bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing the retention of secondary midwives at health centres in rural areas in Cambodia: the role of gender—a qualitative study
Authors: Abe Kimiko , Ros Bandeth , Chea Kimly , Tung Rathavy , Fustukian Suzanne 
Published: November 2021

Abstract
Background
Retention of skilled midwives is crucial to reducing maternal mortality in rural areas; hence, Cambodia has been trying to retain at least one secondary midwife who can provide basic emergency obstetric care at every health centre even in rural areas. The factors influencing the retention of midwives, but not solely secondary midwives, have been identified; however, the security issues that affected female health workers during the conflict and the post-conflict years and gender issues have been unexplored. This study explores these and other potential factors influencing secondary midwife retention and their significance.

Methods
Sequential two-stage qualitative interviews explored influential factors and their significance. The first stage comprised semi-structured interviews with 19 key informants concerned with secondary midwife retention and in-depth interviews with eight women who had deliveries at rural health centres. Based on these interview results, in-depth interviews with six secondary midwives who were deployed to a rural health centre were conducted in the second stage. These midwives ranked the factors using a participatory rural appraisal tool. These interviews were coded with the framework approach.

Results
Living with one’s parents or husband, accommodation and security issues were identified as more significant influential factors for secondary midwife retention than current salary and the physical condition of the health centre. Gender norms were entrenched in these highly influential factors. The deployed secondary midwives who were living apart from one’s parents or spouse requested transfer (end of retention) to health centres closer to home, as other midwives had done. They feared gender-based violence, although violence against them and the women around them was not reported. The health workers surrounding the midwives endorsed the gender norms and the midwives’ responses. The ranking of factors showed similarities to the interview results.

Conclusions
This study suggests that gender norms increased the significance of issues with deployments to rural areas and security issues as negative factors on female health workforce retention in rural areas in Cambodia. This finding implies that further incorporating gendered perspectives into research and developing and implementing gender-responsive policies are necessary to retain the female health workforce, thereby achieving SDGs 3 and 5.
How service modularity can provide the flexibility to support person-centered care and shared decision-making
Authors: Bartels E. A. , Meijboom B. R. , Nahar-van Venrooij L. M. W. , de Vries E. 
Published: November 2021

Abstract
Background
Today’s healthcare provision is facing several challenges, that cause the level of complexity to increase at a greater rate than the managerial capacity to effectively deal with it. One of these challenges is the demand for person-centered care in an approach that is tuned towards shared decision-making. Flexibility is needed to adequately respond to individual needs.

Methods
We elaborate on the potential of service modularity as a foundation for person-centered care delivered in a shared decision-making context, and examine to what extent this can improve healthcare. We primarily focused on theory building. To support our effort and gain insight into how service modularity is currently discussed and applied in healthcare, we conducted a scoping review.

Results
Descriptions of actual implementations of modularity in healthcare are rare. Nevertheless, applying a modular perspective can be beneficial to healthcare service improvement since those service modularity principles that are still missing can often be fulfilled relatively easily to improve healthcare practice. Service modularity offers a way towards flexible configuration of services, facilitating the composition of tailored service packages. Moreover, it can help to provide insight into the possibilities of care for both healthcare professionals and patients.

Conclusions
We argue that applying a modular frame to healthcare services can contribute to individualized, holistic care provision and can benefit person-centered care. Furthermore, insight into the possibilities of care can help patients express their preferences, increasing their ability to actively participate in a shared decision-making process. Nevertheless, it remains essential that the healthcare professional actively collaborates with the patient in composing the care package, for which we propose a model. Altogether, we posit this can improve healthcare practice, especially for the people receiving care.
Randomized, double-blind, placebo-controlled clinical trial measuring the effect of a dietetic food on dermatologic scoring and pruritus in dogs with atopic dermatitis
Authors: de Santiago Miguel Sánchez , Arribas José Luis González , Llamas Yolanda Moral , Becvarova Iveta , Meyer Hein 
Published: November 2021

Abstract
Background
Canine atopic dermatitis (AD) is a common condition that often requires multimodal therapy. Including a diet in the multimodal management of AD may reduce medication doses, saving pet owners money and reducing side effects. The objective of this randomized, double-blind, placebo-controlled clinical trial was to determine if a diet fortified in antioxidants, polyphenols, and omega-3 fatty acids can reduce the clinical signs of AD. Forty client-owned dogs with AD were enrolled in the study and assigned to either an enriched diet (diet B) or control diet (diet A) for 60-days. CADESI-4 index scores and owner-reported pruritus scores were measured periodically.

Results
Total CADESI-4 index scores for dogs eating diet B were lower on day 60 compared to baseline (P = 0.003). There was no statistical difference in scores for dogs eating diet A over a 60-day period. Diet B dogs had 25 and 49% reductions in CADESI-4 index scores on days 30 and 60, respectively (P = 0.0007) while diet A had no change over the study period. When comparing the percent change in owner-reported pruritus scores, diet B also performed better than diet A. By day 60, owners feeding diet B to their dogs reported a significant reduction (P < 0.0001) of 46.4% in itching, while those on diet A reported a 26.8% reduction, which was not statistically significant (P = 0.08).

Conclusions
These study results demonstrate feeding a diet enriched with ingredients to improve skin health and reduce inflammation improves the clinical signs of AD in dogs.
Assessing the relationship between syringe exchange, pharmacy, and street sources of accessing syringes and injection drug use behavior in a pooled nationally representative sample of people who inject drugs in the United States from 2002 to 2019
Authors: Marotta Phillip L. , Stringer Kristi , Beletsky Leo , West Brooke S. , Goddard-Eckrich Dawn , Gilbert Louisa , Hunt Tim , Wu Elwin , El-Bassel Nabila 
Published: November 2021

AbstractProvision of sterile syringes is an evidence-based strategy of reducing syringe sharing and reusing and yet, access to sterile syringes through pharmacies and syringe exchange programs (SEPs) in the United States remains inadequate. This nationally representative study examined associations between obtaining syringes from pharmacies, SEPs, and sterilizing syringes with bleach and risk of syringe borrowing, lending and reusing syringes in a pooled cross-sectional dataset of 1737 PWID from the 2002–2019 National Survey on Drug Use and Health. Logistic regression was used to produce odds ratios (OR) of the odds of injection drug behaviors after adjusting for obtaining syringes from SEPs, pharmacies, the street, and other sources and potential confounders of race, ethnicity, sex, education, and insurance coverage. Obtaining syringes through SEPs was associated with lower odds of borrowing (OR = .4, CI95% = .2, .9, p = .022) and reusing syringes (OR = .3, CI95% = .2, .6, < .001) compared to obtaining syringes on the street. Obtaining syringes from pharmacies was associated with lower odds of borrowing (OR = .5, CI95% = .3, .9, p = .037) and lending (OR = .5 CI95% = .3, .9, p = .020) syringes. Using bleach to clean syringes was associated with increased odds of borrowing (OR = 2.0, CI95% = 1.3, 3.0, p = .002), lending (OR = 2.0, CI95% = 1.3, 3.0, p = .002) and reusing syringes (OR = 2.4, CI95% = 1.6, 3.6, p < .001). Our findings support provision of syringes through pharmacies and SEPs as a gold-standard strategy of reducing sharing and reuse of syringes in the US.
Poorly differentiated thyroid carcinoma arising from a lithium-induced goiter in a patient with schizophrenia: a case report
Authors: Choi Jung Ho , Hong Young Ok , Kim Hyo-Jeong , Jung Ah Ra 
Published: November 2021

Abstract
Background
Lithium use causes goiter by increasing serum thyroid-stimulating hormone levels through the inhibition of thyroid hormone release. However, there are no reports of poorly differentiated thyroid carcinoma resulting from lithium-induced goiter. Herein, we report the case of a patient with schizophrenia who developed poorly differentiated thyroid carcinoma arising from a lithium-induced goiter.

Case presentation
A 61-year-old woman who was taking lithium for schizophrenia, visited the thyroid-endocrine center with a 10 × 12 cm anterior neck mass. She had a slowly growing goiter approximately 30 years ago; however, when she came to the hospital for diabetes diagnosis 2 years ago, she had no accompanying symptoms and refused evaluation. Three months before her visit, her dysphagia and dyspnea worsened as the size of her goiter increased rapidly. A neck ultrasound and enhanced thyroid computed tomography (CT) examination revealed a 10.9 × 9.2 × 12.8 cm size multi-lobulated mass on the right thyroid gland, leading to a leftward deviation of the trachea. Diagnostic total thyroidectomy was performed, and microscopic findings and immunohistochemical staining results indicated poorly differentiated thyroid carcinoma (PDTC) in the right thyroid mass. Mutation analyses for BRAF and the telomerase reverse transcriptase (TERT) promoter was performed. No BRAF gene mutations were detected; however, TERT promoter C228T point mutation was present in the PDTC. The patient underwent radioactive iodine therapy two months after the surgery. At a recent follow-up 4 months postoperatively, she was taking thyroid hormone replacement and remained in a relatively good health with a serum thyroglobulin level of 0.55 ng/ml.

Conclusions
Thyroid examination of psychiatric patients who develop goiter due to long-term lithium treatment should be monitored regularly, and appropriate investigations and surgery should be performed in a timely manner if the goiter is growing rapidly.
Nonlinear relationship between HbA1c and coronary artery calcium score progression: a secondary analysis based on a retrospective cohort study
Authors: Yu Jing , Gao Bo 
Published: November 2021

Abstract
Objective
Coronary artery calcium score and glycated hemoglobin(HbA1c) are both considered risk factors for coronary heart disease. However, the relationship between coronary artery calcium score and HbA1c is still unclear. Consequently, the present study was undertaken to explore HbA1c association with coronary artery calcium score progression in South Korea.

Methods
This study is a secondary analysis based on a retrospective cohort study in which 8151 participants received Health examination kits at the Health Promotion Center, Samsung Medical Center in Seoul, South Korea, from March 1, 2003–December 31, 2013. Cox proportional-hazards regression model was then used to evaluate the independent relationship between HbA1c and coronary artery calcium score progression.

Results
After adjusting potential confounding factors (age, sex, BMI, height, weight, SBP, DBP, TC, LDL-C, HDL-C, triglycerides, smoking status, alcohol consumption, reflux esophagitis status, hypertension, diabetes, dyslipidemia, ischemic heart disease and cerebrovascular disease), it was revealed that there was a nonlinear relationship between HbA1c and coronary artery calcium score progression, while the scoring point was 5.8%. The effect size was 2.06 to the left of the inflection point, while the 95% CI was 1.85 to 2.29. Whereas, the effect size was 1.04, on the right side of the inflection point while 95% CI was 0.99 to1.10.

Conclusion
The relationship between HbA1c and coronary artery calcium score progression is nonlinear. HbA1c is positively related to coronary artery calcium score progression when HbA1c level was less than 5.8%.
Navigation and non-navigation CT scan of the sinuses: Comparison of the effective doses of radiation in children and adults
Authors: Villemure-Poliquin Noémie , Chrétien Mario , Leclerc Jacques E. 
Published: November 2021

Background The advent of 3D navigation imaging has opened new borders to the endoscopic surgical approaches of naso-sinusal inflammatory and neoplastic disease. This technology has gained in popularity among otolaryngologists for endoscopic sinus and skull base surgeries in both adults and children. However, the increased tissue radiation required for data acquisition associated with 3D navigation protocols CT scans is a source of concern because of its potential health hazards. We aimed to compare the effective doses of radiation between 3D navigation protocols and standard protocols for sinus computed tomography (CT) scans for both the adult and pediatric population. Methods We performed a retrospective cohort study through electronic chart review of patients undergoing sinus CT scans (standard and 3D navigation protocols) from May 2019 to December 2019 using a Siemens Drive (VA62A) CT scanner. The effective dose of radiation was calculated in mSv for all exams. Average irradiation doses were compared using a Student's T-Test or a Kruskall–Wallis test when appropriate. Results A total of 115 CT scans were selected for analysis, of which 47 were standard protocols and 68 were 3D navigation protocols CT scans. Among these, 31 exams were performed on children and 84 exams on adults. For the total population, mean effective dose in the non-navigation CT scans was 0.37 mSv (SD: 0.16, N = 47) and mean effective dose in the 3D navigation sinus CT group was 2.33 mSv (SD: 0.45, N = 68). The mean difference between the two groups was statistically significant 1.97 mSv (CI 95% − 2.1 to − 1.83; P < 0.0001). There was a sixfold increase in radiation with utilization of 3D navigation protocols. The ratio was identical when the pediatric as well as the adult subset of patients were analyzed. Conclusion In our center, utilization of 3D navigation sinus CT protocols significantly increases radiation exposure. Otolaryngologists should be aware of this significant increase and should attempt to decrease the radiation exposure of their patients by limiting unnecessary scan orders and by evaluating 3D acquisition protocols locally with radiation physicists. Level of evidence: Level IV. Graphical Abstract
Influence of biobased polyol type on the properties of polyurethane hotmelt adhesives for footwear joints
Authors: Carbonell-Blasco M. P. , Pérez-Limiñana M. A. , Ruzafa-Silvestre C. , Arán-Ais F. , Orgilés-Calpena E. 
Published: November 2021

AbstractPolyurethanes, one of the most used polymers worldwide, are strongly dependent of non-renewable fossil resources. Thus, boosting the production of new polyurethanes based on more sustainable raw materials is crucial to move towards the footwear industry decarbonisation. The aim of this study is to synthesise and characterise reactive hotmelt polyurethanes from biomass and CO2-based polyols as bioadhesives for the footwear industry. The influence of biobased polyols on the polyurethane structure, and therefore, on their final properties was analysed by different experimental techniques such us Fourier transform infrared spectroscopy (FTIR), Differential scanning calorimetry (DSC), Thermogravimetric analysis (TGA), Melting viscosity, Softening temperature and T-peel strength test, in order to assess their viability for the upper to sole bonding process. The results obtained indicated that the incorporation of different amounts of the biobased polyols produces changes in the structure and final performance of the polyurethanes. Therefore, adhesion test carried out by the T-peel test 72 h after the upper -to- sole bonding of the sustainable adhesives show high final adhesion values. These sustainable raw materials provide polyurethane adhesives with additional beneficial non-toxicity and sustainable characteristics, without harming their properties during their useful life.
A review on architecture with fungal biomaterials: the desired and the feasible
Authors: Almpani-Lekka Dimitra , Pfeiffer Sven , Schmidts Christian , Seo Seung-il 
Published: November 2021

AbstractFungal biomaterials are becoming increasingly popular in the fields of architecture and design, with a significant bloom of projects having taken place during the last 10 years. Using mycelium as a stabilizing compound for fibers from agricultural waste, new building elements can be manufactured according to the circular economy model and be used for architectural construction to transform the building industry towards an increased environmental and economic sustainability. Simultaneously, research on those materials and especially fungal biocomposites is producing knowledge that allows for the materials themselves to inspire and transform the architectural design. Novel research on those materials is not only allowing for their use as construction materials, but it inspires and affects the architectural design process through the discovery and variation of the materials’ properties. Today, many interdisciplinary teams are working on this emerging field to integrate fungal biocomposites in the construction industry and to merge science, art, and architecture responsibly.This study provides an overview of the progress that has been made in this field during the last 10 years, focusing on six works that are presented in more detail. Those six works are spaces at an architectural scale which showcase unique elements and innovative aspects for the use of fungal biomaterials in architecture. Each work has followed different design strategies, different fabrication methods, or different post-processing methods. All of them together have produced significant technical knowledge as well as a cultural impact for the field of architecture but also for the field of fungal biotechnology.
Nutrition literacy is associated with income and place of residence but not with diet behavior and food security in the Palestinian society
Authors: Natour Nihal , AL-Tell Mariam , Ikhdour Osama 
Published: November 2021

Abstract
Introduction
Palestinian society is going through health transition that is associated with increase in chronic diseases due to poor dietary habits so adequate integration of nutrition information is important.

Aims
The aim of this study is to find the association between nutrition literacy and diet behavior among a group of Palestinian participants.

Methods
A sample of 101 Palestinian participants were recruited to participate in the study. An online survey was used to collect study data. Newest Vital Sign quiz was used to collect information on nutrition literacy and Short Format of the Diet Health and Knowledge Survey (SFDHKS) was used to collect information on diet behavior and USDA food security questionnaire was used to collect data on food security. Data was analyzed utilizing SPSS 21.

Results
This study included 101 participants, mean age 22.7 y ± 8.7 y, mainly females (females were 83.2% and males were 16.8%). 5.7% of the study participants were obese, 13.8% overweight and 10.3% were underweight. The prevalence of adequate nutrition literacy was 29%. There was minimal association between diet behavior and nutrition literacy, food security and BMI categories, but significant association with income and living in city relative to village (p < 0.05). Only 11 participants had some form of food insecurity.

Conclusion
There is low prevalence of adequate nutrition literacy. Nutrition literacy depends on social and economic aspects but further research is need to understand its relationship to diet behavior.
Sociodemographic factors associated with treatment-seeking and treatment receipt: cross-sectional analysis of UK Biobank participants with lifetime generalised anxiety or major depressive disorder
Authors: Rayner Christopher , Coleman Jonathan R. I. , Purves Kirstin L. , Carr Ewan , Cheesman Rosa , Davies Molly R. , Delgadillo Jaime , Hübel Christopher , Krebs Georgina , Peel Alicia J. , Skelton Megan , Breen Gerome , Eley Thalia C. 
Published: November 2021

Background
Anxiety and depressive disorders can be chronic and disabling. Although there are effective treatments, only a fraction of those impaired receive treatment. Predictors of treatment-seeking and treatment receipt could be informative for initiatives aiming to tackle the burden of untreated anxiety and depression.

Aims
To investigate sociodemographic characteristics associated with treatment-seeking and treatment receipt.

Method
Two binary retrospective reports of lifetime treatment-seeking (n = 44 810) and treatment receipt (n = 37 346) were regressed on sociodemographic factors (age, gender, UK ethnic minority background, educational attainment, household income, neighbourhood deprivation and social isolation) and alternative coping strategies (self-medication with alcohol/drugs and self-help) in UK Biobank participants with lifetime generalised anxiety or major depressive disorder. Analyses were also stratified by gender.

Results
Treatment access was more likely in those who reported use of self-help strategies, with university-level education and those from less economically advantaged circumstances (household income <£30 000 and greater neighbourhood deprivation). Treatment access was less likely in those who were male, from a UK ethnic minority background and with high household incomes (>£100 000). Men who self-medicated and/or had a vocational qualification were also less likely to seek treatment.

Conclusions
This work on retrospective reports of treatment-seeking and treatment receipt at any time of life replicates known associations with treatment-seeking and treatment receipt during time of treatment need. More work is required to understand whether improving rates of treatment-seeking improves prognostic outcomes for individuals with anxiety or depression.