bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Iron-Folate Supplementation on Maternal Hematological Parameters among Pregnant Women in Addis Ababa, Ethiopia: An Institutional Multi-center Prospective Follow-up Study
Authors: Admass Zeleke Endalew , Ayalsew Haimanot Andualem , Gessesse Abraham Dessie , Leminie Abebaye Aragaw , Wondimu Diresibachew Haile 
Published: December 2024

Abstract

Background
Iron-folate (IFA) supplementation is a well-established strategy for reducing anemia in pregnant women. Studies on the extent to which it reduces maternal anemia, its effect on leukocytes and platelet count are limited and require further investigation.
Objective
This study aimed to assess effect of iron folate supplementation on maternal hematological parameters among pregnant women in public hospitals in Addis Ababa, Ethiopia.
Methods
An institution-based prospective follow-up study was conducted in public hospitals in Addis Ababa from May 1, 2023, to March 30, 2024, with 410 participants selected through systematic random sampling. Data collection involved interviews, medical record reviews, and laboratory tests. Statistical analysis was performed using SPSS Version 27, including Shapiro-Wilk test, descriptive statistics, paired sample t-tests, and Wilcoxon signed-rank tests. A p-value of less than 0.05 was considered significant.
Results
The RBC count significantly increased in both sets of respondents. In non-anemic individuals, it rose from a baseline of 4.51 ± 0.43 to 4.70 ± 0.54 million cells per microliter (P < 0.001), while in anemic respondents, it increased from 4.05 ± 0.37 to 4.23 ± 0.39 million cells per microliter (P < 0.001). Similarly, the platelet count decreased across both groups. In anemic participants, it dropped from 293.3 ± 37.01 to 285.4 ± 37.83 thousand per microliter (P < 0.01), and in non-anemic pregnant women, it declined from 274.9 ± 56.3 to 254.29 ± 59.07 thousand per microliter (P < 0.001). After supplementation, no significant change in leukocyte count was observed in both anemic and non-anemic pregnant women (p = 0.065 and p < 0.059) respectively.
Conclusion
Iron-folate supplementation significantly increased RBC counts in both anemic and non-anemic pregnant women, with a slight decrease in platelet counts and no change in leukocyte levels. Further research on the effect of iron folate intake on hematological indices is recommended.
Single paternity in the kelp crab Taliepus dentatus despite polyandry
Authors: Pardo Luis M , Narvaez Karla , Rojas-Hernandez Noemi , Chaparro Oscar , Bruning Maria José , Veliz David 
Published: December 2024

Abstract

The paternity patterns observed in decapods reflect the mating strategies and tactics employed by different species. However, these patterns may be altered by fishery management, particularly through male-biased harvesting, which affects the natural sex ratio and subsequently influences mating success and reproductive success. This study examined the reproductive strategies of the kelp crab Taliepus dentatus, revealing that, unlike other majid crabs, T. dentatus demonstrates a single paternity pattern, apparently unaffected by fishing pressures. Histological analyses supported the sperm economy hypothesis and revealed the seminal receptacle to be non-compartmentalised. Despite this, contrasting mating schemas in laboratory experiments discriminated the impacts of males and females in mating success, revealing that females were receptive approximately 50% of the time, but did not exhibit mate selection during the pre-copulatory period. Additionally, results showed that mating was mostly influenced by the presence of sperm competition, as males rarely mated or displayed guarding behaviour when other males were present. Finally, despite traits promoting multiple paternity, factors such as limited natural encounters, short copulatory durations and full seminal receptacles likely contributed to the observed genetic monogamy in T. dentatus. This species appears to depend on its year-round mating success and sperm storage capabilities to reduce the effects of male-biased fishing pressures. This research emphasises the need 1) to understand reproductive behaviours using multiple approaches (i.e. genetics, behaviour and histology) and 2) to perform contrasting mating experiments in sequential and simultaneous designs.
Isolation, identification and genome analysis of a new Escherichia coli phage XH12 and enhancement of antibacterial activity of its lysozyme by chimeric cationic peptides
Authors: Hou Xuhao , Pu Jiaqi , Li Yu , Xie Wenhai , zhang Limei , Deng Hongkuan 
Published: December 2024

Abstract

Antibiotics are no longer adequate to address the threat of antibiotic resistance, especially Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and other gram-negative pathogens, which pose a serious threat to human health worldwide. The antibiotic resistance pandemic requires the search for new antimicrobials as alternatives that are effective and less prone to resistance. Phages and its lysozyme become an attractive alternative to currently available antibiotics. However, gram-negative bacteria have outer membrane that acts as a strong barrier, so lysozymes are often used in combination with outer membrane permeator, or are modified to overcome the outer membrane barrier. To combat drug-resistant E. coli, in this study, we used multidrug-resistant E. coli eco-3 as host bacteria, a lytic phage XH12 was isolated from sewages, phage XH12 can lyse about 81% (30/37) of E. coli strains tested. The biological characteristics and genome of phage XH12 were analyzed, and we found that lysozyme Lys12 encoded by phage XH12 combined with ethylenediaminetetraacetic acid (EDTA) had antibacterial activity against E. coli. Two fusion lysozymes were obtained by fusing different amounts of cationic amino acid polypeptides with the C-terminal of Lys12. The fusion lysozymes could improve the antibacterial activity against E. coli from extracellular space. The study of phage XH12 and its lysozyme will provide basic information for further study of the treatment of multidrug-resistant E. coli infection.
Moral resilience among Chinese nursing interns: a cross-sectional study with latent profile analysis
Authors: Shuai Ting , Lin Hang , Tao Xiaoqun , Chen Li , Tian Xu , Yi Lijuan 
Published: December 2024

Abstract

Background: Moral resilience is essential for nursing interns to cope with ethical conflicts during their internships. It is critical to gain insights into the characteristics of moral resilience and understanding its influencing factors to promote professional growth and ethical decision-making skills.
Objectives: This study aims to identify the characteristics of moral resilience in nursing interns and explore its influencing factors from demographic, psychological and moral perspectives.
Methods: A secondary analysis was conducted using data from four published studies on junior colleges in Hunan Province, China, enrolling 467 nursing interns. Data were collected on demographic characteristics, moral resilience, moral courage, moral sensitivity, and professional identify. Latent profile analysis was employed to categorize moral resilience. Univariate analysis and multinominal logistic regression were used to identify influencing factors.
Clinical trial number: not applicable.
Results: The data supported a three-profile model of moral resilience: the "low resilience - high efficacy" group (5.14%), the "medium resilience - medium efficacy" group (67.03%), and the "high resilience -low efficacy" group (27.83%). Factors associated with "medium resilience - medium efficacy" group included higher moral courage (Adjusted Odds Ratio [AOR] = 1.107, P < 0.001). Those with higher moral sensitivity (AOR = 1.053, P = 0.011) and better professional identity (AOR = 0.952, P= 0.026) were more likely to belong to "high resilience -low efficacy" group.
Conclusion: This study emphasizes the heterogeneity of moral resilience and its key influencing factors among nursing interns. The findings underscore the importance of tailored psychological interventions to strengthen moral resilience within this group.
Predictive value of serum lipid in intravenous thrombolysis hemorrhagic transformation of acute cerebral infarction: a single-center prospective study
Authors: Cheng Dongxia , Fu Huawen , Li Xiaofeng , Zhou Ziqi 
Published: December 2024

Abstract

Objective: To investigate the effect of total cholesterol (TC)to high-density lipoprotein cholesterol (T/H) ratio in the acute cerebral infarction (ACI) and intravenous thrombolysis (IVT) hemorrhagic transformation (HT) to reduce the incidence of ACI and the rate of HT by controlling blood lipid levels.
Methods: Collect patients with ACI who received alteplase༈rt-PA༉ from January 1, 2022, to December 31, 2023, and patients with non-acute cerebral infarction༈non-ACI༉ in the same period. Patients were categorized into Group A and Group B according to whether HT occurred after IVT, Group C and Group D according to whether tirofiban was coadministered, and Group E and Group F according to prognosis. The risk factors for ACI、HT, and the predictive value of the T/H ratio for HT were observed using SPSS 27.0 software.
Results: Age, TC, and HDL were risk factors for ACI, T/H, and HDL were statistically significant differences in the HT (P < 0.05); by logistics analysis, there was a correlation between T/H and HT; HT was prone to occur when the T/H was ≥ 3.25. The use of tirofiban after IVT did not increase the risk of HT. This study found that HT, type of HT, age, hypertension, baseline NIHSS score, platelet volume distribution width (PDW), TC, D-dimer, and fibrinogen content (FDP) had a statistically significant difference between the two groups in terms of prognosis. There were statistically significant differences between the baseline NIHSS score and the 90-day prognosis.
Conclusion: Patients with IVT for ACI, especially those with high baseline NIHSS, lower TC, higher HDL, and higher T/H ratio, have a higher risk of HT, which also correlates with long-term outcomes of the patient. The T/H ratio is valuable in predicting HT after IVT.
Maternal Environmental Tobacco Smoke Exposure During Pregnancy and the Risk of Congenital Heart Defects: a Case-control Study in Sichuan, China
Authors: Luo Min , Liu Yuci , Zhang Gang , Liu Weixin , Gao Yan , Zhou Tianjin , Zhao Ziling 
Published: December 2024

Abstract

Studies on the association between maternal environmental tobacco smoke (ETS) exposure during pregnancy and congenital heart defects (CHD) in offspring are limited. In this case-control study, we collected data from 116 fetuses with CHD and 3744 fetuses without any congenital anomalies to examine the association between maternal ETS exposure during different weeks of pregnancy and the duration of exposure with offspring CHD. Our results showed that maternal ETS exposure during pregnancy was associated with an increased risk of CHD in a dose-response gradient. The adjusted odds ratios (AOR) and corresponding 95% confidence intervals (CIs) were 2.97(1.42, 6.17) and 3.19(1.35, 7.50) for ETS exposure of 2-5h/week and >5h/week, respectively. Compared to the unexposed group, the AORs for maternal ETS exposure only in the first trimester and continuous exposure throughout pregnancy were 2.32 and 4.89, respectively. Our findings suggest that maternal ETS exposure during pregnancy may increase the risk of offspring CHD in a dose-response manner, and that ETS exposure during different weeks of pregnancy is associated with an increased risk of CHD among non-smoking pregnant women. These results highlight the importance of preventing ETS exposure throughout pregnancy, particularly during the early stages.
Rurality and relative poverty drive acquisition of a stable and diverse gut microbiome in early childhood in a non-industrialized setting
Authors: Seco-Hidalgo Victor , Witney Adam , Chico Martha E , Vaca Maritza , Arevalo Andrea , Schuyler Alexander J , Platts-Mills Thomas AE , Ster Irina Chis , Cooper Philip J 
Published: December 2024

Abstract

There are limited longitudinal data from non-industrialized settings on patterns and determinants of gut bacterial microbiota development in early childhood. We analysed epidemiological data and stool samples collected from 60 children followed from early infancy to 5 years of age in a rural tropical district in coastal Ecuador. Data were collected longitudinally on a wide variety of individual, maternal, and household exposures. Extracted DNA from stool samples were analyzed for bacterial microbiota using 16S rRNA gene sequencing. Both alpha and beta diversity indices suggested stable profiles towards 5 years of age. Greater alpha diversity and lower beta diversity were associated with factors typical of rural poverty including low household incomes, overcrowding, and greater agricultural and animal exposures, but not with birth mode or antibiotic exposures. Consumption of unpasteurized milk was consistently associated with greater alpha diversity indices. Infants living in a non-industrialized setting in conditions of greater poverty and typically rural exposures appeared to acquire more rapidly a stable and diverse gut bacterial microbiome during childhood.
Examining the teacher readiness gap at the interface of artificial intelligence and medical education: A qualitative study of clinical educators
Authors: Murphy Tim , Vaughn Ginger , Carpenter Rob E. , McKinney Benjamin , McWhorter Rochell 
Published: December 2024

Abstract

The integration of Artificial Intelligence (AI) into healthcare is transforming medical education, reshaping how diagnostic skills, treatment approaches, and patient care methods are taught. This study investigates the interface of AI and medical education, focusing on the preparedness and views of clinical educators. Using the Unified Theory of Acceptance and Use of Technology as a framework, this research assesses the factors influencing AI adoption in medical training, including performance expectancy, effort expectancy, social influence, and facilitating conditions. Through an inductive-to-deductive methodology, we conducted semi-structured interviews with 15 clinical educators from the south-central region of the United States who oversee third-year medical students. Key findings of teacher readiness at the interface of AI and medical education centered around 1) the technological learning curve, 2) the need for hands-on, action-based learning, 3) the critical role of institutional support, 4) mentorship as a crucial support system, 5) balancing human elements with AI integration, and 6) divergent comfort levels between generational cohorts. While AI holds promise to reform medical education by fostering adaptive, personalized learning environments, it also raises challenges in preserving essential human elements of patient care. Addressing these challenges demands a strategic, institutionally supported shift in medical pedagogy to ensure that AI integration is both effective and sustainable. The study’s insight into clinical educators' perspectives lay the groundwork for developing AI-ready educational models that balance technical expertise with core humanistic values, supporting a comprehensive approach to medical training in the AI-driven future.
Using a GP prescribed, internet-based self-help program "My Symptoms" for patients with persistent physical symptoms: A qualitative study on patient experiences (the eASY study)
Authors: Frumer Michal , Rask Mette Trøllund , Frostholm Lisbeth , Rosendal Marianne 
Published: December 2024

Abstract

Background
Digital self-help programs are increasingly seen as essential in the transformation of healthcare in response to changing demographics and increasing demands for health care services. While assisted internet-based psychological treatments show promising results, integrating self-help programs into routine care poses challenges. Understanding the interactions between the program and patients is particularly important. This study focuses on an internet-based self-help program for patients with persistent physical symptoms (PPS) prescribed by general practitioners (GPs). The aim was to explore how patients received, utilized, and adopted this program named “My Symptoms”.
Methods
Using a sociomaterial approach, the study focuses on how patients engage with the self-help program “My Symptoms” in their everyday lives. Data was generated through 22 in-depth semi-structured interviews with primary care patients offered the program. Interviews were audiotaped, transcribed verbatim, and analysed with inspiration from a thematic approach focusing on patient use and experiences.
Results
The analytical process led to the identification of four central themes. 1) Engagement and timing: Patients engaged with “My Symptoms” in diverse ways with significant variation in usage. This variation was linked to individual circumstances and the timing of the prescription of the program. 2) Processes of translation: Translating general advice into personal situations and actual behaviour change proved complex. 3) Relational support: Patients faced challenges with the self-care aspect of the program, expressing a need for relational support and guidance to stay motivated and prioritizing program elements. 4) Structuring effects: Patients described that the program provided an incentive and stimulus for change, helping them make small concrete improvements in daily practices.
Conclusions
The study deepens the understanding of patient experiences and use of self-help interventions in primary care and highlights broader challenges of the digitized healthcare system, noting that patients may also need relational support. This emphasizes the importance of ensuring individualised access for different patient populations to counteract health inequalities.
Immunization Without Records: Examining the Impact of Missing Vaccine Cards on Caregiver Recall and Associated Factors Among Public School Children in Rural Nigeria
Authors: Ogbuagu Ifechukwu , Ifemeje Anthonia Ifeyinwa , Odiakosa Alfred , Nri-Ezedi Chisom Adaobi 
Published: December 2024

Abstract

Background
Immunization remains a cornerstone of public health, yet maintaining accurate vaccination records is a challenge in rural communities where vaccine cards are often missing. In such settings, caregivers’ recall of their ward’s vaccination history may be the only available source of information, potentially leading to discrepancies in immunization status. This study aims to evaluate the availability of vaccine cards, assess caregiver recall, and identify factors associated with the absence of vaccination records among public school students in a rural Nigerian community.
Methods
A cross-sectional study was conducted among 2780 public school students and their caregivers in a rural community in Anambra State, Nigeria. Data on vaccination card availability, caregiver recall of vaccines, and demographic characteristics were collected through structured interviews. Logistic regression was employed to identify factors associated with the presence of vaccination cards, with odds ratios (ORs) and 95% confidence intervals (CIs) used to quantify associations, with the following adjustments.
Results
Majority (88.7%) of the subjects did not have a vaccination card. Following adjustments, male students were 36% less likely to have a vaccine card compared to females (aOR: 0.638, 95% CI: 0.443–0.918, p = 0.0155). Older students were also less likely to have a vaccine card (aOR: 0.881 per year increase in age, 95% CI: 0.827–0.938, p < 0.001). Higher caregiver recall percentages were associated with a slightly decreased likelihood of having a vaccine card (aOR: 0.960, 95% CI: 0.947–0.974, p < 0.001).
Conclusion
This study revealed significant gaps in immunization record-keeping in rural Nigeria, where a majority of children lack vaccination cards, and caregiver recall remains unreliable. These findings underscore the urgent need for enhanced record-keeping practices and innovative digital solutions to accurately track vaccination status. Strengthening these systems is crucial for improving vaccine coverage, supporting public health initiatives, and protecting children from preventable diseases in resource-limited settings.
Could Urinary Amino Acids Be as New Biomarkers for Detection of Sarcopenia?
Authors: Sivritepe Rıdvan , Basat Sema Uçak , Gökmen Neslihan , Duygu Aydın , Siyer Özge Kıran , Tiril Serhat Mert 
Published: December 2024

Abstract

Background
Sarcopenia is one of the syndromes that cause falls, fractures, and morbidity in geriatric patients. Early diagnosis of sarcopenia is important as it is known that muscle functions improve with early intervention. We aimed to investigate whether urinary amino acid levels are a biomarker of sarcopenia.
Methods
The study included ninety-one patients aged 45–65 who applied to our outpatient clinic. The patients underwent physical examinations, blood tests and sixteen different urine amino acid levels were analyzed. Anthropometric measurements were made. Physical performances were evaluated. Muscle strengths were measured. Muscle masses were analyzed. Patients were divided into 4 groups: pre-sarcopenic, sarcopenic, severe sarcopenic and non-sarcopenic. Statistical significance level was determined as p < 0.05.
Results
A total of ninety-one patients, fifty-three female and thirty-eight males, were included in the study. Three patients had pre-sarcopenia, eleven had sarcopenia, and two met the criteria for severe sarcopenia, while seventy-five patients were non sarcopenic. A significant difference was found between the sarcopenia and non-sarcopenia groups in terms of glutamine and valine levels (p < 0.001 for both). In the ROC analysis, the cut-off value of glutamine and valine levels in detecting sarcopenia was determined as 492 micromole/L and 209 micromole/L (AUC:0.875;0.968 respectively). In correlation analysis between urine amino acid levels and muscle strength-mass a negative correlation was found between leucine and muscle strength and muscle mass.
Conclusions
We found that patients with sarcopenia had high urinary glutamine and valine levels and that urinary leucine levels were associated with both muscle strength and muscle mass.
Caffeine supplementation does not enhance jump performance: a placebo and nocebo study
Authors: Sousa Victor , Azevedo Vitor Assis Marques , Azevedo Henrique Assis Marques , Loturco Irineu , Azevedo Paulo Henrique Silva Marques 
Published: December 2024

Abstract

Purpose: There is evidence that caffeine supplementation improves jump performance in studies where the design is randomized, counterbalanced and placebo-controlled. However, there is recent evidence that this outcome is expectation-dependent. Here, we applied a method to nullify the expectancy. Therefore, we aimed to check whether caffeine supplementation improves jump performance when nullifying the positive expectation for performance improvement.
Methods: Thirty-four women participated. Participants performed squat jump and countermovement jump in four days. The first day was a control day. In the last three days, we gave the participants caffeine (6 mg. kg-1). However, we informed them that randomly and blindly, participants would receive caffeine (ergogenic), placebo (ineffective) or lactic acid (ergolytic).
Results: Jump performance neither improves along the days (P>0.05) nor through different expectations (P>0.05). Still, there is a moderate chance (>75%) to observe similar performance between control and supplementation days or different expectancies.
Conclusion: We conclude that caffeine supplementation does not improve jump performance in women when positive expectation is nullified.