bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges of primary healthcare nurses regarding the integration of HIV and AIDS services into primary healthcare in Vhembe district of Limpopo province, South Africa
Authors: Tshililo Azwidihwi R. , Mangena-Netshikweta Lizzy , Nemathaga Livhuwani H. , Maluleke Mary 
Published: January 2019

Background: Integration of human immunodeficiency virus and acquired immune deficiency syndrome (HIV and AIDS) services into primary healthcare (PHC) is a key public health approach to achieving universal access to antiretroviral therapy (ART). Despite the government’s efforts of integrating HIV services into PHC, an insufficient number of PHC staff and inadequate infrastructure are challenging when integrating HIV and AIDS services into PHC. This study explored the challenges of PHC nurses regarding the integration of HIV and AIDS services into PHC.Objectives: The aim of the study was to explore the challenges of PHC nurses regarding the integration of HIV and AIDS services into PHC.Method: An exploratory, descriptive and contextual qualitative research design utilising face-to-face semi-structured interviews was conducted with 12 PHC nurses from selected clinics and health centres in the Vhembe district of Limpopo province.Results: Two main themes emerged from data analysis which included challenges related to healthcare recipients and challenges related to healthcare providers.Conclusion: Clear policies on the integration of HIV and AIDS services into PHC should be available and should include strategies to promote HIV testing and counselling, adherence to ART and scheduled appointments, disclosure of HIV status as well as revising the human resource policy to reduce workload.
Monitoring consumptive resource use in South African national parks
Authors: Vermeulen Wessel , Van Wilgen Nicola , Smith Kyle , Dopolo Mbulelo , Swemmer Louise , Annecke Wendy , Bezuidenhout Hugo , Durrheim Graham , Hanekom Nick , Hendricks Howard , McGeoch Melodie , Ngubeni Ntombizodwa , Symonds Alexis 
Published: January 2019

Monitoring is an essential component of measuring the performance of protected areas. This requirement led to the development of a biodiversity monitoring system for South African National Parks (SANParks). The system comprises of ten major programmes, each focusing on a core area of conservation biodiversity monitoring, with resource use being one of the focal areas. With the growing appreciation of the importance of natural resources for the socio-economic well-being of communities and other stakeholders, sustainable resource use is an important component of the management of natural areas and national parks. To gauge sustainability, a sound monitoring and research programme that fits within the context of the SANParks’ adaptive management approach towards social-ecological system management is required. The purpose of this article was to define the context and scope in which consumptive resource use takes place within SANParks and to outline the criteria necessary for developing a sound monitoring programme to assess the sustainability of such use. The monitoring programme is structured in view of the fact that sustainable resource use is achievable only where all dimensions of sustainability (social, economic and ecological) are considered simultaneously. In terms of the social and economic dimensions of sustainability, the programme provides for assessing stakeholder needs, trends in resource use and the social and economic impacts of resource use. Monitoring that relates to the ecological dimension of sustainability of biological resource use deals with the rate of turnover and population dynamics of target species, as well as harvest impact. In terms of abiotic (non-renewable) resources, monitoring deals with sound management practices to minimise impact on the environment, and to optimise benefits through responsible use.Conservation implications: The resource use monitoring programme is intended to ensure that monitoring relating to the harvesting of natural resources from national parks is scientifically sound and conducted in a structured way, towards meeting the objective of sustainable use and compliance with national legislation. The article illustrates how SANParks meets its obligation to monitor biodiversity conservation while at the same time meeting the needs for the consumptive use of resources.
Small renal carcinoma: the “when” and “how” of operation, active surveillance, and ablation
Authors: Wendler Jakob Johann , Liehr Bernd Uwe , Damm Robert , Powerski Maciej , Brunner Thomas , Schostak Martin , Pech Maciej 
Published: January 2019

Small, locally restricted renal cell carcinoma less than 4 cm in size should ideally be removed operatively by nephron-sparing tumour enucleation (partial kidney resection). In an increasingly elderly population, there is a growing trend toward parallel incidence of renal cell carcinoma and chronic renal insufficiency, with the latter’s associated general comorbidities. Thus, for some patients, the risks of the anaesthesia and operation increase, while the advantage in terms of survival decreases. Transcutaneous radio-frequency ablation under local anaesthesia, transcutaneous afterloading high-dose-rate brachytherapy under local anaesthesia, and percutaneous stereotactic ablative radiotherapy may offer a less invasive alternative therapy. Active surveillance is to be regarded as no more than a controlled bridging up to definitive treatment (operation or ablation), while watchful waiting, on account of the lack of prognostic relevance and the symptomatology of renal cell carcinoma, with its comorbidity-related, clearly reduced life expectancy, does not involve any further diagnostic or therapeutic measures.
Corona mortis variant of the obturator artery: a systematic study
of 300 hemipelvises by means of computed tomography angiography
Authors: Perandini Simone , Perandini Alessio , Puntel Gino , Puppini Giovanni , Montemezzi Stefania 
Published: January 2019

PurposeThe purpose of the present study is to systematically assess the prevalence and characteristics of the corona mortis (CM) variant of the obturator artery by means of computerised tomography angiography (CTA).Material and methodsA total of 150 consecutive patients (112 males, average age 73 years) referred to CTA for lower limb arterial evaluation were included in this retrospective study. Patient demographics, anastomosis incidence, artery diameter, distance from the symphysis pubis, Kellgren-Lawrence score, and pelvic size were evaluated.ResultsIn this study 40.6% of patients presented at least one competent CM arterial anastomosis. In the 300 evaluated arteries, 90 arterial anastomoses were found (30%), 40 on the right side (average diameter 1.63 mm) and
50 on the left side (1.78 mm). In 32 cases there was only one anastomosis, while in 29 cases the CM was bilateral. No anastomoses were detected in 89 patients. Mean distance from the symphysis was 50 mm. No relevant association with hip osteoarthrosis was found for CM. Mean pelvic size was 213 mm.ConclusionsThe evidence from this study suggests that CM is a common variant that needs to be acknowledged before pelvic intervention.
Accuracy of the European Thyroid Imaging Reporting and Data System (EU-TIRADS) in the valuation of thyroid nodule malignancy in reference to the post-surgery histological results
Authors: Skowrońska Anna , Milczarek-Banach Justyna , Wiechno Wieslaw , Chudziński Witold , Żach Marcin , Mazurkiewicz Michał , Miśkiewicz Piotr , Bednarczuk Tomasz 
Published: January 2019

PurposeTo assess the clinical usefulness of the European Thyroid Imaging and Reporting Data System (EU-TIRADS) in the valuation of thyroid nodules malignancy in reference to post-surgery histological results.Material and methodsPre-operative ultrasound was performed in consecutive patients admitted for thyroid surgery between June 2017 and January 2018. Thyroid nodules were classified according to EU-TIRADS to five groups: 1-5. At least one fine-needle aspiration biopsy (FNAB)/patient (dominant or suspected nodule) was performed in an outpatient clinic. The final diagnosis was based on the histological result. The percentage of cancers in each EU-TIRADS group was evaluated. Finally, sensitivity, specificity, accuracy, as well as positive and negative predictive values for malignancy were assessed.ResultsFifty-two patients with a total of 140 thyroid nodules (median: 3 nodules/thyroid [minimum-maximum: 1-6]) were enrolled in the study. Thyroid cancer was diagnosed in 0% (0/6) in EU-TIRADS 2; 0% (0/92) in EU-TIRADS 3; 5.9% (2/34) in EU-TIRADS 4, and 75% (6/8) in EU-TIRADS 5. In nodules assessed as EU-TIRADS ≥ 4 sensitivity, specificity, positive and negative predictive values for malignancy were, respectively: 75% (CI 95%: 40.7-93.5), 94.1% (CI 95%: 86.0-98.5), 75% (CI 95%: 40.7-93.5), and 94.1% (CI 95%: 86.0-98.5).ConclusionsEU-TIRADS is a valuable and simple tool for assessment of the risk of malignancy of thyroid nodules and demonstrates a high ultrasound correlation with histological post-surgery results. FNAB should be performed in all nodules assessed as EU-TIRADS ≥ 4, due to higher risk of malignancy.
Estimation of ground-level particulate matter concentrations through the synergistic use of satellite observations and process-based models over South Korea
Authors: Park Seohui , Shin Minso , Im Jungho , Song Chang-Keun , Choi Myungje , Kim Jhoon , Lee Seungun , Park Rokjin , Kim Jiyoung , Lee Dong-Won , Kim Sang-Kyun 
Published: January 2019

Abstract. Long-term exposure to particulate matter (PM) with aerodynamic
diameters < 10 (PM10) and 2.5 µm (PM2.5) has
negative effects on human health. Although station-based PM monitoring has
been conducted around the world, it is still challenging to provide spatially
continuous PM information for vast areas at high spatial resolution.
Satellite-derived aerosol information such as aerosol optical depth (AOD) has
been frequently used to investigate ground-level PM concentrations. In this
study, we combined multiple satellite-derived products including AOD with
model-based meteorological parameters (i.e., dew-point temperature, wind
speed, surface pressure, planetary boundary layer height, and relative
humidity) and emission parameters (i.e., NO, NH3, SO2,
primary organic aerosol (POA), and HCHO) to estimate surface PM concentrations over South Korea. Random
forest (RF) machine learning was used to estimate both PM10 and
PM2.5 concentrations with a total of 32 parameters for 2015–2016. The
results show that the RF-based models produced good performance resulting in
R2 values of 0.78 and 0.73 and root mean square errors (RMSEs) of 17.08 and
8.25 µg m−3 for PM10 and
PM2.5, respectively. In particular, the proposed models successfully
estimated high PM concentrations. AOD was identified as the most significant
for estimating ground-level PM concentrations, followed by wind speed, solar
radiation, and dew-point temperature. The use of aerosol information derived
from a geostationary satellite sensor (i.e., Geostationary Ocean Color Imager, GOCI) resulted in slightly
higher accuracy for estimating PM concentrations than that from a
polar-orbiting sensor system (i.e., the Moderate Resolution
Imaging Spectroradiometer, MODIS). The proposed RF models yielded
better performance than the process-based approaches, particularly in
improving on the underestimation of the process-based models (i.e., GEOS-Chem
and the Community Multiscale Air Quality Modeling System, CMAQ).
Sobre la institucionalización y la filosofía: cuatro miradas en torno a filosofía y educación
Authors: Lucero Díaz Nathalia 
Published: January 2019

Cuando Platón relata que Sócrates, en su defensa, declara no ser un maestro porque nada tiene que enseñar, deposita sobre los hombros de la filosofía el tema de su institucionalización. Este es un peso que ha cargado como disciplina hasta los sistemas educativos actuales, en los que la filosofía intenta mantener su lugar con graves dificultades, las cuales conllevan preguntas como las siguientes: ¿Puede enseñarse la filosofía? ¿Quiénes son aptos para realizar esta labor? ¿Qué es lo que debe enseñarse?
Cuatro autores remiten a la problemática de la institucionalización y cómo ha repercutido esto en los sistemas educativos: Francisco Bilbao, Arthur Schopenhauer, Friedrich Nietzsche y Jacques Rancière. Este trabajo tiene por objetivo mostrar cómo se relacionan sus propuestas y cuáles son las dificultades que cada uno ve en su época respecto a la ligazón entre filosofía y educación.
Economic Evaluation of Different Organizational Models for the Management of Patients with Hepatitis C
Authors: Fagiuoli Stefano , Pasulo Luisa , Maggiolo Franco , Spinella Rosaria , Del Poggio Paolo , Boldizzoni Roberto , Di Marco Mariella , Aronica Alessandro , Benedetti Chiara , Correale Paolo , Garavaglia Chiara , Nicora Carlo 
Published: January 2019

BACKGROUND: Access to Directly Acting Antivirals (DAAs) for Hepatitis C Virus (HCV) treatment in Italy was initially restricted to severe patients. In 2017, AIFA expanded access to all patients, to achieve elimination by 2030.AIM: To investigate the impact of different hospitals’ organizational models on elimination timing, treatment capacity and direct costs.METHODS: Most Regional healthcare systems in Italy deploy a Center of Excellence (CoE) organizational model, where patients are referred to a single major hospital in the area, which is the only one that can prescribe and deliver DAAs. The study was conducted at Bergamo’s (Lombardy, Italy) Papa Giovanni XXIII hospital (PG-23), which deploys a Hub&Spoke model: the Hub (PG-23) prescribes and delivers DAAs while Spokes (four smaller hospitals) can only prescribe them. The study compares the two models (CoE vs. H&S). Patient journey and workloads were mapped and quantified through interviews with hospital stakeholders. Cost data were collected through the hospital’s IT system; the sample comprised 2,277 HCV patients, over one year.RESULTS: The study calculated the average cost to treat HCV patients (~ € 1,470 per patient). Key cost drivers are lab tests (60%) and specialist visits (30%). Over one year, H&S can treat 68% more patients than CoE. As deferred patients absorb up to 40% of total costs, the “Optimized” model was designed by streamlining specialists’ visits and involving general practitioners during follow-up. “Optimized” model increases treatment capacity and reduces costs of deferred patients by 72% vs CoE.CONCLUSION: The study demonstrates the importance of organizational models in efficiently achieving 2030 elimination.
Is it possible to reconstruct an accurate cell lineage using CRISPR recorders?
Authors: Salvador-Martínez Irepan , Grillo Marco , Averof Michalis , Telford Maximilian J 
Published: January 2019

Cell lineages provide the framework for understanding how cell fates are decided during development. Describing cell lineages in most organisms is challenging; even a fruit fly larva has ~50,000 cells and a small mammal has >1 billion cells. Recently, the idea of applying CRISPR to induce mutations during development, to be used as heritable markers for lineage reconstruction, has been proposed by several groups. While an attractive idea, its practical value depends on the accuracy of the cell lineages that can be generated. Here, we use computer simulations to estimate the performance of these approaches under different conditions. We incorporate empirical data on CRISPR-induced mutation frequencies in Drosophila. We show significant impacts from multiple biological and technical parameters - variable cell division rates, skewed mutational outcomes, target dropouts and different sequencing strategies. Our approach reveals the limitations of published CRISPR recorders, and indicates how future implementations can be optimised.Editorial note: This article has been through an editorial process in which the authors decide how to respond to the issues raised during peer review. The Reviewing Editor's assessment is that all the issues have been addressed (<xref ref-type="decision-letter" rid="SA1">see decision letter</xref>).
Medical Degree Disparity Among Authors in Obstetrics and Gynecology Journals
Authors: Merritt Brian , Simunich Thomas , Ashurst John 
Published: January 2019

Abstract

Context
With the transition to a single accreditation system for graduate medical education, the scholarly activity among core faculty in osteopathic and allopathic residency programs has come under scrutiny. Currently, major differences in scholarly activity requirements exist between core faculty in obstetrics and gynecology residencies accredited by the Accreditation Council for Graduate Medical Education and those accredited by the American Osteopathic Association.

Objective
To determine whether there is a disparity between osteopathic and allopathic physicians among authors with original research published in 4 high-impact obstetrics and gynecology journals during 4 select years.

Methods
The authors reviewed Obstetrics & Gynecology (Obstet Gynecol), the American Journal of Obstetrics and Gynecology (Am J Obstet Gynecol), Fertility and Sterility (Fertil Steril), and Menopause for the degree designation of the first and senior (last) author of each original manuscript for the years of 2000, 2005, 2010, and 2015. Data were analyzed using simple descriptive statistics and linear regression.

Results
In total, 3311 articles and 5909 authors were reviewed. Of these authors, 0.80% (47) had a DO degree. Of 1692 authors with dual advanced degrees, only 0.53% (9) had a DO degree. On subgroup analysis of each journal, 0.87% (13 of 1494) of identified authors in Obstet Gynecol, 1.03% (21 of 2038) in Am J Obstet Gynecol, 0.44% (9 of 2030) in Fertil Steril, and 2.20% (4 of 347) in Menopause were osteopathic physicians. During the years studied, no statistically significant trend could be established for first or senior author publication by osteopathic physicians over time, for all 4 journals or for any individual journal.

Conclusion
Very few osteopathic physicians have served as either the first or the senior author in articles published in Obstet Gynecol, Am J Obstet Gynecol, Fertil Steril, or Menopause during the years studied, and no trend was seen for increased publication by osteopathic physicians in these journals over time.
Dose optimization in computed tomography of brain using CARE kV and CARE Dose 4D
Authors: Shah Pooja , Sharma Amish , Gyawali Jayanti , Paudel Sharma , Shrestha Shanta Lall , Maharjan Surendra 
Published: January 2019

Background: Computed Tomography (CT) scan of brain is the most widely used CT examination. Latest CT scanners have the potential to deliver very low radiation dose by utilizing tube potential and tube current modulation techniques. We aim to determine the application of CARE kV (tube potential modulation) and CARE Dose4D (tube current modulation) in CT scan of brain. Both CARE kV and CARE Dose4D are well-established innovative technology of Siemens Medical Solutions.
Methodology: A prospective hospital-based study was conducted during four months at Tribhuvan University Teaching Hospital (TUTH). The data were collected on a Siemens Somatom Definition Edge 128 slices CT scanner. Non-random purposive sampling technique was employed. Ethical approval and consent to participate were taken for every participant. Non-contrast (NC) CT images were acquired without using CARE kV and CARE Dose4D, whereas during contrast-enhanced (CE) investigation, both were turned on keeping other scanning parameters constant for each individual.
Results: A total of 72 patients, 42 males and 28 females - mean age 41y (range 16-87y) participated in this study. The Body Mass Index (BMI) was 22.0, range 20.1-25.0. The mean value of Computed Tomography Dose Index (CTDI), Dose Length Product (DLP) and Effective Dose (ED) before and after switching on both CARE kV and CARE Dose4D were 58.19±0.35 and 39.67±3.59 milli-Gray (mGy), 946.67 and 652.58 mGy-cm, and 1.98 and 1.36 milli-Sievert (mSv) respectively.
Conclusion: CARE kV and CARE Dose4D can reduce radiation dose in CT scan of brain without loss of image quality.
Recent Advances in Perovskite Oxides for Oxygen Evolution Reaction: Structures, Mechanisms, and Strategies for Performance Enhancement
Authors: Sun Xiong , Yuan Ying , Liu Shuzhi , Zhao Hongqing , Yao Suqiang , Sun Yuying , Zhang Mingyue , Liu Yijiang , Lin Zhiqun 
Published: November 2024

AbstractPerovskite‐type oxides are widely employed as oxygen evolution reaction (OER) electrocatalysts due to their tunable composition, diverse structure, abundant natural reserves, remarkable stability, and low cost. The intrinsic OER electrocatalytic activity of these perovskite oxides is generally enhanced by improving conductivity, increasing specific surface area, and optimizing the adsorption of oxygen‐containing intermediates. This is achieved through rationally designed strategies, including compositional engineering, defect engineering, hybridization, and surface regulation. In this review, recent advances in perovskite oxides for OER are summarized, with a focus on exploring structure‐performance relationships. This review provides a brief introduction to the application of perovskite oxides in OER, followed by the classification and characteristics of these perovskite oxides. The primary OER catalytic mechanisms, and well‐established activity descriptors are discussed. The key strategies are concentrated for enhancing OER activity, including composition engineering, defect engineering, hybridization, and surface reconstruction. Finally, the challenges and opportunities in developing high‐performance perovskite oxides as OER electrocatalysts are presented.
A Polysaccharide Metal Phenolic Network Nanocomposite for Theranostic Applications in Inflammatory Bowel Disease
Authors: Hu Jianlun , Wang Xiaofeng , Sun Qi , Yang Shuyang , Feng Min , Zhang Tao , Hong Hao 
Published: November 2024

AbstractNanotechnology has significantly facilitated the diagnosis and therapy of inflammatory bowel disease (IBD). To obtain better therapeutic efficacy, a nanoplatform built from polysaccharides and metal‐phenolic networks (MPN) is developed here to enhance retention in the damaged intestinal region and modulate systemic immunological status in IBD models. Polysaccharides from tragacanth gum (GUM) are coordinated with iron and further interact with shikonin (Shik) to obtain a nanocomposite named Shik‐Fe@GUM. Shik‐Fe@GUM demonstrates strong and persistent accumulation in the inflamed intestinal region, which is validated in clinical specimens from IBD patients, cocultured cellular models, and living animals. Shik‐Fe@GUM served as a strong scavenger for reactive oxygen or nitrogen species in inflamed tissues or cells, and alleviated local and systemic inflammatory status by cytokine downregulation. In addition, Shik‐Fe@GUM restored the functions of damaged colonic barriers and mitigate disease activity index. The working mechanisms of Shik‐Fe@GUM are also explored and genetic sequencing results revealed that Shik‐Fe@GUM imposed its treatment effect from attenuating major inflammatory pathways. In particular, Shik‐Fe@GUM can modulate IL‐17RA relevant cell signaling and reduce the recruitment of Th17 cells (T helper cell 17). This polysaccharide‐metal‐functional molecule hybrid strategy can be broadly applicable to other IBD drugs and enhance their therapeutic index in patients.