). The association between the levels of TyG and the risk of mortality was explored with Cox regression models. After a median follow-up of 7.6 years, 1,774 all-cause death occurred. Univariate analysis showed that the TyG was associated with all-cause mortality (hazard ratio [HR] 1.18, 95% confidence interval [CI] [1.11,1.26]; p < 0.001). Furthermore, multivariate-adjusted analysis found that the third TyG quartile (8.72 ~ 9.16) was associated with the lowest risk of all-cause mortality (HR 0.84, 95%CI [0.73, 0.98]; p < 0.05). Restricted cubic splines showed that the association between levels of TyG index and the risk of all-cause mortality was non-linear (p for nonlinearity < 0.001) and the inflection point was 9.18 using threshold effect analysis. The HR was 0.82 (95%CI [0.71,0.96]) below 9.18 while the HR was 1.32 (95%CI [1.12,1.55]) above 9.18.

Conclusion

TyG index was U-shaped associated with all-cause mortality and the TyG index associated with the lowest risk of all-cause mortality was 9.18.
Effect of a community based social marketing strategy on the uptake of clean delivery kits in peri-urban communities of Karachi, Pakistan
Authors: Usmani Asra , Sultana Shazia , Nisar Imran , Zaidi Shehla , Jehan Imtiaz , Zaidi Anita
Published: May 2022

Background

Pakistan has one of the highest neonatal and maternal mortality rates in the world. Use of clean delivery kits (CDK) at time of delivery improves maternal and newborn outcome. We test effectiveness of a social marketing strategy to increase uptake of CDKs in a low socioeconomic peri-urban community in Pakistan.

Methods

This was a sequential mixed method study. The quantitative component consisted of two arms. In the prospective intervention arm trained community health workers (CHWs) visited pregnant women twice to prepare them for birth and encourage use of CDKs. Availability of these kits was ensured at accessible stores in these communities. The retrospective control arm consisted of women delivering in same area during the past 3 months identified from pregnancy register. Information was collected on sociodemographic, pregnancy characteristics and use of CDKs at time of delivery in both arms. We compared proportion of women using CDKs during home deliveries in the intervention and control arm. We performed logistic regression analysis to identify factors associated with use of CDKs in intervention arm. We carried out separate focused group discussions (FGDs) with women who used CDKs, with women who did not use CDKs and birth attendants.

Results

Total of 568 pregnant women were enrolled in prospective intervention arm and 603 in retrospective control arm. The proportion of women using CDKs during home deliveries in retrospective control arm was 9.4% compared to 23.8% in prospective control arm (p =  < 0.001). In final multivariable model, increasing age of pregnant woman and husband having some education was positively associated with CDK use (aOR 1.1;95% CI 1.1–1.2 and aOR 2.2;95% CI 1.3–3.6 respectively). During FGDs, many women were of the thought that kits should be free or included in the amount charged by birth attendants. Assembly of components of kit into one package was appreciated by birth attendants.

Conclusion

Social marketing strategy targeting pregnant women and their family members resulted in an increase in the uptake of CDKs in our study. Birth attendants were generally satisfied with the assembly of the kit. Many women cited unawareness and cost to be a major impediment in use of CDKs.
Fasting serum fructose is associated with risk of gestational diabetes mellitus
Authors: Zhang Hongmei , Li Xiaoyong , Niu Yixin , Yang Zhen , Lu Youli , Su Qing , Qin Li
Published: May 2022

Objective

To investigate the association of fasting serum fructose concentrations and the incidence of GDM.

Research design and methods

Five hundred twenty six pregnant women who attended the obstetric clinic of Xinhua Hospital, Chongming Branch were recruited prospectively from September 2019 to November 2020. Fasting serum fructose concentrations were measured by a validated liquid chromatography–tandem mass spectrometry method. GDM was diagnosed according to the criteria of the IADPSG. Independent sample t-test was used to compare the differences between groups. Multiple stepwise regression analysis was used to estimate the associations of serum fructose and other variables. Multivariate logistic regression models were adopted to evaluate the odds ratios (ORs) for GDM.

Results

Of the 526 pregnant women, 110 were diagnosed with GDM. Fasting fructose concentrations were increased significantly in GDM patients compared to those without GDM (1.30 ug/ml vs 1.16 ug/ml, p<0.001). Fasting fructose concentration was independently associated with GDM after adjusting the potential confounders, 1 ug/ml increase in fasting serum fructose level was associated with an 81.1% increased risk of GDM (1.811, [1.155-2.840]). Taking fructose <1.036 ug/ml as the reference, the OR for GDM was significantly higher in fructose ≥1.036 ug/ml group (OR, 1.669; 95% CI, 1.031–2.701) after all the potential confounders were adjusted.

Conclusions

Increased fasting serum fructose levels were independently associated with the incidence of GDM.
Health-promoting behaviors and intermediary social determinants of health in low and high-risk pregnant women: an unmatched case-control study
Authors: Masjoudi Marzieh , Khazaeian Somayyeh , Malekzadeh Sanna , Fathnezhad-Kazemi Azita
Published: May 2022

Background

High-risk pregnancies require increased health and care resources to reduce the severe perinatal consequences. The adoption of a health-promoting lifestyle and social determinants is an important strategy for achieving the desired outcomes of pregnancy. This study aimed to compare intermediate determinants of social health in low and high-risk pregnant women.

Methods

This unmatched case-control study was performed with a ratio of 1: 2 and 300 pregnant women including 200 healthy and 100 pregnant women with gestational hypertension were included using the available sampling technique. Data were collected using socio-demographic and obstetrics, Health-promoting behaviors, Self-efficacy, Perceived stress, and Social support questionnaires by the self-report method.

Results

There was no significant difference in the demographic characteristics between the two groups, except for the spouse's education status. The total score of health-promoting behaviors and social support in the healthy group was significantly higher than women with gestational hypertension. However, the perceived stress in women with gestational hypertension was significantly higher than in the healthy group. In the multivariate analysis, those women with high stress [AOR 1.13, 95% CI (1.08–1.18)] and whose Spouse’s Educational status was low [AOR 4.94, 95% CI (1.54–15.81)] had higher odds of gestational hypertension than women who haven’t respectively. The development of gestational hypertension was decreased by increasing the score of social support [AOR 0.96, 95% CI (0.93–0.98)]. The results showed that the two variables of social support (β=0.331) and self-efficacy (β=0.215) have the greatest impact on the score of health-promotion behaviors, respectively. Based on regression analysis, 21.2% of the health-promotion behaviors changes could be explained by three independent variables.

Conclusion

Women with gestational hypertension have unhealthier lifestyles. Having a high level of stress is a risk factor for gestational hypertension but Social support has a protective effect on it. Recognizing the risk factors of gestational hypertension could help the determination of high-risk cases and it is important to pay attention to women's psychosocial to create appropriate sources of social support and provide the necessary action to reduce stress.
Murradambirra Dhangaang (make food secure): Aboriginal community and stakeholder perspectives on food insecurity in urban and regional Australia
Authors: Sherriff Simone , Kalucy Deanna , Tong Allison , Naqvi Nawazish , Nixon Janice , Eades Sandra , Ingram Tangerene , Slater Kym , Dickson Michelle , Lee Amanda , Muthayya Sumithra
Published: May 2022

Background

It is widely acknowledged that the invasion by colonial powers of the Australian continent had profound and detrimental impacts on Aboriginal Communities, including food security. Policies of successive governments since European arrival have since further exacerbated the situation, with food insecurity now affecting 20–25% of Aboriginal and Torres Strait Islander people. Food insecurity contributes to long-term impacts on health, in particular diet-sensitive chronic diseases. This study aimed to describe Aboriginal community and stakeholder perspectives on food insecurity to get a better understanding of the key contributing factors and recommendations for potential strategies to address this issue in Aboriginal communities in urban and regional Australia.

Methods

Semi-structured interviews were conducted with 44 participants who were purposively selected. This included Aboriginal people in two communities and both Aboriginal and non-Aboriginal stakeholders from local food relief agencies, food suppliers, schools, and government in an urban and regional location in NSW. A conceptual framework was developed from literature on food security, and sensitizing concepts of availability, affordability, accessibility and acceptability or the lack thereof of healthy food were used to elicit responses from the participants. Interview transcripts were analysed thematically.

Results

All participants felt strongly that food insecurity was a major problem experienced in their local Aboriginal communities. Five core areas impacting on food security were identified: trapped in financial disadvantage; gaps in the local food system; limitations of non-Aboriginal food relief services; on-going impacts of colonization; and maintaining family, cultural and community commitments and responsibilities. Participants suggested a number of actions that could help ease food insecurity and emphasized that Aboriginal values and culture must be strongly embedded in potential programs.

Conclusions

This study found Aboriginal families in urban and regional Australia are experiencing food insecurity on a regular basis, which is impacted by a range of socio-economic, environmental, systemic and cultural factors, as reported by the participants. Study findings highlight the need to address system level changes in the food environment and acknowledge Aboriginal history, culture and food preferences when considering the development of programs to alleviate food insecurity among Aboriginal people.
Associations between the neighbourhood social environment and preschool children’s physical activity and screen time
Authors: Baldwin Jessica , Arundell Lauren , Hnatiuk Jill A.
Published: May 2022

Background

The neighbourhood social environment (NSE) has been associated with physical activity and screen time behaviours in adults and youth however less is known about this relationship in preschool-aged children (2–5 years). This study seeks to explore associations between the NSE and the physical activity and screen time behaviours of preschool-aged children.

Method

Cross-sectional data was collected in 2019. Parents (n = 214) of preschool-aged children (m = 3.8 ± 0.8 years), from 187 different Australian postcodes representing all states and territories were invited to complete an online survey where they answered questions about their NSE (perceived social cohesion, social interaction, sense of community, social norms and neighbourhood crime) and proxy-reported their child’s usual physical activity and screen time (minutes/day). Two hierarchical linear regressions were run separately to assess relationships between NSE predictor variables and physical activity and screen time. Three logistic regressions were run to determine associations between NSE constructs and the likelihood of meeting: 1) physical activity (≥ 180 min/day including ≥ 60 min of moderate-to-vigorous-intensity), 2) screen time (≤ 60 min/day) and 3) both physical activity and screen time guidelines. Child age, gender, childcare attendance, and neighbourhood level socioeconomic status (SES) were controlled for in all analyses.

Results

Social interaction was associated with increased daily physical activity (b = 17.76, 95%CI = 0.81, 34.71), decreased daily screen time (b = -12.77, 95%CI = -23.23, -2.23) and improved the likelihood of meeting physical activity (OR = 1.81, 95%CI = 1.20, 2.75) and combined physical activity and screen time guidelines (OR = 1.51, 95%CI = 1.03, 2.21). Higher neighbourhood crime was associated with a lower likelihood of meeting screen time guidelines (OR = 0.47, 95%CI = 0.47, 0.99). Social cohesion, sense of community and social norms were not statistically significant predictors of daily physical activity, screen time or meeting guidelines.

Conclusion

Social interaction showed the most consistent associations with physical activity and screen time. Future research should consider potential mediators of this relationship, including parental facilitation of children’s outdoor time. Improving understanding of the relationship between the NSE and physical activity and screen time in young children can help to guide community-based initiatives striving to optimise behavioural, health and social outcomes.
Substance use workforce training needs during intersecting epidemics: an analysis of events offered by a regional training center from 2017 to 2020
Authors: Scott Kelli , Salas Mika D. H. , Bayles Denise , Sanchez Raymond , Martin Rosemarie A. , Becker Sara J.
Published: May 2022

Background

Intersecting opioid overdose, COVID-19, and systemic racism epidemics have brought unprecedented challenges to the addiction treatment and recovery workforce. From 2017 to 2020, the New England Addiction Technology Transfer Center (ATTC) collected data in real-time on the training and technical assistance (TA) requested and attended by the front-line workforce. This article synthesizes practice-based evidence on the types of TA requests, topics of TA, attendance numbers, and socio-demographics of TA attendees over a 3-year period spanning an unprecedented public health syndemic.

Methods

We assessed TA events hosted by the New England ATTC using SAMHSA’s Performance Accountability and Reporting System post-event survey data from 2017 to 2020. Events were coded by common themes to identify the most frequently requested training types/topics and most frequently attended training events. We also evaluated change in training topics and attendee demographics over the three-year timeline.

Results

A total of 258 ATTC events reaching 10,143 participants were analyzed. The number of TA events and attendance numbers surged in the 2019–2020 fiscal year as TA events shifted to fully virtual during the COVID-19 pandemic. The absolute number of opioid-related events increased, but the relative proportion remained stable over time. The relative proportions of events and attendance rates focused on evidence-based practice and health equity both increased over the 3-year period, with the largest increase after the onset of the pandemic and the murder of George Floyd. As events shifted to virtual, events were attended by providers with a broader range of educational backgrounds.

Conclusions

Results of the current analysis indicate that the demand for TA increased during the pandemic, with a prioritization of TA focused on evidence-based practice and health equity. The practice-based evidence generated from the New England ATTC may help other training and TA centers to anticipate and nimbly respond to the needs of the workforce in the face of the intersecting epidemics.
Pain catastrophizing and associated factors in preoperative total knee arthroplasty in Lanzhou, China: a cross-sectional study
Authors: Pei Juhong , Chen Haixia , Ma Tong , Zhang Ying , Wang Xiangfu , Li Chenxu , Ye Binglin , Wang Xingsheng , Zhao Jirong , Dou Xinman
Published: May 2022

Background

Pain catastrophizing in preoperative total knee arthroplasty (TKA) patients is associated with several poorly characterised factors in the literature. This study investigated the current state and associated factors of preoperative pain catastrophizing in patients undergoing TKA.

Methods

This descriptive cross-sectional study was conducted at the orthopedics ward of two tertiary hospitals in Lanzhou, China. Pain catastrophizing was measured using the Chinese versions of the Pain Catastrophizing Scale, Short Form-36 (physical function domain), Numerical Rating Scale, Oxford Knee Score, Hospital Anxiety and Depression Scale, and Life Orientation Test-Revised.

Results

The study included 360 participants. Preoperative TKA pain catastrophizing in all patients was high, with a mean score of 24.92 (SD: 12.38). The stepwise multiple linear regression analysis revealed anxiety (β = 0.548, P < 0.01), education level (β =  − 0.179, P < 0.01), physical function (β =  − 0.156, P < 0.01), and pain intensity during activity (β = 0.105, P = 0.015) as associated factors for pain catastrophizing, possibly explaining 51.2% of the total variation (F = 95.149, P < 0.01).

Conclusion

Anxiety was the most relevant factor for pain catastrophizing in patients with preoperative TKA. Lower education levels, poor physical function, and stronger pain intensity during the activity were also associated with pain catastrophizing.
Effects of combined adjustable Halo-pelvic fixation brace on cervical spine alignment in patients with severe rigid spinal deformity
Authors: Rong Zhigang , Zhang Chengmin , Cheng Peng , Dai Fei , Chen Can , Yu Xueke , Xu Jianzhong , Luo Fei
Published: May 2022

Objective

To evaluate the effect of continuous traction with a combined adjustable Halo-pelvic fixation brace on the cervical spine alignment in patients with severe rigid spinal deformity and analyze its related factors.

Methods

We conducted a retrospective cohort study of 21 patients with severe rigid spinal deformity treated in our department between 2015 and 2019. All subjects received combined adjustable Halo-pelvic fixation brace traction before secondary orthopedic surgery. The influence of the Halo-pelvic fixation brace on the cervical spine alignment was evaluated by measuring the parameters of lateral cervical X-ray at three time points: before traction, at the end of traction, and 6 months after orthopedic surgery. The correlation between parameter changes and total traction duration was analyzed to explore factors influencing cervical alignment.

Results

The C2L-C7L angle was 22.40 ± 15.91° before traction, which decreased to 5.91 ± 6.78° at the end of traction but increased to 14.51 ± 10.07° after orthopedic surgery (BT vs ET p < 0.005, ET vs AOS p < 0.005, BT vs AOS p < 0.005). Accordingly, C2L-C7U angle, C2L-C6L angle, C2L-C6U angle, C2L-C5L angle, C7 or T1 slope, C2-C7 SVA, SCA, C2-T1 Ha, C0 slope, and C0-C2 angle also changed similarly to C2L-C7L angle. Furthermore, moderate correlation was observed between C2L-C7L angle and total traction volume (r = 0.563, p = 0.008) and SCA and traction duration (r = 0.525, p = 0.015). However, no significant correlation was found between other cervical alignment parameters and total traction volume and traction duration.

Conclusions

The continuous traction of a combined adjustable Halo-pelvic fixation brace can affect the cervical spine alignment of patients with severe rigid spinal deformity and straighten the physiological curvature of the cervical spine. However, the sagittal alignment gradually recovers after the traction, without any adverse effects on the orthopedic surgery and global balance after the operation; therefore, this apparatus is worthy of wide application.
Cervical cancer knowledge and barriers and facilitators to screening among women in two rural communities in Guatemala: a qualitative study
Authors: Bevilacqua Kristin G. , Gottschlich Anna , Murchland Audrey R. , Alvarez Christian S. , Rivera-Andrade Alvaro , Meza Rafael
Published: May 2022

Background

Approximately 80% of deaths due to cervical cancer occur in low- and middle-income countries. In Guatemala, limited access to effective screening and treatment has resulted in alarmingly high cervical cancer incidence and mortality rates. Despite access to free-of-cost screening, women continue to face significant barriers in obtaining screening for cervical cancer.

Methods

In-depth interviews (N = 21) were conducted among women in two rural communities in Guatemala. Interviews followed a semi-structured guide to explore knowledge related to cervical cancer and barriers and facilitators to cervical cancer screening.

Results

Cervical cancer knowledge was variable across sites and across women. Women reported barriers to screening including ancillary costs, control by male partners, poor provider communication and systems-level resource constraints. Facilitators to screening included a desire to know one’s own health status, conversations with other women, including community health workers, and extra-governmental health campaigns.

Conclusions

Findings speak to the many challenges women face in obtaining screening for cervical cancer in their communities as well as existing facilitators. Future interventions must focus on improving cervical cancer-related knowledge as well as mitigating barriers and leveraging facilitators to promote screening.
Serum anti-Müllerian hormone as a predictor of polycystic ovarian syndrome among women of reproductive age
Authors: Butt Muhammad Salman , Saleem Javeria , Aiman Sobia , Zakar Rubeena , Sadique Iftikhar , Fischer Florian
Published: May 2022

Background

Polycystic ovarian syndrome (PCOS) affects up to one-fifth of women of reproductive age and causes anovulatory subfertility. Some studies have recommended that an anti-Müllerian hormone (AMH) level greater than 3.8–5 ng/mL can be used for diagnosing PCOS. This study aims to analyse serum AMH levels among PCOS women of reproductive age to use AMH as a biomarker predictor along with other Rotterdam criteria.

Methods

In this cross-sectional study, a total of 98 women visiting the fertility center of a private hospital in Lahore, Pakistan, were screened. Data were obtained from 51 PCOS newly diagnosed women aged 28.24 years (SD ± 4.84 years) meeting at least two of the Rotterdam criteria and specific inclusion criteria. Baseline variables, menstrual cycle length, ovarian morphology on ultrasound, hirsutism, sex hormones, gonadotropin, and serum AMH levels were analysed during the follicular phase (1–5 days) of the menstrual cycle. Serum AMH was measured by an enzyme-linked immunosorbent assay.

Results

A high serum AMH level (7.23 ± 4.67 ng/ml) was recorded with normal sex hormone levels. Women with oligo-/amenorrhea had a significant mean difference for luteinizing hormone (p = 0.02) and AMH levels (p = 0.03) when compared with women of normal menstrual cycle length. PCOS women with high AMH levels (≥ 3.9 ng/ml) showed a significant difference in ovarian morphology (p < 0.05) when compared with the normal AMH group.

Conclusions

An elevated serum AMH level can be used as a strong predictor to reflect the certainty of PCOS diagnosis among women of reproductive age when study concurrently with the other Rotterdam criteria.
Challenges of the organizational structure of county health network in Iran: findings from a qualitative study
Authors: Ghorrabi Ahmad Tahmasebi , Kakemam Edris , Moradi-Joo Ehsan , Dehcheshmeh Nayeb Fadaei
Published: May 2022

Background

Primary healthcare with the right structure is the base for any highly efficient healthcare system to achieve better health outcomes at the lowest cost. Challenges of this system, including structural weaknesses, are one of the factors of inefficiency. Therefore, the purpose of this study was to identify challenges of the organizational structure of county health network in Iran.

Methods

An exploratory qualitative face-to-face semi-structured interviews were carried out with 21 key informants including experts and managers in Ahvaz-Iran. Purposive sampling method with maximum diversity were used. Interviews were recorded digitally and transcribed verbatim. Interview transcripts were analyzed based on a thematic analysis approach via NVivo-11.

Results

In analysis of the interviews, after removing the duplicate codes and merging similar items, finally 6 main challenges and 56 sub-themes were obtained. The themes of structural challenges included formalization, complexity, centralization, culture, environment, and resources.

Conclusions

Based on the present situation, the challenges in the current organizational structure and a change in the goals and strategies of the healthcare system in Iran, the appropriate structure needs to be designed and implemented at different levels in accordance with the goals and strategies. The separation and independence of health centers management and hospitals (treatment) in the county can provide a basis for understanding the challenges to the provision of health services.
Bottom-up synthetic biology approach for improving the efficiency of menaquinone-7 synthesis in Bacillus subtilis
Authors: Ding Xiumin , Zheng Zhiming , Zhao Genhai , Wang Li , Wang Han , Yang Qiang , Zhang Mengxue , Li Luyao , Wang Peng
Published: May 2022

Background

Menaquinone-7 (MK-7), which is associated with complex and tightly regulated pathways and redox imbalances, is produced at low titres in Bacillus subtilis. Synthetic biology provides a rational engineering principle for the transcriptional optimisation of key enzymes and the artificial creation of cofactor regeneration systems without regulatory interference. This holds great promise for alleviating pathway bottlenecks and improving the efficiency of carbon and energy utilisation.

Results

We used a bottom-up synthetic biology approach for the synthetic redesign of central carbon and to improve the adaptability between material and energy metabolism in MK-7 synthesis pathways. First, the rate-limiting enzymes, 1-deoxyxylulose-5-phosphate synthase (DXS), isopentenyl-diphosphate delta-isomerase (Fni), 1-deoxyxylulose-5-phosphate reductase (DXR), isochorismate synthase (MenF), and 3-deoxy-7-phosphoheptulonate synthase (AroA) in the MK-7 pathway were sequentially overexpressed. Promoter engineering and fusion tags were used to overexpress the key enzyme MenA, and the titre of MK-7 was 39.01 mg/L. Finally, after stoichiometric calculation and optimisation of the cofactor regeneration pathway, we constructed two NADPH regeneration systems, enhanced the endogenous cofactor regeneration pathway, and introduced a heterologous NADH kinase (Pos5P) to increase the availability of NADPH for MK-7 biosynthesis. The strain expressing pos5P was more efficient in converting NADH to NADPH and had excellent MK-7 synthesis ability. Following three Design-Build-Test-Learn cycles, the titre of MK-7 after flask fermentation reached 53.07 mg/L, which was 4.52 times that of B. subtilis 168. Additionally, the artificially constructed cofactor regeneration system reduced the amount of NADH-dependent by-product lactate in the fermentation broth by 9.15%. This resulted in decreased energy loss and improved carbon conversion.

Conclusions

In summary, a "high-efficiency, low-carbon, cofactor-recycling" MK-7 synthetic strain was constructed, and the strategy used in this study can be generally applied for constructing high-efficiency synthesis platforms for other terpenoids, laying the foundation for the large-scale production of high-value MK-7 as well as terpenoids.