bluuebunny/crossref_metadata_2025 huggingface dataset:
In-Demand Instructional Communication Competencies for Organizational Trainers
Authors: Engstrom Craig , Helens-Hart Rose
Published: January 2023

An analysis of surveys ( N = 143) and interviews ( n = 34) with human resources and talent development professionals suggest respondents desired corporate trainers who were competent communicators—who could deliver content effectively in an engaging manner. Nonacademic trainers and subject-matter experts (SMEs) were often perceived as less adept at presenting complex material than academics who were considered SMEs in their fields and in the practice of teaching. Based on these findings, we recommend communication academics who desire to train in organizational settings market their expertise in instructional communication to training managers and SMEs seeking professional development.
Entrepreneurship Education & Pedagogy: An Interview With Eric Liguori
Authors: Winkler Christoph
Published: January 2023

In this interview, Eric Liguori talks about the past, and more importantly the future, of entrepreneurship education. Liguori discusses the history and origins of Entrepreneurship Education and Pedagogy (EE&P; this publication), where it has been, and why he believes the future is so bright. He also discusses areas of opportunity for the future entrepreneurship education and advice for educators in how they approach the teaching of entrepreneurship. Liguori was the Founding Executive Editor of EE&P for 5 years, from January 1, 2018 – December 31, 2022. This article aims to honor his leadership to the journal as well as to celebrate his recognition as the United States Association for Small Business and Entrepreneurship’s 2023 Entrepreneurship Educator of the Year.
The Intersectional Impact of Disability and Immigration on Health: A Health Needs Assessment of Immigrants Living With Spinal Cord Injury in Houston, Texas
Authors: Celeste-Villalvir Alane , Kovic Christine , Argüelles Francisco
Published: January 2023

Background

Immigrants with spinal cord injury (SCI) experience challenges with co-morbidities and lack of access to medical supplies and equipment. Much of the current disability and SCI literature does not include Latinx immigrants with SCI. To address this gap in knowledge, the present study explores the intersectional impact of disability and immigration on health as well as the health status and health needs of immigrants living with SCI.

Methods

This community-partnered study is a secondary analysis of needs assessment data collected in February 2019 with 24 of the members of Living Hope Wheelchair Association, a nonprofit organization serving Latinx immigrants living with SCI in Houston, Texas.

Results

Participants shared challenges with accessing healthcare, comorbidities, mental illness, transportation, and discrimination by healthcare professionals. They also shared difficulties accessing medical supplies, medical equipment, and the need for adaptations in their homes and vehicles.

Conclusion

The findings corroborate those of previous studies with people with SCI, but highlights additional layers of marginalization and challenges faced by immigrants living with SCI. More research is needed to understand the health needs and health status of this population, including their access to care and management of chronic diseases such as diabetes and heart disease. Findings support the need for public health and immigration policies to promote inclusion and equitable access to services as well as improve the health and quality of life of immigrants.
Acalabrutinib and high-frequency low-dose subcutaneous rituximab for initial therapy of chronic lymphocytic leukemia
Authors: Wallace Danielle S. , Zent Clive S. , Baran Andrea M. , Reagan Patrick M. , Casulo Carla , Rice Geoffrey , Friedberg Jonathan W. , Barr Paul M.
Published: January 2023

Bruton tyrosine kinase inhibitors are an effective therapeutic agent for previously untreated patients with chronic lymphocytic leukemia but require indefinite treatment that can result in cumulative toxicities. Novel combinations of agents that provide deep remissions could allow for fixed duration therapy. Acalabrutinib, unlike ibrutinib, does not inhibit anti-CD20 monoclonal antibody-dependent cellular phagocytosis, making it a suitable partner drug to rituximab. Using standard dosing (375 mg/m2) of rituximab causes loss of target membrane CD20 cells and exhaustion of the finite cytotoxic capacity of the innate immune system. Alternatively, using high-frequency, low-dose (HFLD), subcutaneous rituximab limits loss of CD20 and allows for self-administration at home. The combination of HFLD rituximab 50 mg administered twice a week for 6 cycles of 28 days with the addition of acalabrutinib starting in week 2 was evaluated in a phase II study of 38 patients with treatment naive chronic lymphocytic leukemia. Patients achieving a complete response with undetectable minimal residual disease after 12 or 24 cycles of acalabrutinib could stop therapy. All patient responded, including one with a complete response with undetectable minimal residual disease in the peripheral blood and bone marrow at 12 months who stopped therapy. At a median follow-up of 2.3 years 2 patients with high-risk features have progressed while on acalabrutinib monotherapy. We conclude that HFLD rituximab in combination with acalabrutinib is an effective and tolerable self-administered home combination that provides a platform to build upon regimens that may more reliably allow for fixed-duration therapy. This trial was registered at www.clinicaltrials.gov #NCT03788291.
Reliabilities of estimated breeding values in models with metafounders
Authors: Bermann Matias , Aguilar Ignacio , Lourenco Daniela , Misztal Ignacy , Legarra Andres
Published: January 2023

Background

Reliabilities of best linear unbiased predictions (BLUP) of breeding values are defined as the squared correlation between true and estimated breeding values and are helpful in assessing risk and genetic gain. Reliabilities can be computed from the prediction error variances for models with a single base population but are undefined for models that include several base populations and when unknown parent groups are modeled as fixed effects. In such a case, the use of metafounders in principle enables reliabilities to be derived.

Methods

We propose to compute the reliability of the contrast of an individual’s estimated breeding value with that of a metafounder based on the prediction error variances of the individual and the metafounder, their prediction error covariance, and their genetic relationship. Computation of the required terms demands only little extra work once the sparse inverse of the mixed model equations is obtained, or they can be approximated. This also allows the reliabilities of the metafounders to be obtained. We studied the reliabilities for both BLUP and single-step genomic BLUP (ssGBLUP), using several definitions of reliability in a large dataset with 1,961,687 dairy sheep and rams, most of which had phenotypes and among which 27,000 rams were genotyped with a 50K single nucleotide polymorphism (SNP) chip. There were 23 metafounders with progeny sizes between 100,000 and 2000 individuals.

Results

In models with metafounders, directly using the prediction error variance instead of the contrast with a metafounder leads to artificially low reliabilities because they refer to a population with maximum heterozygosity. When only one metafounder is fitted in the model, the reliability of the contrast is shown to be equivalent to the reliability of the individual in a model without metafounders. When there are several metafounders in the model, using a contrast with the oldest metafounder yields reliabilities that are on a meaningful scale and very close to reliabilities obtained from models without metafounders. The reliabilities using contrasts with ssGBLUP also resulted in meaningful values.

Conclusions

This work provides a general method to obtain reliabilities for both BLUP and ssGBLUP when several base populations are included through metafounders.
Effects of switching from sacubitril/valsartan to valsartan alone on plasma levels of natriuretic peptides and myocardial remodeling in heart failure with reduced ejection fraction
Authors: Nakamura Akihiro , Kagaya Yuta , Saito Hiroki , Kanazawa Masanori , Miura Masanobu , Kondo Masateru , Sato Kenjiro , Endo Hideaki
Published: January 2023

Background

We examined the effect of switching from angiotensin receptor-neprilysin inhibitor (ARNI) to angiotensin-receptor blocker (ARB) on plasma levels of natriuretic peptides and myocardial remodeling.

Methods

This is a prospective study that included 11 patients with heart failure (HF) treated with ARNI. The patients were divided into two groups: 5 patients who continued treatment with sacubitril/valsartan 194/206 mg/day (ARNI-continue group) and 6 patients who were switched to valsartan 160 mg/day (ARB-switch group). The primary endpoint was percent change (%Change) in plasma A-, B-, and N-terminal pro-B-type natriuretic peptide (ANP, BNP, and NT-proBNP) levels from the baseline to week 24. The secondary endpoint was the change in echocardiographic parameters related to myocardial remodeling from the baseline to week 24.

Results

ANP levels in the ARB-switch group significantly decreased (from 1155.7 ± 592.6 pg/mL to 231.6 ± 233.8 pg/mL, p = 0.035), whereas those in the ARNI-continue group were not significant (p = 0.180). The %Change of decrease in ANP levels was significantly greater in the ARB-switch group than the ARNI-continue group (− 76.9% vs. −9.1%, p = 0.009). BNP levels were not significantly different between the baseline and week 24 in both groups. NT-proBNP levels in the ARB-switch group increased from 1185.3 ± 835.6 pg/mL to 1515.2 ± 1213.5 pg/mL, although the changes were not statistically significant (p = 0.345). The %Change of increase in NT-proBNP levels was significantly greater in the ARB-switch group than the ARNI-continue group (57.9% vs. 17.3%, p = 0.016). In the ARB-switch group, there was a significant increase in left ventricular (LV) end-systolic volume (from 41.3 ± 24.1 mL/m2 to 71.4 ± 8.8 mL/m2, p = 0.043) and LV peak-systolic wall stress (from 187.0 ± 42.7 × 103 dynes/cm2 to 279.7 ± 34.1 × 103 dynes/cm2, p = 0.012) from the baseline to week 24 and a trend toward a decrease in LV ejection fraction (p = 0.080). In the ARNI-continue group, no differences in echocardiographic parameters were observed from the baseline to week 24.

Conclusion

Switching from ARNI to ARB may worsen HF due to returning to myocardial remodeling induced by a sustained decline in ANP levels.
Patient-reported outcome measures for physical function in cancer patients: content comparison of the EORTC CAT Core, EORTC QLQ-C30, SF-36, FACT-G, and PROMIS measures using the International Classification of Functioning, Disability and Health
Authors: Schurr T , Loth F , Lidington E , Piccinin C , Arraras JI , Groenvold M , Holzner B , van Leeuwen M , Petersen MA , Schmidt H , Young T , Giesinger JM ,   European Organisation for Research, Treatment of Cancer Quality of Life Group (EORTC QLG), Arraras Juan I. , Groenvold Mogens , van Leeuwen Marieke
Published: January 2023

Background

Patient-reported physical function (PF) is a key endpoint in cancer clinical trials. Using complex statistical methods, common metrics have been developed to compare scores from different patient-reported outcome (PRO) measures, but such methods do not account for possible differences in questionnaire content. Therefore, the aim of our study was a content comparison of frequently used PRO measures for PF in cancer patients.

Methods

Relying on the framework of the International Classification of Functioning, Disability and Health (ICF) we categorized the item content of the physical domains of the following measures: EORTC CAT Core, EORTC QLQ-C30, SF-36, PROMIS Cancer Item Bank for Physical Function, PROMIS Short Form for Physical Function 20a, and the FACT-G. Item content was linked to ICF categories by two independent reviewers.

Results

The 118 items investigated were assigned to 3 components (‘d – Activities and Participation’, ‘b – Body Functions’, and ‘e – Environmental Factors’) and 11 first-level ICF categories. All PF items of the EORTC measures but one were assigned to the first-level ICF categories ‘d4 – Mobility’ and ‘d5 – Self-care’, all within the component ‘d – Activities and Participation’. The SF-36 additionally included item content related to ‘d9 – Community, social and civic life’ and the PROMIS Short Form for Physical Function 20a also included content related to ‘d6 – domestic life’. The PROMIS Cancer Item Bank (v1.1) covered, in addition, two first-level categories within the component ‘b – Body Functions’. The FACT-G Physical Well-being scale was found to be the most diverse scale with item content partly not covered by the ICF framework.

Discussion

Our results provide information about conceptual differences between common PRO measures for the assessment of PF in cancer patients. Our results complement quantitative information on psychometric characteristics of these measures and provide a better understanding of the possibilities of establishing common metrics.
An analytic hierarchy process analysis for reinforcing doctor–patient communication
Authors: Park Sewon , Kim Han-Kyoul , Lee Munjae
Published: January 2023

Background

As the health paradigm shifts toward patient-centeredness, patients can actively participate in their own treatment. However, there is still a unilateral aspect of doctor-patient communication, so it is necessary to specify obstacles between doctors and patients. Therefore, this study attempted to extract obstacles that block doctor-patient communication and to analyze differences in perception of doctor-patient communication.

Methods

A total of 35 questionnaires composed of brainstorming for the study were distributed, and a total of 21 questionnaires were used for analysis. The collected data was analyzed by AHP using dress ver 17.0.

Results

As a result of the study, doctors ranked the priority of health communication in the order of professionalism, reliability, fairness, communication, and psychologically. On the other hand, for patients, the priority factors of health communication were communication, fairness, professionalism, reliability, and psychologically.

Conclusion

In order to improve the quality of health communication between doctors and patients, doctors will be able to communicate from the patient’s point of view and strengthen communication with patients by providing consistent medical services and patients need to trust the doctor and patients need to trust their doctors and participate in the medical process faithfully.
Neutrophil to High-density Lipoprotein ratio (NHR) as a potential predictor of disease severity and survival time in Creutzfeldt-Jakob disease
Authors: Kong Yu , Chen Zhongyun , Zhang Jing , Wu Liyong
Published: January 2023

Introduction

Creutzfeldt-Jakob disease (CJD) is a fatal and irreversible neurodegenerative disease. Identification of inexpensive and easy-to-implement biomarkers of CJD which could predict disease severity and patient survival is important for improving disease management. The aim of this study was to assess the predictive value of peripheral neutrophil to lymphocyte ratio (NLR), high-density lipoprotein (HDL), monocyte to HDL ratio (MHR) and neutrophil to HDL ratio (NHR) for CJD.

Methods

Patients with definite or probable CJD admitted to the Neurology Department of Xuanwu Hospital from 2014 to 2021 were enrolled and followed up until April 2022. Clinical information including sex, age, Barth Index, survival time and results of auxiliary examination were collected, and NLR, HDL, NHR and MHR were measured for all enrolled patients. The associations between NLR, HDL, NHR and MHR, and disease severity (evaluated by Barth Index), survival time and auxiliary examinations were evaluated.

Results

A total of 88 CJD patients were enrolled and all were deceased. NLR (r = -0.341, p = 0.001), NHR (r = -0.346, p = 0.001) and MHR (r = -0.327, p = 0.002) were significantly associated with disease severity. Higher NHR (HR = 2.344, 95% CI = 1.277–4.303 p = 0.006) and lower HDL (HR = 0.567, 95% CI = 0.346–0.930, p = 0.025) were associated with shorter survival time in the CJD patients.

Conclusions

Peripheral inflammatory biomarkers, especially NHR, were associated with disease severity and survival duration. These findings provide new insights into the mechanisms and treatment strategies of CJD.
Baloxavir safety and clinical and virologic outcomes in influenza virus-infected pediatric patients by age group: age-based pooled analysis of two pediatric studies conducted in Japan
Authors: Hirotsu Nobuo , Sakaguchi Hiroki , Fukao Keita , Kojima Satoshi , Piedra Pedro A. , Tsuchiya Kenji , Uehara Takeki
Published: January 2023

Background

Anti-influenza treatment is important for children and is recommended in many countries. This study assessed safety, clinical, and virologic outcomes of baloxavir marboxil (baloxavir) treatment in children based on age and influenza virus type/subtype.

Methods

This was a post hoc pooled analysis of two open-label non-controlled studies of a single weight-based oral dose of baloxavir (day 1) in influenza virus-infected Japanese patients aged < 6 years (n = 56) and ≥ 6 to < 12 years (n = 81). Safety, time to illness alleviation (TTIA), time to resolution of fever (TTRF), recurrence of influenza illness symptoms and fever (after day 4), virus titer, and outcomes by polymerase acidic protein variants at position I38 (PA/I38X) were evaluated.

Results

Adverse events were reported in 39.0 and 39.5% of patients < 6 years and ≥ 6 to < 12 years, respectively. Median (95% confidence interval) TTIA was 43.2 (36.3–68.4) and 45.4 (38.9–61.0) hours, and TTRF was 32.2 (26.8–37.8) and 20.7 (19.2–23.8) hours, for patients < 6 years and ≥ 6 to < 12 years, respectively. Symptom and fever recurrence was more common in patients < 6 years with influenza B (54.5 and 50.0%, respectively) compared with older patients (0 and 25.0%, respectively). Virus titers declined (day 2) for both age groups. Transient virus titer increase and PA/I38X-variants were more common for patients < 6 years.

Conclusions

The safety and effectiveness of single-dose baloxavir were observed in children across all age groups and influenza virus types. Higher rates of fever recurrence and transient virus titer increase were observed in children < 6 years.

Trial registration

Japan Pharmaceutical Information Center Clinical Trials Information JapicCTI-163,417 (registered 02 November 2016) and JapicCTI-173,811 (registered 15 December 2017).
Protective factors against suicide attempt in Iranian Kurdish women: a qualitative content analysis
Authors: Ariapooran Saeed , Khezeli Mehdi , Janjani Parisa , Jafaralilou Hamid , Narimani Sajad , Mazaheri Maryam , Khezeli Mohsen
Published: January 2023

Background

A proper understanding of the protective factors against suicide attempt can provide the basis for planning preventive interventions. This study aimed to identify protective factors against suicide attempt among women.

Methods

This qualitative study was conducted in Kermanshah, Iran between January and May 2021. Participants were 20 Kurdish women, survivors of suicide attempt, selected by purposive sampling method. The data collection method was face-to face and audio-recorded semi-structured interview. Qualitative data analysis was done according to Diekelmann 7-step approach.

Findings

According to the results, the main topic was protective factors against suicide attempt in women, with two categories; “Individual factors” and “Social factors”. “Individual factors” had five subcategories including coping strategies, reasons for living, resilience, religious beliefs, and fear of death, and “social factors” had two subcategories including social support and effective communication.

Conclusion

This study showed that women who intend to commit suicide may encounter some individual and social factors that play a protective role against suicide. It is recommended to identify and strengthen these protective factors for the effectiveness of suicide prevention interventions.
Feasibility of digital contact tracing in low-income settings – pilot trial for a location-based DCT app
Authors: Handmann Eric , Camanor Sia Wata , Fallah Mosoka P. , Candy Neima , Parker Davidetta , Gries André , Grünewald Thomas
Published: January 2023

Background

Data about the effectiveness of digital contact tracing are based on studies conducted in countries with predominantly high- or middle-income settings. Up to now, little research is done to identify specific problems for the implementation of such technique in low-income countries.

Methods

A Bluetooth-assisted GPS location-based digital contact tracing (DCT) app was tested by 141 participants during 14 days in a hospital in Monrovia, Liberia in February 2020. The DCT app was compared to a paper-based reference system. Hits between participants and 10 designated infected participants were recorded simultaneously by both methods. Additional data about GPS and Bluetooth adherence were gathered and surveys to estimate battery consumption and app adherence were conducted. DCT apps accuracy was evaluated in different settings.

Results

GPS coordinates from 101/141 (71.6%) participants were received. The number of hours recorded by the participants during the study period, true Hours Recorded (tHR), was 496.3 h (1.1% of maximum Hours recordable) during the study period. With the paper-based method 1075 hits and with the DCT app five hits of designated infected participants with other participants have been listed. Differences between true and maximum recording times were due to failed permission settings (45%), data transmission issues (11.3%), of the participants 10.1% switched off GPS and 32.5% experienced other technical or compliance problems.

In buildings, use of Bluetooth increased the accuracy of the DCT app (GPS + BT 22.9 m ± 21.6 SD vs. GPS 60.9 m ± 34.7 SD; p = 0.004). GPS accuracy in public transportation was 10.3 m ± 10.05 SD with a significant (p = 0.007) correlation between precision and phone brand. GPS resolution outdoors was 10.4 m ± 4.2 SD.

Conclusion

In our study several limitations of the DCT together with the impairment of GPS accuracy in urban settings impede the solely use of a DCT app. It could be feasible as a supplement to traditional manual contact tracing.

DKRS, DRKS00029327. Registered 20 June 2020 - Retrospectively registered.
Differences in physical activity participation among young adults in Aotearoa New Zealand
Authors: Wilson Oliver W. A. , Smith Melody , Duncan Scott , Hinckson Erica , Mizdrak Anja , Richards Justin
Published: January 2023

Background

The purpose of this study was to examine socio-demographic differences in physical activity (aerobic and muscle-strengthening) among young adults (18–24 years).

Methods

Data collected between 2017–2019 as a part of Sport New Zealand’s Active NZ survey were examined using logistic regression analyses to determine the odds of participants meeting aerobic, muscle-strengthening and combined physical activity recommendations. Gender, ethnicity, employment/student status, disability status, and socio-economic deprivation were included as explanatory variables in analyses.

Results

The proportion of young adults meeting recommendations varied according to physical activity type (aerobic:63.2%; strength:40.1%; combined:37.2%). Young adults not employed/studying had lower odds of meeting recommendations than those full-time employed (OR = 0.43 [0.34–0.54]). Physical activity levels differ according to gender and this intersects with ethnicity, employment/student status, and social deprivation. For example, the odds of Pasifika young adults meeting combined physical activity recommendations compared to Europeans were not different (OR = 0.95 [0.76–1.19]), but when stratified by gender the odds were significantly higher for men (OR = 1.55 [1.11–2.16]) and significantly lower for women (OR = 0.64 [0.47–0.89]. Similarly, young adults in high deprivation areas had lower odds of meeting combined physical activity recommendations than those in low deprivation areas (OR = 0.81 [0.68–0.95]), but this was mainly due to the difference among women (OR = 0.68 [0.54–0.85]) as there was no difference among men (OR = 0.97 [0.76–1.25]).

Conclusions

Intersections between socio-demographic characteristics should be considered when promoting physical activity among young adults in Aotearoa New Zealand, particularly young adults not employed/studying, and young women who live in deprived areas or identify as Asian or Pasifika. Tailored approaches according to activity type for each of these groups are required.
Comparison of conventional and extended middle meatal antrostomy for the treatment of antrochoanal polyps
Authors: Zong Huiqin , Lou Zhengcai
Published: January 2023

Objective

The objective was to compare the recurrence rate and complications between endoscopic middle meatal antrostomy (MMA) and extended MMA for the treatment of antrochoanal polyps (ACPs).

Methods and materials

95 ACPs were prospectively enrolled to undergo MMA (n = 48) or extended MMA (n = 47). The recurrence rate and complications were compared between these groups.

Results

All patients completed 24 months of follow-up. The recurrence of ACP was demonstrated by only endoscope at 6 and 12 months postoperatively but at 24 months postoperatively by endoscope and CT. Rates of recurrence of ACP differed between groups and significance at postoperative month 6 (7/48 patients in the MMA group and 0/47 patients in the extended MMA group, P = 0.02), month 12 (16/48 vs. 2/47, P < 0.01) and month 24 (21/48 vs. 3/47, P < 0.01). No MMA closure was found in any group, 19.15% (9/47) patients complained of cheek numbness in the extended MMA group, however, no major complications were observed in both groups.

Conclusions

Extended MMA via antidromic extended medial wall of MS may effectively reduce the recurrence of ACP with lower complications.
Dietary pattern scores in relation to pre-diabetes regression to normal glycemia or progression to type 2 diabetes: a 9-year follow-up
Authors: Mirmiran Parvin , Hosseini Shabnam , Bahadoran Zahra , Azizi Fereidoun
Published: January 2023

Background

We aimed to assess potential associations of habitual dietary pattern scores in relation to the risk of pre-diabetes (Pre-DM) progression to type 2 diabetes mellitus (T2DM) or the chance of returning to normal glycemia.

Methods

This cohort study included 334 Pre-DM individuals (mean age of 49.4 years, and 51.5% men) who participated in the third phase of the Tehran Lipid and Glucose Study (2006–2008) and followed up for a median of 9 years. A validated food frequency questionnaire at baseline assessed usual intakes of the participants. Major dietary patterns were identified using principal component analysis. The DASH score and Mediterranean diet score (MDS) were also calculated. Multinomial logistic regression analysis was used to estimate the odds ratios (95% confidence intervals (CIs)) of developing T2DM and returning to normal glycemia in relation to dietary pattern scores.

Results

During the study follow-up, 39.8% progressed to T2DM, and 39.8% returned to normal glycemia. Three following major dietary patterns, including Western-style (with a higher load of red meats, hydrogenated fats, sodium, and total fat intakes), healthy pattern (with a higher load of whole grains, vegetables, and dairy products), and processed-foods pattern (with a higher load of processed-meats, fast-foods, salty snakes, and sweets and candies) were identified. The Western-style dietary pattern increased the risk of progressing to T2DM by 38% (OR = 1.38; 95% CI = 1.00 to 1.89, P = 0.050). Other dietary pattern scores were not related to regression or progression from Pre-DM.

Conclusion

The Western-style dietary pattern (characterized by higher load of red meats, hydrogenated fats, sodium intake, and high-GI foods) may accelerate the progression of Pre-DM to T2DM.
Patient and health worker perspectives on quality of HIV care and treatment services in Haiti
Authors: Puttkammer Nancy , Demes Joseph Adrien Emmanuel , Dervis Witson , Chéry Jean Marcxime , Elusdort Josette , Haight Elizabeth , Honoré Jean Guy , Simoni Jane M.
Published: January 2023

Background

Poor quality of care is a barrier to engagement in HIV care and treatment in low- and middle-income country settings. This study involved focus group discussions (FGD) with patients and health workers in two large urban hospitals to describe quality of patient education and psychosocial support services within Haiti’s national HIV antiretroviral therapy (ART) program. The purpose of this qualitative study was to illuminate key gaps and salient “ingredients” for improving quality of care.

Methods

The study included 8 FGDs with a total of 26 male patients and 32 female patients and 15 smaller FGDs with 57 health workers. The analysis used a directed content analysis method, with the goal of extending existing conceptual frameworks on quality of care through rich description.

Results

Dimension of safety, patient-centeredness, accessibility, and equity were most salient. Patients noted risks to privacy with both clinic and community-based services as well as concerns with ART side effects, while health workers described risks to their own safety in providing community-based services. While patients cited examples of positive interactions with health workers that centered their needs and perspectives, they also noted concerns that inhibited trust and satisfaction with services. Health workers described difficult working conditions that challenged their ability to provide patient-centered services. Patients sought favored relationships with health workers to help them navigate the health care system, but this undermined the sense of fairness. Both patients and health workers described frustration with lack of resources to assist patients in dire poverty, and health workers described great pressure to help patients from their “own pockets.”

Conclusions

These concerns reflected the embeddedness of patient – provider interactions within a health system marked by scarcity, power dynamics between patients and health workers, and social stigma related to HIV. Reinforcing a respectful and welcoming atmosphere, timely service, privacy protection, and building patient perception of fairness in access to support could help to build patient satisfaction and care engagement in Haiti. Improving working conditions for health workers is also critical to achieving quality.
Screening for cervical cancer among women in five countries in sub-saharan Africa: analysis of the role played by distance to health facility and socio-demographic factors
Authors: Dickson Kwamena S. , Boateng Ebenezer N. K. , Acquah Evelyn , Ayebeng Castro , Addo Isaac Y.
Published: January 2023

Background

Cervical cancer significantly affects women in Sub-Saharan Africa (SSA). However, limited studies have concentrated on cervical screening behaviour among women in SSA. This study aimed to assess the interplay of distance to health facilities and socio-demographic factors with cervical screening behaviour among women in five SSA countries.

Methods

The study was based on pooled data of 40,555 women included in Demographic and Health Surveys (DHS) conducted between 2013 to 2021. Proportions and logistic regression models were used in assessing the interplay of distance to health facilities and socio-demographic factors with cervical screening behaviour.

Results

Approximately, 7.9% of women that saw the distance to a health facility as a big problem, tested for cervical cancer compared to 13.5% who indicated that distance to a health facility is not a big problem. More women in urban areas, with a higher level of education, of richest wealth index, aged 40–44 years and using contraceptives who also indicated that distance to a health facility was a big problem tested for cervical cancer compared to those in rural areas with no education, of poorest wealth index, aged 15–19 years and not using contraceptives. Education, age, contraceptive use, frequent exposure to mass media and Sexual Transmitted Infections (STI) had a significant relationship with testing for cervical cancer.

Conclusion

The prevalence of cervical cancer screening was low in the five SSA countries largely due to distance barriers and was also significantly influenced by education, age, contraceptive use, frequent exposure to mass media, and STI status. To improve the screening for cervical cancer and its associated benefits in the five SSA countries, there is a need for policymakers, clinicians and public health workers to channel more commitment and efforts to addressing the barriers identified in this study.
Family physicians collaborating for health system integration: a scoping review
Authors: Grady Colleen , Han Han , Kim Da Hye , Coderre-Ball Angela M. , Alam Nadia
Published: January 2023

Background

In Canada, Ontario Health Teams (OHTs) are a new model for integrated healthcare. Core to OHTs are family physicians (FPs) and their ability to collaborate with other FPs and healthcare providers. Whereas the factors for intra-organizational collaboration have been well-studied, inter-organizational collaboration between FPs and other healthcare organizations as an integrated care network, are less understood. This paper aims to explore the structural factors, processes, and theoretical frameworks that support FPs’ collaboration for integrated healthcare.

Methods

A scoping review was undertaken based on Joanna Briggs Institute (JBI) methodology for scoping review and using the Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Review (PRISMA_ScR) checklist. A search for academic and relevant grey literature published between 2000–2021 was conducted across databases (MEDLINE, EMBASE, EBSCOhost).Thematic analysis was used to identify the key findings of the selected studies.

Results

Thirty-two studies were included as eligible for this review. Three structural components were identified as critical to FPs’ successful participation in inter-organizational partnerships: (1) shared vision/values, (2) leadership by FPs, and (3) defined decision-making procedures. Also, three processes were identified: (1) effective communication, (2) a collective sense of motivation for change, and (3) relationships built on trust. Three theoretical frameworks provided insight into collaborative initiatives: (1) Social Identity Approach, (2) framework of interprofessional collaboration, and (3) competing values framework.

Conclusion

FPs hold unique positions in healthcare and this review is the first to synthesize the best evidence for building collaborations between FPs and other healthcare sectors. These findings will inform collaboration strategies for healthcare integration, including with OHTs.
Biomarker prediction in autism spectrum disorder using a network-based approach
Authors: Rastegari Maryam , Salehi Najmeh , Zare-Mirakabad Fatemeh
Published: January 2023

Background

Autism is a neurodevelopmental disorder that is usually diagnosed in early childhood. Timely diagnosis and early initiation of treatments such as behavioral therapy are important in autistic people. Discovering critical genes and regulators in this disorder can lead to early diagnosis. Since the contribution of miRNAs along their targets can lead us to a better understanding of autism, we propose a framework containing two steps for gene and miRNA discovery.

Methods

The first step, called the FA_gene algorithm, finds a small set of genes involved in autism. This algorithm uses the WGCNA package to construct a co-expression network for control samples and seek modules of genes that are not reproducible in the corresponding co-expression network for autistic samples. Then, the protein–protein interaction network is constructed for genes in the non-reproducible modules and a small set of genes that may have potential roles in autism is selected based on this network. The second step, named the DMN_miRNA algorithm, detects the minimum number of miRNAs related to autism. To do this, DMN_miRNA defines an extended Set Cover algorithm over the mRNA–miRNA network, consisting of the selected genes and corresponding miRNA regulators.

Results

In the first step of the framework, the FA_gene algorithm finds a set of important genes; TP53, TNF, MAPK3, ACTB, TLR7, LCK, RAC2, EEF2, CAT, ZAP70, CD19, RPLP0, CDKN1A, CCL2, CDK4, CCL5, CTSD, CD4, RACK1, CD74; using co-expression and protein–protein interaction networks. In the second step, the DMN_miRNA algorithm extracts critical miRNAs, hsa-mir-155-5p, hsa-mir-17-5p, hsa-mir-181a-5p, hsa-mir-18a-5p, and hsa-mir-92a-1-5p, as signature regulators for autism using important genes and mRNA–miRNA network. The importance of these key genes and miRNAs is confirmed by previous studies and enrichment analysis.

Conclusion

This study suggests FA_gene and DMN_miRNA algorithms for biomarker discovery, which lead us to a list of important players in ASD with potential roles in the nervous system or neurological disorders that can be experimentally investigated as candidates for ASD diagnostic tests.
Co-morbid mental health conditions in people with epilepsy and association with quality of life in low- and middle-income countries: a systematic review and meta-analysis
Authors: Tsigebrhan Ruth , Derese Andualem , Kariuki Symon M. , Fekadu Abebaw , Medhin Girmay , Newton Charles R. , Prince Martin J. , Hanlon Charlotte
Published: January 2023

Background

Comorbid mental health conditions are common in people with epilepsy and have a significant negative impact on important epilepsy outcomes, although the evidence is mostly from high-income countries. This systematic review aimed to synthesise evidence on the association between comorbid mental health conditions and quality of life and functioning among people with epilepsy living in low- and middle income countries (LMICs).

Methods

We searched PubMed, EMBASE, CINAHL, Global Index medicus (GID) and PsycINFO databases from their dates of inception to January 2022. Only quantiative observational studies were included. Meta-analysis was conducted for studies that reported the same kind of quality of life and functioning outcome. Cohen’s d was calculated from the mean difference in quality-of-life score between people with epilepsy who did and did not have a comorbid depression or anxiety condition. The protocol was registered with PROSPERO: CRD42020161487.

Results

The search strategy identified a total of 2,101 articles, from which 33 full text articles were included. Depression was the most common comorbid mental health condition (33 studies), followed by anxiety (16 studies). Meta-analysis was conducted on 19 studies reporting quality of life measured with the same instrument. A large standardized mean effect size (ES) in quality of life score was found (pooled ES = −1.16, 95% confidence interval (CI) − 1.70, − 0.63) between those participants with comorbid depression compared to non-depressed participants. There was significant heterogeneity between studies (I2 = 97.6%, p < 0.001). The median ES (IQR) was − 1.20 (− 1.40, (− 0.64)). An intermediate standard effect size for anxiety on quality of life was also observed (pooled ES = −0.64, 95% CI − 1.14, − 0.13). There was only one study reporting on functioning in relation to comorbid mental health conditions.

Conclusion

Comorbid depression in people with epilepsy in LMICs is associated with poor quality of life although this evidence is based on highly heterogeneous studies. These findings support calls to integrate mental health care into services for people with epilepsy in LMICs. Future studies should use prospective designs in which the change in quality of life in relation to mental health or public health interventions across time can be measured.
Cross-cultural translation, adaptation, and validation of the stroke-specific quality of life (SSQOL) scale 2.0 into Amharic language
Authors: Wayessa Dechasa Imiru , Chala Mulugeta Bayisa , Demissie Solomon Fasika , Abebe Abey Bekele , Janakiraman Balamurugan , Deme Sisay , Gashaw Moges
Published: January 2023

Background

The stroke-specific quality of life 2.0 (SSQOL 2.0) scale is a valid, reliable instrument which has been widely used as a patients reported outcome measure among stroke survivors. However, the SSQOL scale has not been validated and used in any Ethiopian language. This study aimed to translate, culturally adapt, and test the psychometric properties of the SSQOL scale 2.0 in Amharic, which is the official and working language with about 34 million (23%) speakers in Ethiopia.

Methods

The adapted English version of the SSQOL 2.0 scale was translated into Amharic and then back-translated to English. An expert committee translated and created a final Amharic version of SSQOL (SSQOL-AM) scale. Pre-field testing (pilot and cognitive debriefing) was conducted with 15 post-stroke subjects. The SSQOL-Am was administered to 245 stroke survivors from four referral hospitals to determine the psychometric properties. Cronbach’s alpha and Intra-class correlation coefficient were used to calculate the internal consistency and test–retest reliability, spearman’s correlation for the convergent validity of the SSQOL-Am scale. The Standard Error of Measurement (SEM), Minimum Detectable Change (MDC), Bland Altman Limit of Agreement (LOA), Confirmatory Factor Analysis, and Exploratory Factor Analysis were also determined.

Results

The SSQOL-Am demonstrated excellent test–retest reliability (ICC = 0.93), internal consistency (Cronbach’s alpha = 0.96), SEM 0.857, MDC 1.94, and good LOA. As postulated, the mobility domain of the tool demonstrated a significantly strong correlation with the physical function domain of the SF-36 (rho = 0.70, p < 0.001).

Conclusions

The SSQOL-Am is a valid and reliable outcome measure. The tool can be used in both clinical practice and research purposes with Amharic speaking post-stroke survivors.
Complexities of health and care worker migration pathways and corresponding international reporting requirements
Authors: Bourgeault Ivy L. , Spitzer Denise L. , Walton-Roberts Margaret
Published: January 2023

The increasing complexity of the migration pathways of health and care workers is a critical consideration in the reporting requirements of international agreements designed to address their impacts. There are inherent challenges across these different agreements including reporting functions that are misaligned across different data collection tools, variable capacity of country respondents, and a lack of transparency or accountability in the reporting process. Moreover, reporting processes often neglect to recognize the broader intersectional gendered and racialized political economy of health and care worker migration. We argue for a more coordinated approach to the various international reporting requirements and processes that involve building capacity within countries to report on their domestic situation in response to these codes and conventions, and internationally to make such reporting result in more than simply the sum of their responses, but to reflect cross-national and transnational interactions and relationships. These strategies would better enable policy interventions along migration pathways that would more accurately recognize the growing complexity of health worker migration leading to more effective responses to mitigate its negative effects for migrants, source, destination, and transit countries. While recognizing the multiple layers of complexity, we nevertheless reaffirm the fact that countries still have an ethical responsibility to undertake health workforce planning in their countries that does not overly rely on the recruitment of migrant health and care workers.
Bayesian modelling of phosphorus content in wheat grain using hyperspectral reflectance data
Authors: Pacheco-Gil Rosa Angela , Velasco-Cruz Ciro , Pérez-Rodríguez Paulino , Burgueño Juan , Pérez-Elizalde Sergio , Rodrigues Francelino , Ortiz-Monasterio Ivan , del Valle-Paniagua David Hebert , Toledo Fernando
Published: January 2023

Background

As a result of the technological progress, the use of sensors for crop survey has substantially increased, generating valuable information for modelling agricultural data. Plant spectroscopy jointly with statistical modeling can potentially help to assess certain chemical components of interest present in plants, which may be laborious and expensive to obtain by direct measurements. In this research, the phosphorus content in wheat grain is modeled using reflectance information measured by a hyperspectral sensor at different wavelengths. A Bayesian procedure for selecting variables was used to identify the set of the most important spectral bands. Additionally, three different models were evaluated: the first model assumes that the observations are independent, the other two models assume that the observations are spatially correlated: one of the proposed models, assumes spatial dependence using a Conditionally Autoregressive Model (CAR), and the other through an exponential correlogram. The goodness of fit of the models was evaluated by means of the Deviance Information Criterion, and the predictive power is evaluated using cross validation.

Results

We have found that CAR was the model that best fits and predicts the data. Additionally, the selection variable procedure in the CAR model reveals which wavelengths in the range of 500–690 nm are the most important. Comparing the vegetative indices with the CAR model, it was observed that the average correlation of the CAR model exceeded that of the vegetative indices by 23.26%, − 1.2% and 22.78% for the year 2010, 2011 and 2012 respectively; therefore, the use of the proposed methodology outperformed the vegetative indices in prediction.

Conclusions

The proposal to predict the phosphorus content in wheat grain using Bayesian approach, reflect with the results as a good alternative.
Quality evaluation of guidelines for the diagnosis and treatment of radiation enteritis
Authors: Yang Xiao-Feng , Zheng Meng-Yao , An Li-Ya , Sun Jin-Min , Hei Qian-Wen , Ji Yan-Hong , Sun Da-Li , He Hai-Yu
Published: January 2023

Objective

To systematically evaluate the guidelines for the diagnosis and treatment of radioactive enteritis, compare their differences and reasons and provide some reference for updating them.

Methods

This study used guidelines related to radiation enteritis by searching a database. Four independent reviewers used the AGREE II evaluation tool to evaluate the quality of the included guidelines, collate their main recommendations, and analyze the highest evidence supporting the main recommendations.

Results

Six diagnostic and therapeutic guidelines for radiation enteritis were included in this study, one of which, the American Society for Gastrointestinal Endoscopy guidelines, had an overall score of over 60%, which is worthy of clinical recommendation. In the diagnosis and treatment of radioactive rectal injury, the recommendations for hemorrhagic endoscopic treatment are mature and mainly include (I) argon plasma coagulation; (II) formalin treatment; (III) bipolar electrocoagulation; (IV) heater probe; (V) radiofrequency ablation; and (VI) cryoablation.

Conclusion

The methodological quality of radioactive enteritis guidelines is unequal; even in the same guidelines, different domains have a large difference. For radioactive rectal damage diagnosis, a type of endoscopic treatment recommendation is more mature, but the overall diagnosis and treatment of radioactive enteritis still lacks high-quality research evidence.