bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community-based physical and social activity for older adults with mild frailty: a rapid qualitative study of a collaborative intervention pilot
Authors: Liddle Jennifer , Stowell Melanie , Ali Michael , Warwick Stephanie , Thompson Alexandra , Brittain Katie , Brougham Adam , Hanratty Barbara 
Published: December 2024

Abstract
Background
Intervening to modify frailty trajectories may be critical to maintain health and independence in later life. The Active Ageing Programme (AAP) is a 16-week community-based intervention for older people with mild frailty that combines physical activity and social interaction. The programme aims to positively impact resilience and wellbeing, changing the physical, mental and social factors that impact on frailty trajectories. We conducted a rapid qualitative study with the first cohort to understand the acceptability and feasibility of the AAP.

Methods
Purposive sampling was used to identify and recruit staff and participants involved in the AAP for semi-structured interviews. The topic guides covered experiences and perceptions of training and referral, delivery and participation in activities, and benefits and challenges. Data from 20 interviews were analysed using a reflexive thematic approach with inductive coding. The Theoretical Domains Framework prompted consideration of potential individual, social and environmental factors influencing changes in behaviour and practice.

Results
Sixteen AAP staff (10) and participants (6) completed interviews. Two themes were developed: combining motivating components; addressing what matters. The AAP brought together a number of components that supported its acceptability and successful implementation by motivating older people and staff and sustaining their engagement. These included the convenient and familiar location, the opportunity to improve physical health (participants) and to gain experience of an activity intervention, training and confidence (staff), and the variety of activities on offer. The programme was perceived to have potential to improve physical and mental health and increase the personal resources (e.g. knowledge, confidence, motivation) of those taking part. Areas identified as important for the AAP’s future sustainability and success were: tailoring recruitment practices; enhancing organisational communication; and strengthening support for participants to achieve long-term increased physical and social activity and resilience.

Conclusions
Our findings suggest that community-based physical and social activity interventions targeting frailty may be acceptable, feasible and useful. Further work is needed to investigate the impact of such programmes on health and service utilisation. Efforts should be targeted at improving the potential for long-term sustainability of programmes and their impacts.
Nickel and human sperm quality: a systematic review
Authors: Vinnikov Denis , Syurin Sergei 
Published: December 2024

Abstract
Background
Reproductive effects of chronic exposure to nickel (Ni), including sperm quality, have been a matter of debate given that published studies yielded contrasting results. We have, therefore, planned to systematically search and analyze medical literature with the aim to ascertain the association of exposure to nickel with the sperm quality in humans.

Materials and methods
We systematically searched Pubmed, Scopus and Embase for studies reporting the association of Ni with the sperm quality in humans with no time or language limits and used PRISMA to report the findings. The risk of bias was assessed using JBI critical appraisal checklist and SIGN tool. Because the reported effects were no coherent, meta-analysis was not possible.

Results
All included studies were observational and planned to test the effect of a group of trace elements, but not Ni alone. We identified and included 19 studies from 23 publications, published from 12 countries, which assessed sperm quality, sperm DNA damage and sperm metabolome. Ni was quantified in blood, semen plasma, spermatozoa and urine. Sixteen included cross-sectional studies were of acceptable quality, whereas three more case-control reports were of poor quality. Multivariate models were reported in only eight studies. Overall, studies were inconsistent in the direction of effect, when elevated Ni was not associated with the outcome (N = 8 studies), or some association was present (N = 11 studies). In the latter, 9 studies yielded elevated risk and 2 studies exhibited protective effect. Only one report was in an occupationally exposed population with some association with tail defects, but present in both welders and controls.

Conclusions
Existing evidence from the studies in humans is inconsistent and does not confirm a clear adverse effect of higher Ni concentrations in blood, urine or semen on the sperm quality. Robust methodology must be a key issue in the future studies. Studies with more powerful evidence, such as cohort or experimental reports are needed.
Smartphone-generated 3D facial images: reliable for routine assessment of the oronasal region of patients with cleft or mere convenience? A validation study
Authors: Singh Pradeep , Hsung Richard Tai‑Chiu , Ajmera Deepal Haresh , Said Noha A. , Leung Yiu Yan , McGrath Colman , Gu Min 
Published: December 2024

Abstract
Objectives
To evaluate the validity and reliability of smartphone-generated three-dimensional (3D) facial images for routine evaluation of the oronasal region of patients with cleft by comparing their accuracy to that of direct anthropometry (DA) and 3dMD.

Materials and methods
Eighteen soft-tissue facial landmarks were manually labelled on each of the 17 (9 males and 8 females; mean age 23.3 ± 5.4 years) cleft lip and palate (CLP) patients’ faces. Two surface imaging systems, 3dMDface and Bellus3D FaceApp, were used to perform two imaging operations on each labelled face. Subsequently, 32 inter-landmark facial measurements were directly measured on the labelled faces and digitally measured on the 3D facial images. Statistical comparisons were made between smartphone-generated 3D facial images (SGI), DA, and 3dMD measurements.

Results
The SGI measurements were slightly higher than those from DA and 3dMD, but the mean differences between inter-landmark measurements were not statistically significant across all three methods. In terms of clinical acceptability, 16% and 59% of measures showed differences of ≤ 3 mm or ≤ 5º, with good agreement between DA and SGI and 3dMD and SGI, respectively. A small systematic bias of ± 0.2 mm was observed generally among the three methods. Additionally, the mean absolute difference between the DA and SGI methods was the highest for linear measurements (1.31 ± 0.34 mm) and angular measurements (4.11 ± 0.76º).

Conclusions
SGI displayed fair trueness compared to DA and 3dMD. It exhibited high accuracy in the orolabial area and specific central and flat areas within the oronasal region. Notwithstanding this, it has limited clinical applicability for assessing the entire oronasal region of patients with CLP. From a clinical application perspective, SGI should accurately encompass the entire oronasal region for optimal clinical use.

Clinical relevance
SGI can be considered for macroscopic oronasal analysis or for patient education where accuracy within 3 mm and 5º may not be critical.
Correlation between measured oral health and oral health-related quality of life in people with epidermolysis bullosa: a prospective cohort study
Authors: Joanning Theresa , Trento Guilherme , Köppe Jeanette , Daume Linda , Kleinheinz Johannes , Hanisch Marcel , Oelerich Ole 
Published: December 2024

Abstract
Background
Inherited epidermolysis bullosa (EB) is a genetic disorder characterized by skin fragility and unique oral features. This prospective study aimed to analyze the correlation between oral health-related quality of life (OHRQoL) and the objectively measured oral health indices of people suffering from EB and within their subtypes.

Methods
The German version of the Oral Health Impact Profile (OHIP-14G) was employed for the assessment of OHRQoL. Furthermore, all participants underwent a comprehensive clinical examination to evaluate their oral health via the Physical Oral Health Index (PhOX). Study participants were included through various self-help groups in Germany, regular appointments at the outpatient clinic for rare diseases with orofacial involvement, at the Department of Cranio-maxillofacial Surgery at the University Hospital Münster and through contact via social media.

Results
A total of 33 individuals participated in the study. The study revealed that both OHRQoL and oral health were reduced. Individuals with dystrophic epidermolysis bullosa (DEB) were more negatively affected than were those in the junctional epidermolysis bullosa (JEB) and epidermolysis simplex (EBS) groups. The OHIP-G14 mean score of participants diagnosed with DEB was 25.2 (95% CI: 18.4–32.0; ± 13.7, range 5–49), and the PhOX mean score of DEB was 54.6 (± 15.7). A significant correlation was observed between PhOX and the OHIP score (rs = -0.54; p < 0.001).

Conclusions
The findings of this study corroborate the challenges faced by patients with EB in the oral domain and the deterioration of their OHRQoL. These results emphasize the necessity for dentists to engage comprehensively in disease management, encompassing routine examinations, preventive dental care and oral hygiene education. Consequently, enhanced communication is required not only between dental and dermatological teams but also with caregivers.
Online learning modules improve confidence in providing gender affirming care for youth
Authors: Hodax Juanita K. , Kahn Nicole F. , Crouch Julia M. , Sethness Janis L. , Bocek Kevin M. , Sumerwell Catherine , Sequeira Gina M. 
Published: December 2024

Abstract
Purpose
Healthcare providers often lack training and education in caring for gender diverse youth. We aimed to explore changes in provider confidence and behaviors following the implementation of an online learning course focused on gender affirming care for youth.

Methods
An asynchronous, online training consisting of 2 modules was made available in October 2021. Participants were asked to complete 3 surveys for each module they completed: a pre-survey, a post-survey, and a 3-month follow-up survey. Surveys included demographic data and an assessment of provider confidence and self-reported behaviors related to the provision of gender affirming care for adolescents that were in line with the objectives outlined in each module. Paired sample t-tests were used to compare participant confidence at all timepoints.

Results
Participants (n = 487) completed at least one survey from one module. There was notable diversity in provider types, including mental health providers (n = 86, 17.7%), community health workers (n = 71, 14.6%), and medical students or health professionals (n = 61, 12.5%). Participants were significantly more confident in all aspects of care provision when comparing pre-surveys and post-surveys (p < 0.001 for all survey items focused on change in provider confidence ). At 3-month follow-up after module completion, improvements in confidence were sustained in providing information and resources to adolescents and their families, and having conversations with them about gender identity along with the importance of using affirming language. However, these modules did not result in self-reported behavior change regarding provision of gender affirming hormones or puberty blockers.

Conclusions
Online learning modules may be an effective means of educating a large number of healthcare providers about caring for gender diverse youth in a variety of settings and across disciplines.
Effect of a multimodal continuing professional development initiative on HIV testing in primary care in British Columbia, Canada
Authors: Lynn Brenna M. , Barrows Jennifer A. , Lam Vivian W.Y. , Curran Vernon R. 
Published: December 2024

Abstract
Introduction
Many persons are unaware of HIV infection until they present in an advanced stage of the disease. Diagnosing HIV infection in its earliest stages reduces morbidity and mortality and contributes to improved public health. Increased testing for HIV is critical for prevention, and primary care providers play an essential role in early HIV screening. However, lack of knowledge and confidence are barriers to the adoption of screening practices. Continuing professional development (CPD) may enhance greater HIV testing uptake amongst primary care providers by improving awareness and comfort. This paper aims to report on the impact of a multimodal CPD initiative to increase HIV screening and test ordering across primary care settings in British Columbia, Canada.

Methods
The ‘HIV Testing Initiative in Family Practice’ was designed as a multimodal education strategy to encourage family physicians to adopt routine HIV testing in their practices. The initiative encompassed a variety of core and supplementary educational activities, including interactive in-person CPD workshops, practice resources, and patient education materials. An interrupted time series study was undertaken to evaluate the effect on HIV test ordering before and after workshop participation. Participants also completed post-workshop surveys to assess satisfaction.

Results
In total, 316 individuals participated in the core educational activities of the initiative. The number of HIV tests ordered increased significantly amongst participants following workshop participation (p < .001). HIV test ordering increased for both rural and urban providers with no significant difference (p = .075) on the number of tests ordered between these groups. Participants were very satisfied with workshop participation, with an overall mean satisfaction rating of 4.78 (out of 5) and reported high satisfaction with the format (4.64 out of 5) and interactivity (4.76 out of 5) features across the workshops.

Discussion
The findings suggest that the introduction of a multimodal CPD intervention may have effected change in family physicians’ HIV testing practices. The HIV testing rates of physicians who had participated in CPD workshops increased significantly, and participant evaluation data indicated a greater understanding of the rationale for routine HIV testing, as well as an increase in comfort with recommending HIV tests to patients.
Quantitative Comparison and Clustering of Circular Dichroism Spectra Using a Symmetrized Weighted Spectral Difference
Authors: Chouchane Karim , Kirkitadze Marina , Misra Rahul , Kowal Przemyslaw , Dalloz-bourguignon Olivier , Greco Frederic , Fayard Sylvie , Marco Sergio , Clenet Didier 
Published: December 2024

Abstract
Spectroscopy (UV-visible, circular dichroism, infrared, Raman, fluorescence, etc.) is of fundamental importance to determine the structures of macromolecules and monitor their stability, especially for drug products, based on proteins or nucleic acids. In their 2014 article, Dinh et al. proposed Weighted Spectral Difference (WSD) as a method to quantitatively compute the dissimilarity of a given spectrum to a reference one. Despite the various properties of this method, its lack of symmetry and dependence on the selection of a reference limits the range of possible applications. Here, we propose a reference-free, symmetrized version of WSD (SWSD) that allows the computation of a semi-distance between two spectra. SWSD can be applied to perform group comparisons, track spectral kinetics, or construct a SWSD matrix leading to the hierarchical clustering of spectra. This method was tested on circular dichroism spectra from a split-virus-based (influenza) vaccine and a recombinant spike protein (COVID-19 vaccine). This approach resulted, first, in a perfect clustering of influenza A and B viruses into two distinct clusters, and second, in the detection of the change of secondary structure of the spike protein during a heating experiment, identifying two main temperatures of denaturation (Tm) by SWSD kinetics, in agreement with results obtained by conventional DSC. In summary, we have shown that SWSD is a versatile and efficient tool for quantitative spectral comparison, tracking spectral kinetics and enabling relevant unsupervised classification.
Propiedades psicométricas del Test de Evaluación Clínica de la Depresión en población general española
Authors: Guillot Valdés María , Guillén Riquelme Alejandro , Sierra Freire Juan Carlos , Buela Casal Gualberto 
Published: December 2024

La depresión es una enfermedad mental que requiere de instrumentos de evaluación que proporcionen medidas fiables y válidas. El Test de Evaluación Clínica de la Depresión es un instrumento multifactorial creado con el fin de cubrir la amplia sintomatología depresiva en diferentes momentos temporales (mes, año y siempre). El objetivo de este trabajo es confirmar su estructura factorial, obtener coeficientes de fiabilidad y aportar evidencias acerca de la validez convergente de sus medidas con el Inventario de Depresión de Beck-II. Método. Se administraron el Test de Evaluación Clínica de la Depresión y el Inventario de Depresión de Beck-II a 501 adultos de la población general sin trastornos psicológicos diagnosticados (Medad = 36, DT = 16, 51% mujeres). Resultados. El ajuste del modelo original de 12 factores resulta adecuado, así como la fiabilidad. Las correlaciones de las puntuaciones del Test de Evaluación Clínica de la Depresión con las del Inventario de Depresión de Beck-II fueron moderadas-altas. Conclusiones. Se confirma que el Test de Evaluación Clínica de la Depresión es un instrumento con adecuadas propiedades psicométricas para evaluar la depresión en adultos.
Nuevas perspectivas pedagógicas para integrar la dimensión ambiental para la sostenibilidad en el currículum desde un enfoque transformador
Authors: Alcántara Rubio Lucia , Limón Domínguez Dolores , García Pérez Francisco F. 
Published: December 2024

Existe robusta literatura en el ámbito de la Educación Ambiental para la Sostenibilidad (EAS) que reclama la necesidad de poner en marcha nuevas formas de enseñar y aprender, superadoras de las visiones tradicionales como imperativo para que se produzcan aprendizajes que verdaderamente supongan un impacto en la mejora ecosocial. La EAS debe contribuir a la educación (personal, política, social y ambiental) de una ciudadanía que, en el sentido de un aprendizaje transgresor, sean capaces de cuestionar las estructuras existentes, de pensar más allá de ellas y así poder contribuir a estimular procesos de aprendizaje verdaderamente transformadores. Asumiendo esta premisa, el presente trabajo analiza nuevas perspectivas pedagógicas para favorecer la integración de la dimensión ambiental para la sostenibilidad en el curriculum educativo desde un enfoque transformador. Como resultados se presenta a) una panorámica de los enfoques pedagógicos clave para la EAS; b) se analiza la importancia de incorporar la dimensión (trans)personal, subjetiva e interior como elemento vertebrador en los escenarios de aprendizaje; c) se sitúa el Aprendizaje Transformador como enfoque pedagógico profundo para la incorporación de la dimensión intrapersonal en el desarrollo de la EAS. Los resultados obtenidos permiten concluir que es necesario integrar procesos y escenarios formativos que faciliten la autorreflexión crítica y la generación de procesos de aprendizaje profundo que, al mismo tiempo, desencadenen procesos de conflicto y reflexión compartida, de resolución de problemas y experiencias de participación en una actividad comunitaria, pues será lo que permita, favorezca y habilite un cambio de conciencia en el alumnado, en el profesorado y, en general, en las personas, para participar desde su quehacer profesional y personal a la construcción de un mundo mejor.
Abu, déjame que pinte tu cuento: un proyecto intergeneracional de educación artística
Authors: Colomina Molina Teresa , López Martínez María Dolores , Mesas Escobar Eva 
Published: December 2024

Las artes son un vehículo de encuentro y diálogo entre personas. Con la pandemia de la Covid-19 las relaciones sociales y familiares disminuyen debido al confinamiento. Desde esta perspectiva surge el proyecto: Abu, déjame que pinte tu cuento, concedido por el Ayuntamiento de Murcia en la convocatoria de Reactivos Culturales. La iniciativa consistió en la realización de un mapa virtual tras recopilar obras artísticas infantiles generadas a partir de historias narradas por sus abuelos y abuelas sobre un suceso vivido en diversos lugares de la ciudad de Murcia. La finalidad principal fue incorporar la mediación artística como herramienta de inclusión social, participación y diálogo intergeneracional en un entorno virtual. La intervención se fundamentó en una metodología de investigación basada en las historias de vida biográfico-narrativas y en la etnografía visual. La experiencia ha demostrado cómo las imágenes ayudan a generar vínculos emocionales con el patrimonio y que las prácticas artísticas colaborativas son un vehículo para la democracia cultural e interrelación activa entre ciudadanos de diferentes generaciones.
Facilitators and barriers to Tuberculosis case notification among private health facilities in Kampala Capital City, Uganda
Authors: Kembabazi Veronica , Ssentongo Julius , Rutebemberwa Elizeus 
Published: December 2024

Introduction
Private Health Facilities (PHFs), Uganda’s main healthcare providers, are indispensable stakeholders in the national tuberculosis (TB) program’s efforts to improve TB case notification and combat the epidemic. However, notification rates remain relatively low in PHFs compared to public providers. In this study, we sought to assess facilitators and barriers to TB case notification among private facilities in Kampala Capital City.

Methods
We conducted a cross-sectional study utilizing a mixed-methods approach to assess facilitators and barriers to TB notification in Kampala Capital City between March and July 2022. For the quantitative strand of the study, we interviewed the TB focal persons at 224 PHFs using a structured questionnaire and for the qualitative, we conducted 14 key informant and in-depth interviews with Ministry of Health-Uganda staff, and TB focal persons at the Kampala Division administration level and at the PHFs. The quantitative analysis involved Modified Poisson regression and the qualitative analysis was carried out using thematic analysis to identify the facilitators and barriers to TB case notification.

Results
Of the 224 PHFs surveyed, the majority, 39.3%(88), were facilities in Nakawa division and 55.4% (124) of the respondents were male, with a mean age of 32.6 years (SD = 8.6). We found that the prevalence of TB case notification was significantly lower for facilities in Kawempe (PR 0.16; 95%CI 0.05,0.47) and Nakawa (PR 0.39, 95%CI 0.21,0.73). Notification was lower among facilities that had no guide for TB screening and diagnosis (PR 0.50; 95%CI 0.25,0.97) and among those facilities where training of other health workers at the facility in TB diagnosis was unknown (PR 0.35; 95%CI 0.13,0.93). Qualitative data showed that the main facilitators of TB case notification were: regular engagements between the NTLP and private health providers and, provision of materials and support to conduct case finding, while the main barriers included TB stigma, lack of resources such as TB diagnostic facilities.

Conclusions
PHFs in Kampala Capital City are receptive to programmatic TB case notification. However, they need regular supervision and engagement activities to ensure that they have updated knowledge, equipment and funding support to carry out TB case notification according to policy.