bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of clinically uninfected diabetic foot ulcers, with and without antibiotics
Authors: Huizing Eline , Schreve Michiel A , Stuart James WT Cohen , de Vries Jean-Paul PM , Çağdaş Ünlü
Published: February 2024

Objective:

Current guidelines do not recommend the use of antibiotics to treat clinically uninfected ulcers. However, physicians continue to prescribe antibiotics for clinically uninfected ulcers with the rationale ‘better to be safe than sorry’. Yet, antibiotic resistance is increasing, side-effects are common and treatment costs are rising. Evidence is needed to identify whether antibiotic treatment for clinically uninfected ulcers can be justified or we should stop prescribing them. The aim of this study was to evaluate whether antibiotic treatment in cases of clinically uninfected ulcers improved ulcer healing compared to treatment without antibiotics.

Method:

Consecutive patients treated in the outpatient clinic for clinically uninfected diabetic foot ulcer both in 2015 and in 2017 were retrospectively analysed. Primary outcome was ulcer healing at one year. Secondary outcomes were limb salvage, freedom from any amputation, amputation-free survival (AFS) and survival.

Results:

A total of 102 ulcers of 91 patients were included for final analyses. The non-antibiotics and antibiotics groups both consisted of 51 ulcers. Ulcer healing at one year was 77.3% in the non-antibiotics group and 74.7% in the antibiotics group (p=0.158). No difference was found for limb salvage (93.8% versus 95.9%, respectively; p=0.661), freedom from any amputation (85.6% versus 85.6%, respectively; p=1.000), AFS (85.4% versus 79.1%, respectively; p=0.460) or survival (89.6% versus 83.7%, respectively; p=0.426).

Conclusion:

In this study, no benefits of antibiotic treatment over non-antibiotic treatment for clinically uninfected ulcers were identified. The findings of this study emphasise the recommendation of current guidelines to not treat clinically uninfected ulcer with antibiotics.
Scalp wound management: a narrative review from a neurosurgical perspective
Authors: Cardona Santiago , Hernández Carolina , Bohórquez-Tarazona Maria Paz , Rubiano Andrés M , Parra Diana Marcela Sánchez
Published: February 2024

Objective:

This article aims to present a narrative review of current literature about the anatomical characteristics of the scalp as well as current practices in the management of surgical, traumatic and pressure injuries in the scalp, which are common in neurosurgery practice.

Method:

We searched PubMed for publications and book chapters in English from 2011 to 2021. We also included commonly referenced papers that we considered relevant to the subject with publication before these dates. We used the search terms ‘laceration,’ and/or ‘neurosurgery’ and/or, ‘pressure injury,’ and/or ‘craniotomy,’ and/or ‘surgical incision’ in combination with ‘scalp,’ and/or ‘wound care.’ We also searched the reference lists of publications identified by the search strategy and selected those that we judged relevant.

Results:

We pre-selected 52 articles that covered various aspects of anatomy, pathophysiology, scalp wound management, or general wound care that we considered applied to the anatomical region of our interest. After abstract review, we selected 34 articles that met our search criteria and were included in our review.

Conclusion:

There is limited evidence regarding classification and care of scalp wounds. As a result, many of the current practices for scalp wound management are based on evidence derived from studies involving different anatomical regions, not considering its particular anatomy, vasculature and microbiome. Further research is needed for more comprehensive and effective protocols for the management of scalp injuries. However, this present review proposes responses to the identified gaps concerning the management of scalp wounds.
RESEARCH ROUNDUP
Authors: Winter George
Published: February 2024

George Winter provides an overview of recently published articles that may be of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference is provided.
ROBOTIC-ASSISTED VERSUS MANUAL TOTAL HIP ARTHROPLASTY: PATIENT-REPORTED OUTCOME MEASURES AT 12 MONTHS
Authors: Ammori M. , Hancock S. , Talukdar P. , Munro C. , Johnston A.
Published: February 2024

The objectives of our study were to compare patient reported outcome measures between manual and robotic-assisted total hip arthroplasty.

Between 1st May 2021 and 31st August 2022, 539 consecutive patients who underwent 564 primary total hip arthroplasties were identified from the local registry database. Data were prospectively collected, and included patient demographics, American Society of Anaesthesiologists (ASA) grade, surgical approach, robotic-assistance, Oxford Hip Score (OHS), EQ-5D-3L and EQ-VAS pre-operatively and at twelve months.

Robotic-assistance, compared against manual total hip arthroplasty, was associated with an enhanced median (interquartile range) OHS (46 [42 – 48] vs 43 [36 – 47], p-value < 0.001), EQ-5D-3L (5 [5 – 7] vs 6 [5 – 8], p-value 0.002), and EQVAS (90 [75 – 95] vs 80 [70 – 90], p-value 0.003) at twelve months after surgery. Robotic-assistance was confirmed to be an independent predictor of a greater OHS at twelve months on a multivariate linear regression analysis (p-value 0.001).

Robotic assistance was superior to manual total hip arthroplasty in enhancing patient reported outcomes at twelve months after surgery.
A COMPARATIVE ANALYSIS OF MEMORY STAPLES AND COMPRESSION PLATE WITH CROSS SCREW FOR FIRST METATARSOPHALANGEAL (MTP) JOINT ARTHRODESIS: A QUANTIFICATION OF FUNCTIONAL OUTCOMES UTILIZING THE MANCHESTER–OXFORD FOOT QUESTIONNAIRE (MOXFQ)
Authors: Zaffar H. , Benjamin B. , Syed T. , Drampalos E.
Published: February 2024

Arthrodesis of the first metatarsophalangeal joint (MTPJ) is the most reliable surgical option, for hallux rigidus from end-stage osteoarthritis. The aim of the study was to compare the functional outcomes of memory nickel-titanium staples versus a compression plate with a cross screw construct for first MTPJ arthrodesis using the Manchester–Oxford Foot Questionnaire (MOXFQ).

Patients who underwent MTPJ arthrodesis using either memory nickel-titanium staples or a compression plate with a cross screw construct were identified from the surgical lists of two orthopaedic consultants. Pre and post-operative MOXFQ questionnaire, a validated patient-reported outcome measure, was administered, and responses were analysed to derive the MOXFQ summary index.

The study included 38 patients (staple group N=12 and plate and cross screw group N=26). 23 patients were female and 15 were male. Mean age was 64.8 years (SD 9.02; 40 to 82). Initial analysis showed no significant difference in preoperative MOXFQ scores between the groups (p = 0.04). Postoperatively, the staple group exhibited a mean improvement of 36.17, surpassing the plate group's mean improvement of 23. Paired t-test analysis revealed a statistically significant difference (t-score= 2.5, p = 0.008), favouring the use of staples.

The findings indicate that the use of staples in MTPJ arthrodesis resulted in a significantly greater improvement in MOXFQ scores compared to plates. Further research is needed to explore the underlying factors contributing to this difference and to evaluate long-term effects on patient outcomes.
Why do individuals in democratic societies support stringent policies? A narrative policy framework analysis
Authors: Liu Li-Yin , Yen Wei-Ting
Published: February 2024

Why do individuals in democratic societies voluntarily request and support stringent policies? What factors contribute to variations in support for different restrictive measures among citizens? This study examines the micro-level impact of the securitisation narrative on individuals’ voluntary support for stringent policies within a democratic context, using the narrative policy framework. Based on evidence from a conjoint experiment conducted in Taiwan, the study finds that agreeing with the narrative ‘COVID-19 is a national security threat’ does not translate into support for all types of restrictive measures. The contents of the securitisation narrative matter significantly; individuals who are more persuaded by the narratives are more likely to support border containment measures and mask mandates because of how narrative contents were structured. These findings highlight the importance for researchers and policymakers to carefully consider policy narrative contents to effectively communicate and garner support for a range of policies during times of crisis.
Beyond sovereignty as authority: the multiplicity of European approaches to digital sovereignty
Authors: Lambach Daniel , Monsees Linda
Published: February 2024

Digital Sovereignty is core to many contemporary debates on the regulation of digital technology, securing supply chains and strengthening the digital economy. In this paper, we focus on the European debates and policies around this project. We argue that the notion of digital sovereignty should be understood more as an overarching economic, societal and geopolitical project, rather than a project aimed at achieving any kind of political sovereignty or autarky in the digital sector. We arrive at this conclusion by analysing European policy documents and commentaries from various stakeholders for two cases: platform governance and semiconductors. The case of platform governance shows how the EU and its member states struggle to extend their regulatory power over the ‘data monopolies’ of the major Silicon Valley companies. The other is semiconductors, where the EU has kick-started several projects to improve the competitiveness of European manufacturers in a highly integrated global market. These examples demonstrate two things: a) that the pursuit of digital sovereignty does have some impact on the Internet (platform regulation) but also extends to other technological fields beyond it (semiconductors) and b) that digital sovereignty is not only a regulatory or technological project but also an economic, societal and geopolitical one.
Interdisciplinary team members’ experiences of family meetings in an Irish rehabilitation hospital: a social work action-research project
Authors: Donnelly Sarah , Butler Philomena , O’Loughlin Anne , Russell Eleanor , Carroll Paul
Published: February 2024

This study set out to gain a better understanding of how family meetings are facilitated and experienced in an Irish rehabilitation hospital setting from the perspectives of interdisciplinary team (IDT) members, patients and their family members. This article reports the findings from IDT members’ perspectives. A critical-realist action-research approach was utilised that involved medical social workers (N = 15) and a social work academic. A quantitative, descriptive study design was adopted, which utilised a cross-sectional survey of IDT members. A total of 85 clinical staff responded to the questionnaire, of which 69 were fully completed. Four key themes emerged: pre-meeting engagement and preparation – a critical step; the impact of organisational structures; supporting participation; and mechanisms for effective family meetings. Findings indicate the importance of pre-meeting preparation, the mutuality of the relationships between participants, a standardised approach and the use of patient-centred and inclusive practices to achieve truly participatory family meetings. Family meetings involve complex processes in which mutual influence, context, preferences, values, information shared, the nature of the relationships involved and the communicative style of participants all play significant roles in both the process and decision-making outcomes. This study concluded that social workers are perhaps in a unique position to work with IDTs in clarifying the reality of the limits of choice and the involvement of the patient and family in rehabilitation hospital settings. In preparation for the role of family-meeting facilitation, the implementation of education and training programmes for IDT members is strongly recommended.
Optimizing pharmacogenomic decision-making by data science
Authors: Behdani Amir M. , Lai Jessica , Kim Christina , Basalelah Lama , Halsey Trey , Donohoe Krista L. , Wijesinghe Dayanjan
Published: February 2024

Healthcare systems have made rapid progress towards combining data science with precision medicine, particularly in pharmacogenomics. With the lack of predictability in medication effectiveness from patient to patient, acquiring the specifics of their genotype would be highly advantageous for patient treatment. Genotype-guided dosing adjustment improves clinical decision-making and helps optimize doses to deliver medications with greater efficacy and within safe margins. Current databases demand extensive effort to locate relevant genetic dosing information. To address this problem, Patient Optimization Pharmacogenomics (POPGx) was constructed. The objective of this paper is to describe the development of POPGx, a tool to simplify the approach for healthcare providers to determine pharmacogenomic dosing recommendations for patients taking multiple medications. Additionally, this tool educates patients on how their allele variations may impact gene function in case they need further healthcare consultations. POPGx was created on Konstanz Information Miner (KNIME). KNIME is a modular environment that allows users to conduct code-free data analysis. The POPGx workflow can access Clinical Pharmacogenomics Implementation Consortium (CPIC) guidelines and subsequently be able to present relevant dosing and counseling information. A KNIME representational state transfer (REST) application program interface (API) node was established to retrieve information from CPIC and drugs that are exclusively metabolized through CYP450, and these drugs were processed simultaneously to demonstrate competency of the workflow. The POPGx program provides a time-efficient method for users to retrieve relevant, patient-specific medication selection and dosing recommendations. Users input metabolizer gene, genetic allele data, and medication list to retrieve clear dosing information. The program is automated to display current guideline recommendations from CPIC. The integration of this program into healthcare systems has the potential to revolutionize patient care by giving healthcare practitioners an easy way to prescribe medications with greater efficacy and safety by utilizing the latest advancements in the field of pharmacogenomics.
Infant feeding practices and risk of preschool obesity in AlAin, UAE: A cross-sectional study
Authors: AlTarrah Dana , Lanigan Julie , Feehan Jack , Al Dhaheri Ayesha S. , Shah Syed M. , Cheikh Ismail Leila , Singhal Atul
Published: February 2024

Early childhood obesity is serious public health problem, and poses a risk of obesity in later life. The study aimed to investigate whether infant feeding affects risk of overweight and obesity in preschool children in the United Arab Emirates (UAE). A cross-sectional study was carried out. Data was collected in a kindergarten in Al Ain, UAE. One hundred and fifty parents and preschool children aged 2 to 6 years participated in the study. Univariate and multivariate linear regression were used to investigate associations. A longer duration of breastfeeding and later introduction of complementary foods were associated with a lower BMI z-score in preschool children. Each month of any breastfeeding was associated with a lower BMI z-score in the unadjusted model (β = -0.03; 95% CI -0.05, -0.01; p = 0.01), and each month increase in the age of introducing complementary foods was associated with a lower BMI z-score in the unadjusted model (β = -0.43; 95% CI: -0.60 to—0.027; p<0.001). These associations remained after adjustment for potential confounding factors (age, sex, maternal BMI, maternal education level, mother’s age, social class, father’s BMI) for duration of breastfeedinig (β = -0.02; 95% CI: -0.05 to 0.00; p<0.001) and age of complementary feeding (β = -0.39; 95% CI: -0.57 to—0.21; p<0.001). Poor infant feeding practices (shorter duration of breastfeedinig and early introduction of complementary foods) were found to be associated with higher BMI in preschool children. Promoting appropriate proper infant feeding practices in line with recommendations could be one strategy to help prevent childhood obesity in the UAE.
A lesion in two: Buruli ulcer and squamous cell carcinoma coexistence
Authors: O’Keeffe Jessica C. , Yin Albert H. , O’Brien Daniel P.
Published: February 2024

The concurrent diagnoses of Buruli ulcer (BU) and cutaneous squamous cell carcinoma (SCC) is a phenomenon not previously described, despite the fact that both conditions are highly prevalent in Australia. This report presents an intriguing case of concurrent diagnoses, with clues alluding to more than one skin condition being present. The case involves a 73-year-old man with BU diagnosed on the scalp, an atypical location, which led to the consideration of malignancy, ultimately revealing concurrent SCC. This case highlights the importance of considering both conditions in patients with epidemiological risk factors, necessitating multiple lines of investigation for accurate diagnosis. Medical practitioners must remain vigilant and incorporate this possibility into their diagnostic algorithms for suspicious skin lesions to optimize treatment and outcomes. This is the first recorded instance of simultaneous diagnosis, underlining the need for enhanced awareness and attention to these unique cases.
A meta-analysis for the diagnostic accuracy of SelectMDx in prostate cancer
Authors: Wu Hanting , Wu Yanling , He Peijie , Liang Juan , Xu Xiujuan , Ji Conghua
Published: February 2024

To overview the diagnostic accuracy of SelectMDx for the detection of clinically significant prostate cancer and to review sources of methodologic variability. Four electronic databases, including PubMed, Embase, Web of Science, and Cochrane Library were searched for eligible studies investigating the diagnostic value of SelectMDx compared with the gold standard. The pooled sensitivity, specificity, and positive and negative predictive values were calculated. Included studies were assessed according to the Standards for Quality Assessment of Diagnostic Accuracy Studies 2 tool. The review identified 14 relevant publications with 2579 patients. All reports constituted phase 1 biomarker studies. Pooled analysis of findings found an area under the receiver operating characteristic analysis curve of 70% [95% CI, 66%-74%], a sensitivity of 81% [95% CI, 69%-89%], and a specificity of 52% [95% CI, 41%-63%]. The positive likelihood ratio was 1.68, and the negative predictive value is 0.37. Factors that may influence variability in test results included the breath collection method, the patient’s physiologic condition, the test environment, and the method of analysis. Considerable heterogeneity was observed among the studies owing to the difference in the sample size. SelectMDx appears to have moderate to good diagnostic accuracy in differentiating patients with clinically significant prostate cancer from people at high risk of developing prostate cancer. Higher-quality clinical studies assessing the diagnostic accuracy of SelectMDx for clinically significant cancer are still needed.
Evaluation of contrast sensitivity in visually impaired individuals using K-CS test. A novel smartphone-based contrast sensitivity test–Design and validation
Authors: Karampatakis Vasileios , P. Papadopoulou Eleni , Almpanidou Stavroula , Karamitopoulos Leonidas , Almaliotis Diamantis
Published: February 2024

Background

To describe the development and investigate the accuracy of a novel smartphone-based Contrast Sensitivity (CS) application, the K-CS test.

Methods

A total of 67 visually impaired and 50 normal participants were examined monocularly using the novel digital K-CS test and the Pelli-Robson (PR) chart. The K-CS test examines letter contrast sensitivity in logarithmic units, using eight levels of contrast from logCS = ~0,1 to logCS = ~2,1 at two spatial frequencies of 1.5 and 3 cycles per degree (cpd). The K-CS test was compared to the gold standard, PR test and intra-session test repeatability was also examined.

Results

The K-CS test in normally sighted was found to agree well with the PR, providing comparable mean scores in logCS (±SD) (K-CS = 1.908 ± 0.06 versus PR = 1.93 ± 0.05) at 1.5 cpd and mean (± SD) logCS at 3 cpd (K-CS = 1.83 ± 0.13 versus PR = 1.86 ± 0.07). The mean best corrected visual acuity of visually impaired participants was 0.67 LogMAR (SD = 0.21) and the K-CS was also found to agree well with the Pelli-Robson in this group, with an equivalent mean (±SD) logCS at 1.5 cpd: (K-CS = 1.19 ± 0.27, PR = 1.15 ± 0.31), 3 cpd: K-CS = 1.01 ± 0.33, PR = 0.94 ± 0.34. Regarding the intra-session test repeatability, both the K-CS test and the PR test showed good repeatability in terms of the 95% limits of agreement (LoA): K-CS = ±0.112 at 1.5 cpd and ±0.133 at 3 cpd, PR = ±0.143 at 1.5 cpd and ±0.183 in 3 cpd in visually impaired individuals.

Conclusion

The K-CS test provides a quick assessment of the CS both in normally sighted and visually impaired individuals. The K-CS could serve as an alternative tool to assess contrast sensitivity function using a smartphone and provides results that agree well with the commonly used PR test.
Assessing the validity of the zero-velocity update method for sprinting speeds
Authors: Aristizábal Pla Gerard , Martini Douglas N. , Potter Michael V. , Hoogkamer Wouter
Published: February 2024

The zero-velocity update (ZUPT) method has become a popular approach to estimate foot kinematics from foot worn inertial measurement units (IMUs) during walking and running. However, the accuracy of the ZUPT method for stride parameters at sprinting speeds remains unknown, specifically when using sensors with characteristics well suited for sprinting (i.e., high accelerometer and gyroscope ranges and sampling rates). Seventeen participants performed 80-meter track sprints while wearing a Blue Trident IMeasureU IMU. Two cameras, at 20 and 70 meters from the start, were used to validate the ZUPT method on a stride-by-stride and on a cumulative distance basis. In particular, the validity of the ZUPT method was assessed for: (1) estimating a single stride length attained near the end of an 80m sprint (i.e., stride at 70m); (2) estimating cumulative distance from ∼20 to ∼70 m; and (3) estimating total distance traveled for an 80-meter track sprint. Individual stride length errors at the 70-meter mark were within -6% to 3%, with a bias of -0.27%. Cumulative distance errors were within -4 to 2%, with biases ranging from -0.85 to -1.22%. The results of this study demonstrate the ZUPT method provides accurate estimates of stride length and cumulative distance traveled for sprinting speeds.
Same-day versus rapid ART initiation in HIV-positive individuals presenting with symptoms of tuberculosis: Protocol for an open-label randomized non-inferiority trial in Lesotho and Malawi
Authors: Gerber Felix , Semphere Robina , Lukau Blaise , Mahlatsi Palesa , Mtenga Timeo , Lee Tristan , Kohler Maurus , Glass Tracy Renée , Amstutz Alain , Molatelle Mamello , MacPherson Peter , Marake Nthuseng Bridgett , Nliwasa Marriot , Ayakaka Irene , Burke Rachael , Labhardt Niklaus
Published: February 2024

Background

In absence of contraindications, same-day initiation (SDI) of antiretroviral therapy (ART) is recommended for people testing HIV-positive who are ready to start treatment. Until 2021, World Health Organization (WHO) guidelines considered the presence of TB symptoms (presumptive TB) a contraindication to SDI due to the risk of TB-immune reconstitution inflammatory syndrome (TB-IRIS). To reduce TB-IRIS risk, ART initiation was recommended to be postponed until results of TB investigations were available, and TB treatment initiated if active TB was confirmed. In 2021, the WHO guidelines changed to recommending SDI even in the presence of TB symptoms without awaiting results of TB investigations based on the assumption that TB investigations often unnecessarily delay ART initiation, increasing the risk for pre-ART attrition from care, and noting that the clinical relevance of TB-IRIS outside the central nervous system remains unclear. However, this guideline change was not based on conclusive evidence, and it remains unclear whether SDI of ART or TB test results should be prioritized in people with HIV (PWH) and presumptive TB.

Design and methods

SaDAPT is an open-label, pragmatic, parallel, 1:1 individually randomized, non-inferiority trial comparing two strategies for the timing of ART initiation in PWH with presumptive TB (“ART first” versus “TB results first”). PWH in Lesotho and Malawi, aged 12 years and older (re)initiating ART who have at least one TB symptom (cough, fever, night sweats or weight loss) and no signs of intracranial infection are eligible. After a baseline assessment, participants in the “ART first” arm will be offered SDI of ART, while those in the “TB results first” arm will be offered ART only after active TB has been confirmed or refuted. We hypothesize that the “ART first” approach is safe and non-inferior to the “TB results first” approach with regard to HIV viral suppression (<400 copies/ml) six months after enrolment. Secondary outcomes include retention in care and adverse events consistent with TB-IRIS.

Expected outcomes

SaDAPT will provide evidence on the safety and effects of SDI of ART in PWH with presumptive TB in a pragmatic clinical trial setting.

Trial registration

The trial has been registered on clinicaltrials.gov (NCT05452616; July 11 2022).
Residual current detection method based on improved VMD-BPNN
Authors: Bai Yunpeng , Zhang Xiangke , Wang Yajing , Wang Lei , Wei Qinqin , Zhao Wenlei
Published: February 2024

To further enhance the residual current detection capability of low-voltage distribution networks, an improved adaptive residual current detection method that combines variational modal decomposition (VMD) and BP neural network (BPNN) is proposed. Firstly, the method employs the envelope entropy as the adaptability function, optimizes the [k, ɑ] combination value of the VMD decomposition using the bacterial foraging-particle swarm algorithm (BFO-PSO), and utilizes the interrelation number R as the classification index with the Least Mean Square Algorithm (LMS) to classify, filter, and extract the effective signal from the decomposed signal. Then, the extracted signals are detected by BPNN, and the training data are utilized to predict the residual current signals. Simulation and experimental data demonstrate that the proposed algorithm exhibits strong robustness and high detection accuracy. With an ambient noise of 10dB, the signal-to-noise ratio is 16.3108dB, the RMSE is 0.4359, and the goodness-of-fit is 0.9627 after processing by the algorithm presented in this paper, which are superior to the Variational Modal Decomposition-Long Short-Term Memory (VMD-LSTM) and Normalized-Least Mean Square (N-LMS) detection methods. The results were also statistically analyzed in conjunction with the Kolmogorov-Smirnov test, which demonstrated significance at the experimental data level, indicating the high accuracy of the algorithms presented in this paper and providing a certain reference for new residual current protection devices for biological body electrocution.
Temporary childbirth migration and maternal health care in India
Authors: Diamond-Smith Nadia , Gopalakrishnan Lakshmi , Patil Sumeet , Fernald Lia , Menon Purnima , Walker Dilys , El Ayadi Alison M.
Published: February 2024

Background

Women in South Asia often return to their natal home during pregnancy, for childbirth, and stay through the postpartum period—potentially impacting access to health care and health outcomes in this important period. However, this phenomenon is understudied (and not even named) in the demographic or health literature, nor do we know how it impacts health.

Objective

The aim of this study is to measure the magnitude, timing, duration, risk factors and impact on care of this phenomenon, which we name Temporary Childbirth Migration.

Methods

Using data from 9,033 pregnant and postpartum women collected in 2019 in two large states of India (Madhya Pradesh and Bihar) we achieve these aims using descriptive statistics and logistic regression models, combined with qualitative data from community health workers about this practice.

Results

We find that about one third of women return to their natal home at some point in pregnancy or postpartum, mostly clustered close to the time of delivery. Younger, primiparous, and non-Hindu women were more likely to return to their natal home. Women reported that they went to their natal home because they believed that they would receive better care; this was born out by our analysis in Bihar, but not Madhya Pradesh, for prenatal care.

Conclusions

Temporary childbirth migration is common, and, contrary to expectations, did not lead to disruptions in care, but rather led to more access to care.

Contribution

We describe a hitherto un-named, underexplored yet common phenomenon that has implications for health care use and potentially health outcomes.
Sustained antibacterial activity of orthodontic elastomeric ligature ties coated with a novel kombucha-derived bacterial nanocellulose: An in-vitro study
Authors: Eskandari Fateme , Borzou Susan , Razavian Alireza , Babanouri Neda , Yousefi Khadije
Published: February 2024

Incipient carious lesions, the most common complication in orthodontic patients with fixed appliances, call for the development of novel preventive dental materials that do not rely on patient adherence. The present study aimed to assess the ability of elastomeric ligatures coated with bacterial nanocellulose (BNC) to deliver sustained antibacterial activity, during the standard 28-day interval between orthodontic appointments, without compromising their mechanical properties. Kombucha membrane was used to produce cellulose as a secondary product from the fermentation of tea broth with symbiotic bacteria and yeast culture. Characterization of BNC-coated elastomeric ligatures was performed using Fourier Transform Infrared Spectroscopy and Energy Dispersive Spectroscopy analysis. The samples were pre-treated by immersion first in isopropyl alcohol, then in 8 mL nanocellulose solution for 7 days. Tensile strain and strength of the BNC-coated and conventional ligatures were evaluated using a tensile testing machine. Direct contact and agar diffusion tests were performed to assess the antibacterial activity of nanocellulose. In addition, the release profile of BNC was evaluated. Data analysis was performed by one-way analysis of variance (ANOVA) followed by post-hoc Tukey’s test and Wilcoxon signed-rank test. P values less than 0.05 was regarded as significant. There was no statistically significant difference in tensile strain and strength between the BNC-coated and conventional ligatures. The coated ligatures provided sustained antibacterial activity during the required 28 days. The use of BNC-coated elastomeric ligatures in patients with fixed orthodontic appliances might be a promising solution to plaque formation and subsequent enamel decalcification.
Motivation communication training programme for healthcare professionals to support adherence in patients with diabetic foot ulcers: Proof of concept study
Authors: Hancox Jennie E. , Chaplin Wendy J. , Hilton Charlotte E. , Vadaszy Noemi , Gray Katie , Game Fran , Vedhara Kavita
Published: February 2024

Patients with diabetic foot ulcers have poor adherence to treatment recommendations. However, the most effective way to support adherence in this population is unknown. This study aimed to assess the preliminary effectiveness of a motivation communication training programme for healthcare professionals working with these patients, using theory and evidence-based strategies.A proof-of-concept study using a non-randomised, controlled before-and-after design. Six podiatrists took part in the motivation communication training programme. Pre-training, observation was undertaken to examine the communication style currently used by podiatrists in routine consultations. Patients’ (n = 25) perceptions of podiatrist autonomy support, self-determination for limiting weight-bearing activity and average daily step count were also assessed. Post training, observations and patient measures were repeated with a different group of patients (n = 24). Observations indicated that podiatrists exhibited a more need-supportive communication style (e.g., taking time to understand patients’ perspectives) after undergoing the training programme. Patients in the post-training group reported higher levels of autonomy support, while self-determination to limit weight-bearing activity remained unchanged. Although the post-training group had a lower average daily step count, the difference was not statistically significant. This is the first study to investigate implementation of motivation communication strategies in routine consultations with patients with diabetic foot ulcers. Results suggest that training can enhance healthcare professionals’ motivation communication skills with potential for addressing adherence issues, however, a larger cluster randomised controlled trial is necessary to confirm this.
Working dogs in dynamic on-duty environments: The impact of dark adaptation, strobe lighting and acoustic distraction on task performance
Authors: Sheldon Elizabeth L. , Hart Carla J. , Wilkinson Anna , Soulsbury Carl , Ratcliffe Victoria F. , Mills Daniel S.
Published: February 2024

Sudden changes in sound and light (e.g., sirens and flashing police beacons) are a common component of working dogs’ on-duty environment. Yet, how such stimuli impact dogs’ ability to perform physical and cognitive tasks has not been explored. To address this shortcoming, we compared the accuracy and time taken for twelve dogs to complete a complex physical and cognitive task, before, during and after exposure to three ‘real-world’ stimuli: an acoustic distractor (85dB), white strobe lighting (5, 10 & 15 Hz), and exposure to a dazzling white, red, or blue lights. We found that strobe lighting, and to a greater extent, acoustic distraction, significantly reduced dogs’ physical performance. Acoustic distraction also tended to impair dogs’ cognitive performance. Dazzling lights had no effect on task performance. Most (nine out of twelve) dogs sensitised to the acoustic distraction to the extent of non-participation in the rewarded task. Our results suggest that without effective distractor response training, sudden changes in noise and flickering lights are likely to impede cognitive and physical task performance in working dogs. Repeated uncontrolled exposure may also amplify these effects.
Mechanistic role of alpha oscillations in a computational model of working memory
Authors: Soroka Gustavo , Idiart Marco , Villavicencio Aline
Published: February 2024

Brain oscillations are believed to be involved in the different operations necessary to manipulate information during working memory tasks. We propose a mechanistic role for the observed inhibition effect of the alpha rhythm based on its interference with the theta rhythm. Using the Lisman-Idiart model for multi-item working memory, we show that the interaction between these two oscillations is capable of creating a long lasting destructive interference that prevents the cyclic reactivation of neuronal ensembles and, as a consequence, memory maintenance. Additionally, to ensure robustness we propose a modular version of the model and implement oscillations as traveling waves. Using this model, we show that the interactions between theta and gamma determine the allocation of multiple memories in distinct modules, while the interference between theta and alpha disrupts the maintenance of the information already stored in them. The effect of alpha in erasing or blocking storage is robust and seems fairly independent of frequency, as long as it stays within the alpha range. This model helps us to understand why the alpha and theta oscillations, which have close frequency bands, could have opposite roles in working memory.
Urban rats are the ‘fall-guy’: Resident motivations for municipal rat complaints
Authors: Lee Michael Joseph , Byers Kaylee A. , Guo Xiaocong , Lee Lisa K. F. , Cox Susan M. , Himsworth Chelsea G.
Published: February 2024

Rats are an important issue in cities globally. Despite their ubiquity, perceptions and concerns about rats vary with circumstance and the context in which a person interacts with them. Municipal rat management programs are a service to communities and therefore must be responsive to the varied concerns of their residents. Understanding why communities are concerned about rats can help inform rat management programs to meet the specific needs of their residents. The objective of this study was to identify why the residents of Vancouver, Canada care about rats and what they want done to address them. To do this, we qualitatively analyzed 6,158 resident complaints about rats made to the city’s municipal government between January 2014 and May 2020. Using a qualitative descriptive coding process, we found that rats were a priority in a minority of cases. In general, people were more concerned about broader community issues, such as neighborhood disorder, of which rats were one part. Complaints tended to be made when problems were highly visible, nearby, and when the complainant wanted the city to take action to alleviate this issue, particularly when they were in and around their living spaces. The rates of complaints were highest in the most economically and socially deprived neighborhoods and lowest in the most privileged neighbourhoods. We synthesize this information with a view towards understanding how to develop objectives and actions for municipal management strategies that are grounded in community concerns.
Predictors for estimating subcortical EEG responses to continuous speech
Authors: Kulasingham Joshua P. , Bachmann Florine L. , Eskelund Kasper , Enqvist Martin , Innes-Brown Hamish , Alickovic Emina
Published: February 2024

Perception of sounds and speech involves structures in the auditory brainstem that rapidly process ongoing auditory stimuli. The role of these structures in speech processing can be investigated by measuring their electrical activity using scalp-mounted electrodes. However, typical analysis methods involve averaging neural responses to many short repetitive stimuli that bear little relevance to daily listening environments. Recently, subcortical responses to more ecologically relevant continuous speech were detected using linear encoding models. These methods estimate the temporal response function (TRF), which is a regression model that minimises the error between the measured neural signal and a predictor derived from the stimulus. Using predictors that model the highly non-linear peripheral auditory system may improve linear TRF estimation accuracy and peak detection. Here, we compare predictors from both simple and complex peripheral auditory models for estimating brainstem TRFs on electroencephalography (EEG) data from 24 participants listening to continuous speech. We also investigate the data length required for estimating subcortical TRFs, and find that around 12 minutes of data is sufficient for clear wave V peaks (>3 dB SNR) to be seen in nearly all participants. Interestingly, predictors derived from simple filterbank-based models of the peripheral auditory system yield TRF wave V peak SNRs that are not significantly different from those estimated using a complex model of the auditory nerve, provided that the nonlinear effects of adaptation in the auditory system are appropriately modelled. Crucially, computing predictors from these simpler models is more than 50 times faster compared to the complex model. This work paves the way for efficient modelling and detection of subcortical processing of continuous speech, which may lead to improved diagnosis metrics for hearing impairment and assistive hearing technology.
Gender-based stigma and the prevention and treatment of HIV/AIDS among older women: A scoping review protocol
Authors: Vu Thi , Manalel Jasmine , Nyhan Kate , Wang Katie , Monin Joan
Published: February 2024

Introduction

The population of women aged 50 years and older living with HIV is increasing. Older women face unique challenges in the prevention and management of HIV; however, they are often under engaged in HIV/AIDS research. One such challenge is gender-based stigma, which can be manifested through harmful gendered stereotypes, discrimination, prejudice, and sexism that could potentially hinder HIV care engagement among this population. We propose a scoping review to identify and synthesize evidence pertaining to how experiences of gender-based stigma impacts HIV prevention and care among older women.

Materials and methods

We will use the framework by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) to conduct this scoping review. We will search MEDLINE/PubMed, Web of Science, PsycINFO, CINAHL and Scopus for empirical literature published between January 1981 and the date of search commencement. Supplementary screening will be conducted using backwards citation chaining of the final list of included full-text articles. Two reviewers will independently screen all titles and abstracts for articles that meet the predetermined inclusion criteria. Two reviewers will also screen full-text articles and chart data using a standardized data collection form.

Results

We will synthesize the findings through tables, charts, and narrative summaries. We will also identify gaps in the current literature and provide recommendations for future research. Findings will be shared at conferences and submitted to a peer-reviewed publication.

Discussion

To our knowledge, this will be the first scoping review to examine gender-based stigma in relation to HIV prevention and care among older women. We anticipate that our results will be of interest to older women living with HIV, healthcare providers, policy makers, and community activists working to improve quality of life and care experiences for older women living with HIV.
The multiplicity of thioredoxin systems meets the specific lifestyles of Clostridia
Authors: Anjou Cyril , Lotoux Aurélie , Zhukova Anna , Royer Marie , Caulat Léo C. , Capuzzo Elena , Morvan Claire , Martin-Verstraete Isabelle
Published: February 2024

Cells are unceasingly confronted by oxidative stresses that oxidize proteins on their cysteines. The thioredoxin (Trx) system, which is a ubiquitous system for thiol and protein repair, is composed of a thioredoxin (TrxA) and a thioredoxin reductase (TrxB). TrxAs reduce disulfide bonds of oxidized proteins and are then usually recycled by a single pleiotropic NAD(P)H-dependent TrxB (NTR). In this work, we first analyzed the composition of Trx systems across Bacteria. Most bacteria have only one NTR, but organisms in some Phyla have several TrxBs. In Firmicutes, multiple TrxBs are observed only in Clostridia, with another peculiarity being the existence of ferredoxin-dependent TrxBs. We used Clostridioides difficile, a pathogenic sporulating anaerobic Firmicutes, as a model to investigate the biological relevance of TrxB multiplicity. Three TrxAs and three TrxBs are present in the 630Δerm strain. We showed that two systems are involved in the response to infection-related stresses, allowing the survival of vegetative cells exposed to oxygen, inflammation-related molecules and bile salts. A fourth TrxB copy present in some strains also contributes to the stress-response arsenal. One of the conserved stress-response Trx system was found to be present both in vegetative cells and in the spores and is under a dual transcriptional control by vegetative cell and sporulation sigma factors. This Trx system contributes to spore survival to hypochlorite and ensure proper germination in the presence of oxygen. Finally, we found that the third Trx system contributes to sporulation through the recycling of the glycine-reductase, a Stickland pathway enzyme that allows the consumption of glycine and contributes to sporulation. Altogether, we showed that Trx systems are produced under the control of various regulatory signals and respond to different regulatory networks. The multiplicity of Trx systems and the diversity of TrxBs most likely meet specific needs of Clostridia in adaptation to strong stress exposure, sporulation and Stickland pathways.
Consolidação dos estados nacionais Sul-americanos a partir das fronteiras e da integração regional
Authors: Dhenin Miguel
Published: February 2024

Esse artigo tem como propósito principal oferecer aos leitores um panorama amplo do processo de consolidação das fronteiras sul-americanas à luz da integração regional, desde o começo do século XVI até os dias atuais. Para tal, mobilizamos elementos conceituais oriundos do campo da história e da geopolítica para analisar as principais evoluções e linhas de pensamento utilizadas durante o processo de construção da América do Sul. O argumento do artigo é que a dinâmica regional resulta da tensão (ou dialética) entre os centros (geo)políticos e as áreas de fronteiras, inserindo-se nos processos de consolidação interna das nações sul-americanas. Como resultado, podemos afirmar a resistência histórica, por parte das nações do continente sul-americano, em aprofundar politicamente o processo de integração regional, particularmente à luz da experiência vivenciada durante a pandemia global.
Aplicativos de mensagens instantâneas, um potencial no fluxo de informação entre bibliotecas
Authors: Almeida Aline Christian Pimentel , Santos Simone de Fátima Rodrigues dos
Published: February 2024

A pesquisa busca refletir sobre a importância nos fluxos informacionais entre Bibliotecas do Instituto Federal do Pará, investigando como as tecnologias de aplicativo de mensagens instantâneas podem potencializar esses fluxos, tal como as atividades desses setores, otimizando o tempo de respostas em demandas pontuais ou na tomada de decisão. O objetivo geral visa verificar as percepções dos servidores sobre o uso de aplicativos de mensagens, como ferramenta potencial nos fluxos de informação. Os objetivos específicos são constatar os níveis, as direções e os tipos de fluxos informacionais que circulam nessa tecnologia; identificar os canais de comunicação interna utilizados no Instituto e; categorizar os elementos representativos detectados nesse fluxo. Desenvolveu-se um estudo de caso, caracterizado como uma pesquisa qualitativa, abrangendo as seguintes etapas; elaboração e gerenciamento do questionário pela ferramenta Google Forms© e aplicação em um grupo de servidores do citado Instituto que trabalham nas bibliotecas; representação dos resultados e; a elaboração do quadro de fatores que envolve o fluxo de informação do processo comunicativo entre essas bibliotecas. O estudo concluiu que os participantes acessam com frequência os grupos de mensagens instantâneas do trabalho, principalmente para tirarem dúvidas vinculadas aos seus setores, a maioria considera essa ferramenta eficiente e com tempo de resposta satisfatório, considerando-a uma tecnologia potencial na comunicação interna em organizações. Conclui-se que o processo de comunicação interna e seus fluxos informacionais são essenciais para o sucesso em qualquer atividade, com características complexas, que apresentam aspectos positivos e negativos, podendo ocorrer com fluidez ou não, e isso dependerá da sincronia dos elementos envolvidos.