bluuebunny/crossref_metadata_2025 huggingface dataset:
An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes
Authors: Lynch-Godrei Anisha , Sapkota Sudhir , Rowe Jennifer , Paudel Bishnu Dutta , Aryal Garima , Doherty Megan
Published: February 2024

OBJECTIVES

The goal of this implementation study was to describe the implementation and evaluation of the impact of an online pediatric palliative care training program in Nepal, using the Project ECHO model.

METHODS

The study used mixed methods, including a program case study describing the online learning program and before-and-after surveys of program participants, assessing learning through changes in knowledge, comfort, and attitudes. An end-of-program survey was used to evaluate participants’ overall experiences with the learning program and use of the learning resources.

RESULTS

A literature review, stakeholder surveys, and expert input informed the design of the intervention. The course used the Project ECHO model of online education, with modifications based on the leadership team's previous ECHO experiences and local stakeholder input. The intervention occurred over 9 months, with 22 online teaching sessions. Each session consisted of a didactic lecture, case presentation, and interactive discussion with expert clinical teachers. Fifty-five clinicians in Nepal participated, including physicians (47%), nurses (44%), and psychotherapists (5%). Clinicians reported improvements in knowledge, skills, and attitudes after program participation. Program acceptability scores were high, with 93% of participants reporting that the course provided effective learning.

CONCLUSIONS

Project ECHO can be successfully implemented to deliver continuing professional development in Nepal. Delivering palliative care education online using the Project ECHO model, leads to improved knowledge, skills, and attitudes for clinicians. Project ECHO suggests an innovative solution which can provide training and support to clinicians in settings where educational opportunities in palliative care are limited.
OSBP is a Major Determinant of Golgi Phosphatidylinositol 4-Phosphate Homeostasis
Authors: Doyle Colleen P. , Timple Liz , Hammond Gerald R. V.
Published: February 2024

The lipid phosphatidylinositol 4-phosphate (PI4P) plays a master regulatory role at Golgi membranes, orchestrating membrane budding, non-vesicular lipid transport and membrane organization. It follows that harmonious Golgi function requires strictly maintained PI4P homeostasis. One of the most abundant PI4P effector proteins is the oxysterol binding protein (OSBP), a lipid transfer protein that exchanges trans-Golgi PI4P for ER cholesterol. Although this protein consumes PI4P as part of its lipid anti-porter function, whether it actively contributes to Golgi PI4P homeostasis has been questioned. Here, we employed a series of acute and chronic genetic manipulations, together with orthogonal targeting of OSBP, to interrogate its control over Golgi PI4P abundance. Modulating OSBP levels at ER:Golgi membrane contact sites produces reciprocal changes in PI4P levels. Additionally, we observe that OSBP has a high capacity for PI4P turnover, even at orthogonal organelle membranes. However, despite also visiting the plasma membrane, endogenous OSBP makes no impact on PI4P levels in this compartment. We conclude that OSBP is a major determinant of Golgi PI4P homeostasis.
Brown syndrome: a literature review
Authors: Khorrami-Nejad Masoud , Azizi Elham , Tarik Farah Fareed , Akbari Mohamad Reza
Published: February 2024

The current data on various aspects of Brown syndrome are limited and sporadic. This review provides a coherent and comprehensive review of basic features, etiology, classification, differential diagnosis, and different management strategies of patients with Brown syndrome. In this topical review, PubMed, Scopus, and Google Scholar search engines were searched for papers, published between 1950 and January 2023 based on the keywords of this article. The related articles were collected, summarized, categorized, assessed, concluded, and presented. Brown syndrome is identified by restricted passive and active elevation of the eye in adduction. The condition is divided into congenital and acquired causes. The clinical features result from a restricted motion of the superior oblique tendon sheath through the trochlea while trying to look up in adduction. The newest explanation of the underlying pathophysiology has been explained as the presence of a fibrotic strand in the superior oblique muscle tendon with variable insertion sites which creates various elevation deficits seen in Brown syndrome. The most common clinical features include the presence of an abnormal head posture, V-pattern strabismus, and hypotropia in the primary position. Management of Brown syndrome includes watchful observation, surgical, and non-surgical procedures. Some cases might resolve spontaneously without any intervention; however, some acquired cases might require systemic and/or intra-trochlear steroid administration to treat the underlying causes. Surgical procedures such as superior oblique tenectomy and using a silicon tendon expander are indicated in the presence of hypotropia and significant abnormal head posture in the primary position.
Cross-Cultural Validation of the Arabic Short-Form McGill Pain Questionnaire (SF-MPQ): Libyan Version in Patients With Musculoskeletal Pain
Authors: Jahan Alhadi M , Rwaiha Ali E , Anaiba Salima M , Alghoul Rasha A
Published: February 2024

Background:

The Short-form McGill Pain Questionnaire (SF-MPQ) is a widely used tool for assessing musculoskeletal pain, both in research and clinical practice. However, a culturally appropriate Arabic version for the Libyan context has not been available. This study aims to translate the SF-MPQ, and to examine its reliability and validity for assessing musculoskeletal pain in Libya.

Methods:

The SF-MPQ was cross-culturally adapted into Arabic using a forward-backward method. A total of 151 patients (Mean age ± SD = 40.66 ± 14) with musculoskeletal pain completed the SF-MPQ and other measures. Of these, 148 patients completed the second round of questionnaire completion two days after the first visit. The intraclass correlation coefficient (ICC) was used to examine relative test-retest reliability and Bland-Altman plots was performed to examine absolute agreement between the two assessments. Spearman’s correlation was applied to assess construct validity.

Results:

The Arabic translation of the SF-MPQ was linguistically equivalent, without significant discrepancies. All but two of the Arabic descriptors were used by more than 33% of the participants, indicating good item measurement equivalency. The results showed a satisfactory Cronbach’s α (0.74 for the total score), which indicates good internal consistency. The ICC for the total score revealed a high correlation for the test-retest (0.91), suggesting excellent relative reliability. Bland-Altman analyses showed no significant systematic bias between the repeated measurements. There were positive statistically significant correlations among the SF-MPQ, the Visual Analog Scale, and the Fatigue Severity Scale ( P < 0.001), demonstrating good construct validity.

Conclusion:

These results suggest that the Arabic SF-MPQ is reliable, valid, and cross-culturally equivalent to the original SF-MPQ for evaluating musculoskeletal pain among Arabic-speaking patients in Libya. Clinicians and researchers may therefore consider using this scale, as it is easy to use and understand by different age groups. Further research is needed to confirm our findings and to test the developed Arabic version of the SF-MPQ on different patient populations.
Seeing the city and democracy: A commentary
Authors: Magnusson Warren
Published: February 2024

When the idea of democracy went through its revival in the early modern period, it was eventually attached to the ideal of the state – a legal order that restrained popular enthusiasm and that could exist on any scale. The common assumption was that any viable political order had to be on a relatively large scale if it was to persist in the face of external challenges and deal effectively with modern problems. The implication was that it had to transcend the city. Beveridge and Koch challenge these modern assumptions, suggesting that urbanization re-establishes the connection between democracy and urban life. Although they focus on the stakes and conditions of a form of life that transcends both city and state, they still insist that we should see democracy ‘like a city’. Does seeing democracy like a city help us understand how such issues might be resolved democratically? I hope so, but my hopes are often sorely tested.
Daratumumab, carfilzomib, lenalidomide, and dexamethasone with tandem transplant for high-risk newly diagnosed myeloma
Authors: Touzeau Cyrille , Perrot Aurore , Hulin Cyrille , Manier Salomon , Macro Margaret , Chretien Marie-Lorraine , Karlin Lionel , Escoffre Martine , Jacquet Caroline , Tiab Mourad , Leleu Xavier , Avet-Loiseau Herve , Jobert Alexandra , Planche Lucie , Corre Jill , Moreau Philippe
Published: February 2024

High-risk (HR) cytogenetics are associated with poor outcomes in newly diagnosed multiple myeloma (NDMM), and dedicated studies should address this difficult-to-treat population. The phase 2 study 2018-04 from the Intergroupe Francophone du Myelome evaluated feasibility of an intensive strategy with quadruplet induction and consolidation plus tandem transplant in HR transplant-eligible (TE) NDMM. HR cytogenetics were defined by presence of del(17p), t(4;14), and/or t(14;16). Treatment consisted of daratumumab-carfilzomib-lenalidomide-dexamethasone (D-KRd) induction, autologous stem cell transplantation (ASCT), D-KRd consolidation, second ASCT, and daratumumab-lenalidomide maintenance. The primary end point was feasibility. Fifty patients with previously untreated NDMM were included. Median age was 57. Del(17p), t(4;14), and t(14;16) were found in 40%, 52%, and 20% of patients, respectively. At data cutoff, the study met the primary end point with 36 patients completing second transplant. Twenty patients discontinued the study due to stem cell collection failure (n = 8), disease progression (n = 7), adverse event (n = 4), or consent withdrawal (n = 1). Grade 3 to 4 D-KRd induction/consolidation–related adverse events (>5% of patients) were neutropenia (39%), anemia (12%), thrombocytopenia (7%), and infection (6%). The overall response rate was 100% for patients completing second transplant, including 81% complete response. Premaintenance minimal residual disease (MRD) negativity rate (10–6) was 94%. After a median follow-up of 33 months, the 30-month progression-free survival (PFS) and overall survival were 80% and 91%, respectively. In conclusion, D-KRd with tandem transplant is feasible in patients with HR TE-NDMM and resulted in high response rates and PFS. This trial was registered at www.clinicaltrials.gov as #NCT03606577.
Spatial–temporal evolution and land use transition of rural settlements in mountainous counties
Authors: Chen Song , Wang Xiyue , Qiang Yi , Lin Qing
Published: February 2024

Background

Rural settlements are undergoing significant changes under the rapid urbanisation, and understanding their evolution characteristics and surrounding land use will provide a basis for land spatial planning. This study takes Pingnan County, Fujian Province, China as study area, reveals the characteristics of spatial–temporal evolution and surrounding land use transition of settlements during 1985–2020 through landscape metrics, spatial “hot spot” analysis, scale classification statistics, rank-size model, Gini index, land use transition matrix.

Results

The results show that: (1) Concerning the size and morphological characteristics, the settlements have witnessed a considerable increase in number and scale while remaining stable in shape. (2) Regarding spatial distribution characteristics, the settlements became more evenly spread, forming three main hotspot clusters. (3) Concerning scale structure characteristics, there are significant differences in scale, growth rates, and polarisation of settlements; the polarisation of large settlements shifted from a marked divergence before 2010 to a more balanced trend after 2010. (4) The land use transition around settlements differed in buffer zones and periods. During 1985–2010, settlement expansion heavily depended on cropland, depleting nearby resources, with an increase of woodland and grassland. During 2010–2020, expansion integrated cropland, woodland, and grassland, with cropland growth mainly encroaching on woodland and grassland.

Conclusions

The study's findings are significant for optimising rural settlement structure in mountains and promoting sustainable land resource use.
Mining and functional characterization of NADPH-cytochrome P450 reductases of the DNJ biosynthetic pathway in mulberry leaves
Authors: Liao Yangzhen , Du Wenmin , Wan Jingqiong , Fan Jiahe , Pi Jilan , Wu Min , Wei Yuan , Ouyang Zhen
Published: February 2024

Background

1-Deoxynojirimycin (DNJ), the main active ingredient in mulberry leaves, with wide applications in the medicine and food industries due to its significant functions in lowering blood sugar, and lipids, and combating viral infections. Cytochrome P450 is a key enzyme for DNJ biosynthesis, its activity depends on the electron supply of NADPH-cytochrome P450 reductases (CPRs). However, the gene for MaCPRs in mulberry leaves remains unknown.

Results

In this study, we successfully cloned and functionally characterized two key genes, MaCPR1 and MaCPR2, based on the transcriptional profile of mulberry leaves. The MaCPR1 gene comprised 2064 bp, with its open reading frame (ORF) encoding 687 amino acids. The MaCPR2 gene comprised 2148 bp, and its ORF encoding 715 amino acids. The phylogenetic tree indicates that MaCPR1 and MaCPR2 belong to Class I and Class II, respectively. In vitro, we found that the recombinant enzymes MaCPR2 protein could reduce cytochrome c and ferricyanide using NADPH as an electron donor, while MaCPR1 did not. In yeast, heterologous co-expression indicates that MaCPR2 delivers electrons to MaC3'H hydroxylase, a key enzyme catalyzing the production of chlorogenic acid from 3-O-p-coumaroylquinic acid.

Conclusions

These findings highlight the orchestration of hydroxylation process mediated by MaCPR2 during the biosynthesis of secondary metabolite biosynthesis in mulberry leaves. These results provided a foundational understanding for fully elucidating the DNJ biosynthetic pathway within mulberry leaves.
Molecular hydrogen attenuates sepsis-induced cardiomyopathy in mice by promoting autophagy
Authors: Cui Yan , Li Yingning , Meng Shuqi , Song Yu , Xie Keliang
Published: February 2024

Background

Approximately 40 to 60% of patients with sepsis develop sepsis-induced cardiomyopathy (SIC), which is associated with a substantial increase in mortality. We have found that molecular hydrogen (H2) inhalation improved the survival rate and cardiac injury in septic mice. However, the mechanism remains unclear. This study aimed to explore the regulatory mechanism by which hydrogen modulates autophagy and its role in hydrogen protection of SIC.

Methods

Cecal ligation and puncture (CLP) was used to induce sepsis in adult C57BL/6J male mice. The mice were randomly divided into 4 groups: Sham, Sham + 2% hydrogen inhalation (H2), CLP, and CLP + H2 group. The 7-day survival rate was recorded. Myocardial pathological scores were calculated. Myocardial troponin I (cTnI) levels in serum were detected, and the levels of autophagy- and mitophagy-related proteins in myocardial tissue were measured. Another four groups of mice were also studied: CLP, CLP + Bafilomycin A1 (BafA1), CLP + H2, and CLP + H2 + BafA1 group. Mice in the BafA1 group received an intraperitoneal injection of the autophagy inhibitor BafA1 1 mg/kg 1 h after operation. The detection indicators remained the same as before.

Results

The survival rate of septic mice treated with H2 was significantly improved, myocardial tissue inflammation was improved, serum cTnI level was decreased, autophagy flux was increased, and mitophagy protein content was decreased (P < 0.05). Compared to the CLP + H2 group, the CLP + H2 + BafA1 group showed a decrease in autophagy level and 7-day survival rate, an increase in myocardial tissue injury and cTnI level, which reversed the protective effect of hydrogen (P < 0.05).

Conclusion

Hydrogen exerts protective effect against SIC, which may be achieved through the promotion of autophagy and mitophagy.
Limited incremental predictive value of the frailty index and other vulnerability measures from routine care data for mortality risk prediction in older patients with COVID-19 in primary care
Authors: la Roi-Teeuw Hannah M. , Luijken Kim , Blom Marieke T. , Gussekloo Jacobijn , Mooijaart Simon P. , Polinder-Bos Harmke A. , van Smeden Maarten , Geersing Geert-Jan , van den Dries Carline J.
Published: February 2024

Background

During the COVID-19 pandemic, older patients in primary care were triaged based on their frailty or assumed vulnerability for poor outcomes, while evidence on the prognostic value of vulnerability measures in COVID-19 patients in primary care was lacking. Still, knowledge on the role of vulnerability is pivotal in understanding the resilience of older people during acute illness, and hence important for future pandemic preparedness. Therefore, we assessed the predictive value of different routine care-based vulnerability measures in addition to age and sex for 28-day mortality in an older primary care population of patients with COVID-19.

Methods

From primary care medical records using three routinely collected Dutch primary care databases, we included all patients aged 70 years or older with a COVID-19 diagnosis registration in 2020 and 2021. All-cause mortality was predicted using logistic regression based on age and sex only (basic model), and separately adding six vulnerability measures: renal function, cognitive impairment, number of chronic drugs, Charlson Comorbidity Index, Chronic Comorbidity Score, and a Frailty Index. Predictive performance of the basic model and the six vulnerability models was compared in terms of area under the receiver operator characteristic curve (AUC), index of prediction accuracy and the distribution of predicted risks.

Results

Of the 4,065 included patients, 9% died within 28 days after COVID-19 diagnosis. Predicted mortality risk ranged between 7–26% for the basic model including age and sex, changing to 4–41% by addition of comorbidity-based vulnerability measures (Charlson Comorbidity Index, Chronic Comorbidity Score), more reflecting impaired organ functioning. Similarly, the AUC of the basic model slightly increased from 0.69 (95%CI 0.66 – 0.72) to 0.74 (95%CI 0.71 – 0.76) by addition of either of these comorbidity scores. Addition of a Frailty Index, renal function, the number of chronic drugs or cognitive impairment yielded no substantial change in predictions.

Conclusion

In our dataset of older COVID-19 patients in primary care, the 28-day mortality fraction was substantial at 9%. Six different vulnerability measures had little incremental predictive value in addition to age and sex in predicting short-term mortality.
Experiences of Boosting Inpatient Exercise After HipFracture Surgery Using An Alternative Workforce - A Qualitative Study
Authors: Lau Benny , March Marie K. , Harmer Alison R. , Caruana Sarah , Mahony Christopher , Dennis Sarah
Published: February 2024

Background

Thrice-daily physiotherapy immediately following surgical repair of hip fracture has been shown to be safe and to reduce total hospital length of stay. However, implementing this is challenging with respect to health service funding and staffing. A novel approach may be to utilize an alternative workforce (allied health staff and student physiotherapists) to deliver two of the three daily treatments. However, how patients and staff may view such an approach is unknown. Thus, the aim of this qualitative study was to explore the views of inpatients with surgical repair of a hip fracture, their carers, health care professionals, and physiotherapy students about the implementation and acceptability of thrice-daily physiotherapy, with two sessions delivered by the alternative workforce (the BOOST study).

Methods

Semi-structured interviews and focus groups with patients, carers, health professionals and physiotherapy students. All interviews were digitally recorded and transcribed via verbatim. The transcripts were coded, and the data analysed via inductive thematic analysis.

Results

A total of 37 interviews (32 one-to-one interviews and five focus group interviews) were analysed. Five main themes were identified: (1) individual perceptions of the intervention: inpatients/carer/staff/student, (2) implementation within the service and organisational context, (3) implementation strategies that were effective, (4) improvements to implementation strategies/barriers to implementation/unsuccessful strategies and (5) future directions of BOOST.

Conclusions

The qualitative data revealed that higher frequency physiotherapy was well-received by inpatients and that staff/students involved in providing care perceived it as a safe, acceptable and valuable practice. Implementation of higher daily frequency of physiotherapy using an alternative workforce may feasibly be adopted for inpatients following hip fracture surgery.

Trial registration

This study was approved by the Human Research Ethics Committee (HREC) of the Western Sydney Local Health District (2020/ETH02718). Mutual recognition of approval was subsequently obtained from Northern Sydney Local Health District HREC.
Budget impact analysis of a Lifestyle-integrated Functional Exercise (LiFE) program for older people in Germany: a Markov model based on data from the LiFE-is-LiFE trial
Authors: Dams Judith , Gottschalk Sophie , Schwenk Michael , Nerz Corinna , Becker Clemens , Klenk Jochen , Jansen Carl-Philipp , König Hans-Helmut
Published: February 2024

Background

Fall prevention is important for healthy ageing, but the economic impact of fall prevention are scarcely investigated. A recent cost-effectiveness analysis compared a group-delivered Lifestyle-integrated Functional Exercise Program (gLiFE) with an individually-delivered program (LiFE) in community-dwelling people (aged ≥ 70 years) at risk of falling. In addition, the current study aimed to analyze the budget impact of LiFE and gLiFE, compared with standard care in Germany.

Methods

A Markov model was developed to reflect falls and associated care needs for community-dwelling persons over 5 years. The intervention effects of LiFE and gLiFE were shown to be equivalent in a non-inferiority trial, although the costs differed. Outpatient, inpatient, and intervention costs were assessed from a payer’s perspective. The effect of parameter uncertainty was assessed in sensitivity analyses.

Results

The budget impact due to intervention costs was €510 million for LiFE and €186 million for gLiFE. Over five years, health care expenditures were €35,008 million for those receiving standard care, €35,416 million for those receiving LiFE, and €35,091 million for persons receiving gLiFE. Thereby, LiFE and gLiFE could prevent 2700 deaths and 648,000 falls over 5 years. Parameter uncertainties in the risk of falling, uptake of an intervention offer, and in the intervention effects had a major influence; thus cost savings for LiFE and gLiFE compared with standard care could be achieved for individuals with a high risk of falling.

Conclusions

The results revealed that cost savings for LiFE and gLiFE compared with standard care could only be achieved for individuals at high risk of falling, with gLiFE being superior to LiFE. Future research should consider benefits and aspects of fall prevention beyond falls (e.g., physical activity, social aspects, and personal preferences of participants).

Trial registration

The study was preregistered under underclinicaltrials.gov (identifier: NCT03462654) on 12th March 2018; https://clinicaltrials.gov/ct2/show/NCT03462654.
Influence of spectral shaping and tube voltage modulation in ultralow-dose computed tomography of the abdomen
Authors: Feldle Philipp , Grunz Jan-Peter , Kunz Andreas Steven , Pannenbecker Pauline , Patzer Theresa Sophie , Pichlmeier Svenja , Sauer Stephanie Tina , Hendel Robin , Ergün Süleyman , Bley Thorsten Alexander , Huflage Henner
Published: February 2024

Purpose

Unenhanced abdominal CT constitutes the diagnostic standard of care in suspected urolithiasis. Aiming to identify potential for radiation dose reduction in this frequent imaging task, this experimental study compares the effect of spectral shaping and tube voltage modulation on image quality.

Methods

Using a third-generation dual-source CT, eight cadaveric specimens were scanned with varying tube voltage settings with and without tin filter application (Sn 150, Sn 100, 120, 100, and 80 kVp) at three dose levels (3 mGy: standard; 1 mGy: low; 0.5 mGy: ultralow). Image quality was assessed quantitatively by calculation of signal-to-noise ratios (SNR) for various tissues (spleen, kidney, trabecular bone, fat) and subjectively by three independent radiologists based on a seven-point rating scale (7 = excellent; 1 = very poor).

Results

Irrespective of dose level, Sn 100 kVp resulted in the highest SNR of all tube voltage settings. In direct comparison to Sn 150 kVp, superior SNR was ascertained for spleen (p ≤ 0.004) and kidney tissue (p ≤ 0.009). In ultralow-dose scans, subjective image quality of Sn 100 kVp (median score 3; interquartile range 3–3) was higher compared with conventional imaging at 120 kVp (2; 2–2), 100 kVp (1; 1–2), and 80 kVp (1; 1–1) (all p < 0.001). Indicated by an intraclass correlation coefficient of 0.945 (95% confidence interval: 0.927–0.960), interrater reliability was excellent.

Conclusions

In abdominal CT with maximised dose reduction, tin prefiltration at 100 kVp allows for superior image quality over Sn 150 kVp and conventional imaging without spectral shaping.
The practice of key essential nutrition actions among pregnant women in southwest Ethiopia: implications for optimal pregnancy outcomes
Authors: Mudasir Shamil , Muktar Ebrahim , Oumer Abdu
Published: February 2024

Background

Nutrition during pregnancy is a major determinant of human health and child development, and the role of promoting essential nutrition actions (ENA) is of a paramount importance for the health of the mother and newborn. However, the practice of ENA could be hampered by many factors, which need to be understood for tailored actions. This study assessed the practice of key ENAs and associated factors among pregnant mothers in southwest Ethiopia.

Method

A community-based cross-sectional study was employed among 373 pregnant mothers. A simple random sampling method was used to select the study participants. The data was entered into EpiData Manager and exported to SPSS version 21 for analysis. A bivariable logistic regression was conducted to explore the association between independent variables and the outcome variable. Variables with p-values less than 0.25 during bivariable analysis were entered into a multivariable logistic regression model. Level of statistical significance was declared at a p-value below 0.05. The crude and adjusted odds ratios, along with the 95% CI, were estimated to measure the strength of the association between the dependent variables and independent variables.

Result

In this study, 373 pregnant mothers have participated, with a response rate of 97%. A total of 275 (73.7%; 95% CI: 68.9–78.0) women practiced key essential nutrition actions at optimal level. Monthly household income of 2500 ETB (AOR = 0.45, 95% CI: 0.23, 0.89), rural residence (AOR = 2.31, 95% CI: 1.25, 4.4), and poor knowledge of key ENA messages (AOR = 3.36, 95% CI: 1.81, 6.26) were factors that were significantly associated with poor practice of key ENA messages.

Conclusions

The practice of key ENA messages was poor and closely linked to household income, residence, and knowledge of pregnant women’s on ENA key messages. Therefore, nutritional intervention with a focus on intensified nutritional counseling is needed for better adoption of key ENA practices.
Antibiotic prophylaxis with piperacillin–tazobactam reduces organ/space surgical site infection after pancreaticoduodenectomy: a retrospective and propensity score-matched analysis
Authors: Yang Yifei , Sheng Jianjie , Cai Zhenghua , Zhu Linxi , Lu Chenglin , Mao Liang , Qiu Yudong , Fu Xu
Published: February 2024

Background

The occurrence of surgical site infection (SSI) after pancreaticoduodenectomy (PD) is still relatively high. The aim of this retrospective study is to evaluate the efficacy of piperacillin-tazobactam as perioperative prophylactic antibiotic on organ/space SSI for patients underwent PD.

Methods

Four hundred seven consecutive patients who underwent PD between January 2018 and December 2022 were enrolled and analyzed retrospectively. The univariate and multivariate analysis were used to identify independent risk factors of organ/space SSI. Postoperative complications were compared between the two groups according to the use of prophylactic antibiotics by a ratio of 1:1 propensity score-matched (PSM) analysis.

Results

Based on perioperative prophylactic antibiotic use, all 407 patients were divided into the ceftriaxone group (n = 192, 47.2%) and piperacillin–tazobactam group (n = 215, 52.8%). The rate of organ/space SSI was 31.2% with the choice of perioperative antibiotics (OR = 2.837, 95%CI = 1.802–4.465, P < 0.01) as one of independent risk factors. After PSM, there were similar baseline characteristics among the groups. Meanwhile, the piperacillin–tazobactam group had a significant lower rate of organ/space SSI compared to the ceftriaxone group both before and after PSM(P < 0.05).

Conclusions

The adoption of piperacillin–tazobactam as perioperative prophylaxis for patients underwent PD reduced organ/space SSI significantly.
How the social media impact women’s psychological well-being in the patriarchal structure? The moderating effect of social capital
Authors: He Liu , Firdaus Amira , Gong Jiankun , Dharejo Nasrullah , Aksar Iffat Ali
Published: February 2024

Background

Despite technological, political and economic progress, Pakistan is still a traditionally patriarchal society, and cultural norms curb women’s freedom of socialization, which contributes to poor mental health. The digital technology spaces are rampant with male dominance, and offline cultural behaviours are replicated. Therefore, the current research in Pakistan intends to focus solely on women, their social media uses and the consequent impact on their psychological well-being. Furthermore, the mediation role of social capital is explored, which is linked to women’s socialization. In virtual communication, women can expand their connection or remain limited to known people.

Methods

An online survey collected 240 responses from women social media users. The questionnaire was divided into demographics, social media use patterns like access, online time, frequency of use, social media uses, online social capital and psychological well-being. The obtained responses were statistically analyzed using Smart PLS.

Results

Pakistani women use social media extensively; however, their uses are culturally influenced. The women use social media and socialize online but do not openly disclose their personalities and emotions to extend the connection. They seek information only from acquaintances and do not trust newly developed online contacts. Therefore, the mediation role of bonding social capital is significant, referring to the importance of close ties and trust in psychological well-being. Though virtual spaces provide an opportunity for bridging social capital, women use social media for socialization; however, it doesn’t contribute to women’s psychological well-being.

Conclusion

Despite the higher penetration of digital technologies, cultural power still rules in developing countries like Pakistan. Social media uses are gender- and culturally specific, contributing to psychological well-being and developing social capital. The results from Pakistani society recommend ensuring a secure digital experience for women to get maximum benefits from social media and enhance their psychological well-being.
How an agreement with restriction of unhealthy food marketing and sodium taxation influenced high fat, salt or sugar (HFSS) food consumption
Authors: Jindarattanaporn Nongnuch , Phulkerd Sirinya , Chamratrithirong Aphichat , Soottipong Gray Rossarin , Pattaravanich Umaporn , Loyfah Nutnicha , Thapsuwan Sasinee , Thongcharoenchupong Natjera
Published: February 2024

Background

Food taxation and food marketing policy are very cost-effectiveness to improve healthy diets among children. The objective of this study was to investigate the socio-demographic characteristics of Thais and attitude towards on policy unhealthy food marketing restriction and sodium taxation which influence high fat, sodium, and sugar (FHSS) food eating.

Methods

The data were obtained from the 2021 Health Behavior of Population Survey, four-stage sampling method of the Thai people, aged 15 years and above, using a offline survey application-assisted face-to-face interview. Logistic Regression were used to analyze the explanatory variables on agreement and HFSS food intake.

Results

Almost half (48.4%) of samples disagreed with sodium taxation, and 42.7% of the samples disagreed with food marketing restriction. Most (99.6%) of Thai respondents consumed HFSS food, including sugar sweetened beverages (SSB). Gender, age, education, income, BMI, and health status were associated with agreement with food marketing restriction policy and sodium taxation policy. There is no association between agreement with policy on sodium taxation and food marketing and HFSS food consumption.

Conclusion

Nearly half of Thais indicated that they disagreed with policy on food marketing restriction and sodium taxation. Therefore, understanding and awareness of the two policies among Thais should be further investigated in order to develop better policy communication for increased public understanding and engagement.
High prevalence of zero-dose children in underserved and special setting populations in Ethiopia using a generalize estimating equation and concentration index analysis
Authors: Biks Gashaw Andargie , Shiferie Fisseha , Tsegaye Dawit Abraham , Asefa Wondwossen , Alemayehu Legese , Wondie Tamiru , Zelalem Meseret , Lakew Yohannes , Belete Kidist , Gebremedhin Samson
Published: February 2024

Background

Globally, according to the World Health Organization (WHO) 2023 report, more than 14.3 million children in low- and middle-income countries, primarily in Africa and South-East Asia, are not receiving any vaccinations. Ethiopia is one of the top ten countries contributing to the global number of zero-dose children.

Objective

To estimate the prevalence of zero-dose children and associated factors in underserved populations of Ethiopia.

Methods

A cross-sectional vaccine coverage survey was conducted in June 2022. The study participants were mothers of children aged 12–35 months. Data were collected using the CommCare application system and later analysed using Stata version 17. Vaccination coverage was estimated using a weighted analysis approach. A generalized estimating equation model was fitted to determine the predictors of zero-dose children. An adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p-value of 0.05 or less was considered statistically significant.

Results

The overall prevalence of zero-dose children in the study settings was 33.7% (95% CI: 34.9%, 75.7%). Developing and pastoralist regions, internally displaced peoples, newly formed regions, and conflict-affected areas had the highest prevalence of zero-dose children. Wealth index (poorest [AOR = 2.78; 95% CI: 1.70, 4.53], poorer [AOR = 1.96; 95% CI: 1.02, 3.77]), single marital status [AOR = 2.4; 95% CI: 1.7, 3.3], and maternal age (15–24 years) [AOR = 1.2; 95% CI: 1.1, 1.3] were identified as key determinant factors of zero-dose children in the study settings. Additional factors included fewer than four Antenatal care visits (ANC) [AOR = 1.3; 95% CI: 1.2, 1.4], not receiving Postnatal Care (PNC) services [AOR = 2.1; 95% CI: 1.5, 3.0], unavailability of health facilities within the village [AOR = 3.7; 95% CI: 2.6, 5.4], women-headed household [AOR = 1.3; 95% CI:1.02, 1.7], low gender empowerment [AOR = 1.6; 95% CI: 1.3, 2.1], and medium gender empowerment [AOR = 1.7; 95% CI: 1.2, 2.5].

Conclusion

In the study settings, the prevalence of zero-dose children is very high. Poor economic status, disempowerment of women, being unmarried, young maternal age, and underutilizing antenatal or post-natal services are the important predictors. Therefore, it is recommended to target tailored integrated and context-specific service delivery approach. Moreover, extend immunization sessions opening hours during the evening/weekend in the city administrations to meet parents’ needs.
Arm circumference for age, arm circumference and weight-for-height z-score for the evaluation of severe acute malnutrition: a retrospective cohort study in eastern Democratic Republic of Congo
Authors: Ngaboyeka Gaylord , Bisimwa Ghislain , Neven Anouk , Mwene-Batu Pacifique , Kambale Richard , Ongezi Emmanuel , Chimanuka Christine , Ntagerwa Joseph , Balolebwami Serge , Mulume Francis , Battisti Oreste , Dramaix Michèle , Donnen Philippe
Published: February 2024

Background

Little is known about the use of mid-upper arm circumference for age (MUACZ) for diagnosing of severe acute malnutrition (SAM) and its correlation with WHZ (weight-for-height Z-score) in an area endemic for severe acute malnutrition (SAM) and with a high prevalence of kwashiorkor. Our study aims to analyze the concordance between the diagnostic criteria of SAM in a region presenting these characteristics.

Methods

We analyzed a database of children admitted from 1987 to 2008 for the management of SAM in Eastern Democratic Republic of Congo. Anthropometric indicators (z-score) were calculated and classified into 3 categories according to WHO standards. Cohen’s kappa coefficient (κ) was calculated to assess the concordance between these indicators.

Results

Out of the 9969 selected children aged 6 to 59 months, 30.2% had nutritional edema, 70.1% had a height-for-age (HAZ) z-score <-2, 11.5% WHZ<-3 z-score, 14.9% had a MUAC < 115 mm and 21.8% had a MUACZ <-3 z-score. With the classic combination WHZ and MUAC, 36% of children with SAM had both criteria at the same time and MUAC alone being the indicator that recruited more children with SAM (77%) compared with 65% with WHZ only. By replacing MUAC with MUACZ, 34% of SAM children fulfilled both criteria, WHZ and MUACZ. MUACZ alone recruited more children with SAM (88%) compared with 46% with WHZ alone. Considering these three indicators together, MUACZ remained the indicator that recruited more children with SAM (85%). WHZ and MUAC showed a moderate agreement [ κ (95% CI) = 0.408(0.392–0.424)], WHZ and MUACZ a weak agreement [ κ (95% CI) = 0.363(0.347–0.379)] and MUAC and MUACZ a good agreement [ κ (95% CI) = 0.604 (0.590–0.618)].

Conclusion

Adjusting MUAC according to age improves its effectiveness in identifying severe acute malnutrition. With low concordance, MUAC and WHZ remain complementary in our context. MUACZ proves to be crucial, especially in the presence of kwashiorkor and chronic malnutrition, becoming a valuable tool for assessing severe acute malnutrition in our context.
The mediating role of children’s intergenerational support in association between grandparenting and cognitive function among middle-aged and older Chinese: findings from the CHARLS cohort study
Authors: Hou Xuebei , Luo Yujun , Yang Fen , Zhu Xinhong , Gao Xiaolian , Wang Wenqiang , Qiao Guiyuan , Zhou Jing
Published: February 2024

Objectives

With the world’s population increasing in age, there has been a significant rise in the prevalence of cognitive impairment and dementia among individuals. This study aims to investigate the association between grandparenting and cognitive function among middle-aged and older Chinese using data from 2011 to 2018 China Health and Retirement Longitudinal Study (CHARLS). Additionally, the study seeks to explore the potential mediating effect of intergenerational support from children on this relationship, using data from the CHARLS 2011 database.

Methods

5254 participants were recruited at the baseline survey in CHARLS 2011. Subsequently, a follow-up survey was conducted over 8 years, from CHARLS 2011 to 2018, with 1472 individuals completing the follow-up survey. The CHARLS included surveys on grandparenting and cognitive assessments. Grandparenting was categorized as yes and no. The assessment of cognitive function involved the evaluation of episodic memory and mental intactness. The present study used cross-sectional and longitudinal analyses to examine the relationship between grandparenting and cognitive function. The bootstrap method assessed the mediating effect of children’s intergenerational support.

Results

The results of both cross-sectional and longitudinal studies indicated a positive association between grandparenting and cognitive function in middle-aged and older Chinese (B = 0.138, p < 0.05; B = 0.218, p < 0.05). Children’s emotional and economic support played intermediary roles between grandparenting and cognitive function.

Conclusion

The results emphasized the significance of policymakers considering the consequences of intergenerational care and family support when formulating and executing social service policies targeted at the middle-aged and older population in China.
A population based study on human papillomavirus infection and associated risk factors among women of the remote South Andaman Island, India
Authors: Parvez Rehnuma , Vijayachari Paluru , Thiruvengadam Kannan , Roy Avijit , Saha Mrinmoy Kumar , Ramasamy Jawahar , Vins Alwin , Biswas Lipika , Vaz Alvencia , Kaur Harpreet , Nagarajan Muruganandam
Published: February 2024

Background

Human papillomavirus (HPV) is associated with cervical cancer and cervical dysplasia worldwide. Data on HPV prevalence in a region is important because it serves as a predictor of the likelihood of the population in that particular region acquiring cervical cancer. Moreover, with the availability of effective vaccines, the public health system must be aware of the preponderance of HPV to implement the vaccine. The present study was designed to understand the prevalence of HPV and associated factors among the women of South Andaman Island.

Methods

A cross-sectional study was conducted among married women of reproductive age (18–59 years) from South Andaman District from 2018 to 2022. Cervical scrapes were collected from participants after obtaining informed written consent for HPV molecular testing (HPV DNA) such as PCR assay. Demographic data was collected using a standard questionnaire and statistical analyses were performed to determine the associated factors.

Results

The study showed prevalence of HPV as 5.9%(95% CI: 3.9–7.9) and prevalence of HR-HPV16 was 4.1% (95% CI 2.6 – 5.5) and HR-HPV18 prevalence was 1.8(95% CI: 0.6–3). The independent factors associated the HPV positivity were age above 55 years, menopause, post-menopausal bleeding, blood-stained vaginal discharge and loss of weight. Age was associated with all HPV infections among the South Andaman women.

Conclusions

HPV 16 was reported as the predominant high risk HPV type circulating among women of South Andaman. Cervical cancer and precancerous lesions were significantly associated with HPV positivity and High risk HPV 16. Based on the knowledge of the risk factors associated with HPV, implementation of stronger public health awareness and prophylactic HPV vaccination is crucial among the women of this remote island.
Impact of familiarity with the format of the exam on performance in the OSCE of undergraduate medical students – an interventional study
Authors: Neuwirt Hannes , Eder Iris E. , Gauckler Philipp , Horvath Lena , Koeck Stefan , Noflatscher Maria , Schaefer Benedikt , Simeon Anja , Petzer Verena , Prodinger Wolfgang M. , Berendonk Christoph
Published: February 2024

Background

Assessments, such as summative structured examinations, aim to verify whether students have acquired the necessary competencies. It is important to familiarize students with the examination format prior to the assessment to ensure that true competency is measured. However, it is unclear whether students can demonstrate their true potential or possibly perform less effectively due to the unfamiliar examination format. Hence, we questioned whether a 10-min active familiarization in the form of simulation improved medical students´ OSCE performance. Next, we wanted to elucidate whether the effect depends on whether the familiarization procedure is active or passive.

Methods

We implemented an intervention consisting of a 10-min active simulation to prepare the students for the OSCE setting. We compared the impact of this intervention on performance to no intervention in 5th-year medical students (n = 1284) from 2018 until 2022. Recently, a passive lecture, in which the OSCE setting is explained without active participation of the students, was introduced as a comparator group. Students who participated in neither the intervention nor the passive lecture group formed the control group. The OSCE performance between the groups and the impact of gender was assessed using X2, nonparametric tests and regression analysis (total n = 362).

Results

We found that active familiarization of students (n = 188) yields significantly better performance compared to the passive comparator (Cohen´s d = 0.857, p < 0.001, n = 52) and control group (Cohen´s d = 0.473, p < 0.001, n = 122). In multivariate regression analysis, active intervention remained the only significant variable with a 2.945-fold increase in the probability of passing the exam (p = 0.018).

Conclusions

A short 10-min active intervention to familiarize students with the OSCE setting significantly improved student performance. We suggest that curricula should include simulations on the exam setting in addition to courses that increase knowledge or skills to mitigate the negative effect of nonfamiliarity with the OSCE exam setting on the students.