bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trajectories of Breastfeeding-Related Thoughts and Attitudes Among Low-Income Smoke-Exposed Pregnant Women: A Latent Class Growth Analysis
Authors: St Fleur Ruth G. , von Ash Tayla , Alikhani Anna , Dunsiger Shira I. , Risica Patricia Markham 
Published: September 2024

Background: Psychosocial predictors of breastfeeding and changes in those factors during pregnancy, along with the relationship of those changes with both breastfeeding and smoke use and exposure, are not well explored. Research Aim: The aim of this study was to identify distinct trajectories of psychosocial determinants of breastfeeding and smoking in pregnant women. Methods: We used a longitudinal study design and data from a randomized controlled trial conducted among smoke-exposed pregnant women and their infants. Participants were recruited early in pregnancy and were surveyed at ≤ 16 and 32 weeks gestation, delivery, 3 and 6 months postpartum for breastfeeding intentions, initiation, continuation, and smoke use and exposure. Psychosocial variables associated with breastfeeding were measured at baseline and 32 weeks gestation using the Mitra index, a structured questionnaire that assesses barriers and facilitators of breastfeeding intentions. Latent class growth analysis was performed using Mitra scores to identify distinct subgroups of participants with different trajectories. Sociodemographic characteristics, breastfeeding, and tobacco smoke use and exposure were compared across classes. Results: Three or four trajectories were identified for each of the six Mitra scores. Trajectories for all Mitra scores were associated with breastfeeding intention and initiation. Overall, Mitra, knowledge, self-efficacy, social support, and time barrier classes all differed by tobacco smoke use or exposure. Conclusion: Trajectories of breastfeeding knowledge, self-efficacy, social support, and time to breastfeed/social barriers are associated with tobacco smoke use and exposure during pregnancy. Encouragement to breastfeed and to cease and avoid tobacco smoke should start early in pregnancy, focusing on these determinants to improve health outcomes.
Impact of moral resilience and interprofessional collaboration on nurses’ ethical competence
Authors: Amin Shaimaa Mohamed , Atta Mohamed Hussein Ramadan , Khedr Mahmoud Abdelwahab , El-Gazar Heba Emad , Zoromba Mohamed Ali 
Published: September 2024

Background Home care nurses are central in providing holistic and compassionate care to patients in home-based palliative care. Ethical caring competency is essential for home care to sustain nurses’ integrity in the face of moral adversity. Interprofessional collaboration is vital for ensuring ethical decision-making and providing patient-centered care in home-based palliative care settings. Aim This study explored the predictive roles of interprofessional collaboration and moral resilience on ethical caring competency among home care nurses in home-based palliative care. Methods A cross-sectional survey of 400 nurses was conducted from October to December 2023, utilizing standardized scales to measure interprofessional collaboration, moral resilience, and ethical caring competency. A convenience sample of 400 home care nurses was also included in this study. Correlation and linear regression analysis were used to clarify the associative and predictive findings. Ethical Considerations Ethical approval from the ethics committee, institutional permission, and informed consent from the participants were obtained for data collection. Results Correlation analysis showed significant positive correlations between the ethical caring competency, interprofessional collaboration, and moral resilience constructs, with coefficients ranging from 0.482 to 0.967. Linear regression revealed that management of collaborative systems and total moral resilience significantly predict ethical caring competency, explaining 14.6% and 36.6% of its variance, respectively. Other variables, such as the effects of collaboration and communication, did not significantly influence ethical caring competency. Conclusion The study highlights the significant impact of interprofessional collaboration, particularly the management of collaborative systems and moral resilience, on enhancing ethical caring competency among nurses. Implications Enhancing interprofessional collaboration and moral resilience through targeted strategies in nursing practice and education can significantly improve ethical caring competencies. These efforts are essential for delivering high-quality, patient-centered care and for fostering a healthcare environment that respects the ethical principles guiding nursing practice.
Profile of Pulmonary Tuberculosis in People Living with HIV—A Cross-sectional Study
Authors: Maddala Shanti Annapurna , Perumal Shalini , Raghumanda Sunil Kumar , Sreerama Praveena 
Published: September 2024

Introduction: The interface between tuberculosis (TB) and HIV is increased in countries like India where both TB and HIV infection are maximally prevalent. Worldwide, TB is the second leading infectious killer after COVID-19. Ten percent of persons infected by both TB and HIV develop TB disease annually and in one-third of them, it turns out to be fatal. HIV- tuberculosis co-infection has an atypical presentation which mostly depends on the degree of immunosuppression. Aims and Objectives: To study the socio-demographic profile, clinical manifestations, and radiological presentation with relation to the CD4 count of patients co-infected with pulmonary TB and HIV. Methodology: This is a hospital-based observational, cross-sectional study done in 100 HIV-PTB co-infected patients from Nov’2021 to Nov’2023. The study was carried out after getting Institutional ethics clearance and Informed written consent from the participants. Results: The majority (74%) were males with 75% belonging to 31–50 years of age. Fifty-eight percent had a CD4 count between 50 and 200 cells/mm 3 . Fever (90%) was the most common presenting symptom followed by cough (85%). Atypical features of TB were present in 52% of the patients. Conclusion: CBNAAT must be indicated as a primary diagnostic modality for detecting TB in PLHIV. Atypical presentations of TB on Chest X-rays are common which are attributed to low CD4 count (≤200) in the present study. Awareness regarding HIV/AIDS, safe sex practices and cough etiquette is the need of the hour.
Use of a quadratus lumborum block in queens undergoing ovariectomy: a randomised controlled trial
Authors: Paolini Andrea , Bianchi Amanda , Bucci Roberta , Parrillo Salvatore , Di Giosia Alessandro , Ristori Claudia , Carluccio Augusto , Tamburro Roberto , Vignoli Massimo , Collivignarelli Francesco , Robbe Domenico , Costanzini Giulia , Santoro Francesco 
Published: September 2024

Objectives The aim of the study was to evaluate the perioperative analgesic effect of a quadratus lumborum (QL) block in queens undergoing ovariectomy. Methods A total of 37 healthy queens admitted for elective ovariectomy were randomised into two groups: control (CTRL, n = 19) and QL block (QL, n = 18). All cats were premedicated with dexmedetomidine 0.005 mg/kg, alfaxalone 1 mg/kg and methadone 0.1 mg/kg IM. Under general anaesthesia, cats allocated to the QL group received a bilateral ultrasound-guided QL block with 0.4 ml/kg of ropivacaine 0.4% (3.2 mg/kg). No treatment was administered to cats in the CTRL group. Intraoperative rescue fentanyl boluses were administered if haemodynamic and/or respiratory parameters exceeded 30% of the pre-incisional values. Postoperative methadone boluses were administered based on Feline Grimace Scale scores. Demographics, baseline vital parameter values, requirement for rescue analgesia, incidence of hypotension, sialorrhoea, vomiting and dysphoria, and number of cats accepting food at 6 h after extubation were compared between groups. Results A higher number of queens required intraoperative fentanyl in the CTRL group (14/18, 77.8%) compared with the QL group (1/19, 5.3%) ( P <0.001). The median total fentanyl dose was 4 µg/kg (range 0–4) in the CTRL group and 0 µg/kg (range 0–4) in the QL group ( P <0.001). No statistically significant difference was found between groups when comparing the number of animals requiring postoperative methadone, total methadone dose, episodes of hypotension, sialorrhoea, vomiting and dysphoria, and number of queens accepting food at 6 h postoperatively. No adverse effect or complication potentially related to the block was recorded. Conclusions and relevance The QL block resulted in a lower intraoperative fentanyl requirement in queens undergoing ovariectomy. Further studies are needed to clarify the postoperative analgesic effect of this technique in cats.
Graphene nanoplatelet additive impact on compression and bending strength of S-2 glass face-sheet honeycomb sandwich panels: An experimental study
Authors: Demirci Ibrahim 
Published: September 2024

In this study, the three-point bending, edge-wise, and flat-wise strengths of Nomex® sandwich structures with un-doped S-2 glass fiber face-sheet (Neat/S-2/glass) and those with Graphene nanoplatelet-doped S-2 glass fiber face-sheet (GNPs/S-2/glass) were examined parametrically. In the macroscopic images obtained post-experimentation, the damage to the structures’ face layer, core, and interface with GNP (graphene nanoplatelet) additives was visualized. Morphological images depicting the damaged structures were obtained by applying image processing techniques to the macroscopic images. Finally, the fracture mechanisms of fiber/fiber and fiber/matrix interfaces within the shell layers were examined in SEM images. As a result of the study, the addition of GNPs increased the strength of the interfaces between the fiber layers and the fiber core within the face layers of S-2 glass face-sheet Nomex® sandwich structures, leading to a 40% enhancement in bending strength, a 14% improvement in core compressive strength, and a 2.85% increase in edge-wise compressive strength. Moreover, the delamination damage between the face layer and the core, which undermines the structural integrity of the sandwich structure, was not observed in GNPs/S-2/glass sandwich structures. Thus, the damage propagation throughout the sandwich structure contributed to enhancing its load-carrying capacity. The collapse extent of the sandwich structures, determined through image processing, measured 8676 mm in Neat/S-2/glass sandwiches, whereas it amounted to 10,410 mm in GNPs/S-2/glass sandwiches. The inclusion of GNPs additive augmented the collapse strength of the sandwich structure by 19.9%. Utilizing GNPs as a filler in the matrix material has been recognized as a practical approach to enhancing the mechanical strength of sandwich structures.
What are the reported procedural costs of vascular access surgery?
Authors: Edgar Ben , Jones Catrin , Aitken Emma , Stevenson Karen , Jackson Andrew , Gaianu Lucian , Thomson Peter , Kasthuri Ram , Stove Callum , Kingsmore David B 
Published: September 2024

Introduction: Since the inception of arteriovenous grafts (AVG) as a novel technique, there has been greater emphasis on the assessment of outcomes rather than costs. Gross-costing methods over-simplify vascular access surgery and do not reflect the true costs of the service, preventing accurate cost-effectiveness analysis. The aim of this study is to assess the reporting of procedural costs of arteriovenous access creation in economic analyses of vascular access surgery, and to compare the reported costs of the two most performed procedures – arteriovenous fistula (AVF) and arteriovenous graft (AVG). Methods: This systematic review included studies reporting a per-procedure cost for AVF or AVG creation. Costs were adjusted from original to target price year using a Gross Domestic Product (GDP) deflator index and converted to 2021 US Dollars using conversion rates based on purchasing power parities. Results: The results demonstrate wide discrepancy in the reported procedural costs of arteriovenous access creation. Most of the data represents retrospectively observed costs rather than prospective data collected on an intention-to-treat basis. Charges are frequently presented in lieu of costs, and aggregated gross-costing methodology predominates rather than more accurate micro-costing. Conclusion: Future micro-costing studies of vascular access surgery are essential to allow a greater understanding of cost-drivers and allow accurate cost-effectiveness analysis.
Health Risk Assessment of Heavy Metals in Lettuce and Spring Onion on Human Health in Kumasi, Ghana
Authors: Adoma Prince Owusu , Amponsah Afia Sakyiwaa , Ankrah Kwarteng Twumasi , Acquah Francis , Amu Hubert , Agjei Richard Osei , Hanson Ruby 
Published: September 2024

Introduction: The demand and consumption of vegetables are significantly increasing worldwide, which has resulted in urban farming on anthropogenic sites. This study assessed the concentrations of some selected heavy metals in lettuce and spring onion in line with the WHO/FAO required standard and its implications on human health. Methods: The study was carried out in Kumasi, within moist semi-deciduous forest vegetation, Ghana. The digested samples were analyzed for heavy metals (Cu, Cr, Fe, Mg, Ni, and Zn) using atomic absorption spectrophotometer (AAS Model AA 400p). Analysis of variance was used to test the level of significance at α = .05. Results: The study found mean concentrations of chromium and iron in lettuce and spring onion to be below detection level (BDL) in all study sites based on WHO/FAO permissible level. Also, while copper in lettuce was BDL at all the sites, there were higher mean concentration of copper in spring onion at BSGS (131.5 ± 0.31 mg/kg) and BSG (120.8 ± 0.01 mg/kg). The mean concentration of nickel in lettuce (137.15 ± 0.0231) and spring onion (173.55 ± 0.02 mg/kg) at BSGS were higher than WHO/FAO permissible level. Mean concentration of zinc in both lettuce and spring onion were higher than WHO/FAO permissible level in all the study sites, except zinc in spring onion at KT. The ANOVA test statistics showed no significant difference among the concentrations of heavy metals in all sites, except zinc in lettuce and nickel in spring onion. The study found cancer risk factor for nickel, which exceeded the benchmark of 1 × 10−6 for both lettuce and spring onion, indicating that long-term consumption could increase the risk of cancer in consumers. Conclusion: The study’s findings call for strict regulation and regular monitoring of heavy metals in vegetables cultivated at anthropogenic sites in urban areas to ensure food safety and consumer health.
‘The glowing fireflies’: Invisible activism under China’s queer necropolitics
Authors: Bernot Ausma , Yang Fan , Davies Sara E 
Published: September 2024

In China, the escalating repression of gender and sexual diversity has given rise to ‘queer necropolitics’. ‘Queer necropolitics’ – a concept we build on – refers to the hegemonic ability to determine who is allowed to suffer, survive, or thrive. We examine China’s sustained re-enforcement of traditional gender norms, which has rendered queer communities non-existent from official recognition. In this context, we aim to understand how China’s state queer necropolitics has shaped queer organising in the country. From 2021 to 2022, we conducted 26 semi-structured interviews with a diverse cohort of self-identified LGBTIQ+ members and activists across 12 provinces in China. We find that the interplay of legal invisibility and politicised, moralised visibility has placed queer communities under hegemonic governance techniques of suppression. The paper argues that China’s queer necropolitics has established invisible activism. The juxtaposition of invisibility with activism denotes the quiet, implicit, and everyday embodied acts of communal care among queer communities as a form of resistance. Building on the metaphor of ‘glowing fireflies’ shared by a research participant, invisible activism presents a more sustainable approach than conventional rights-based activism. The paper expands our understanding of politically antagonistic practices, acknowledging the diversity and complexity embedded within queer activism.
A scoping review of qualitative studies on sexual and reproductive health and rights in Uganda: Exploring factors at multiple levels
Authors: Buser Julie M , Kumakech Edward , August Ella , Rana Gurpreet K , Gray Rachel , Auma Anna Grace , Jacobson-Davies Faelan E , Endale Tamrat , Pebolo Pebalo Francis , Smith Yolanda R 
Published: September 2024

Background: Uganda is burdened by high unintended and teen pregnancies, high sexually transmitted infections, and harm caused by unsafe abortion. Objectives: Explore factors influencing sexual and reproductive health and rights (SRHR) in Uganda by synthesizing evidence from qualitative studies using a scoping review. Eligibility Criteria: Original qualitative peer-reviewed research studies published between 2002 and 2023 in any language exploring factors influencing SRHR in Uganda. Sources of Evidence: Eight databases searched using qualitative/mixed methods search filters and no language limits. Charting Methods: Information extracted included author, article title, publication year, study aims, participant description, data collection type, sample size, main findings, factors at the individual, interpersonal, community, and policy levels, implications for SRHR in Uganda, and study limitations. Quality of the selected articles was assessed using the Critical Appraisal Skills Programme tool. Results: One hundred seventy-three studies met inclusion criteria. At the individual level, knowledge and attitudes toward SRHR, risky sexual behavior, and access to maternal SRHR services were identified as critical factors influencing health outcomes. Interpersonal factors included communication with sexual partners and relationships with family, school, and community members. Healthcare organization factors included adolescent access to education, SRHR services, and HIV prevention. Cultural and social factors included gendered norms and male involvement in SRHR. Policy-level factors included the importance of aligning policy and practice. Conclusions: Multiple factors at individual, interpersonal, community, healthcare, cultural, and policy levels were found to influence SRHR in Uganda. The findings suggest that interventions targeting multiple levels of the socio-ecological system may be necessary to improve SRHR outcomes. This review highlights the need for a holistic approach that considers the broader socio-ecological context. Reducing identified gaps in the literature, particularly between policy and practice related to SRHR, is urgently needed in Uganda. We hope this review will inform the development of policies and interventions to improve SRHR outcomes.
Growth hormone treatment in children with Prader–Willi syndrome: safety and effectiveness data from the PATRO Children study
Authors: Lämmer Constanze , Backeljauw Philippe , Tauber Maite , Kanumakala Shankar , Loche Sandro , Otfried Schwab Karl , Pfäffle Roland , Höybye Charlotte , Lundberg Elena , Dahlgren Jovanna , Ek Anna E. , Battelino Tadej , Kriström Berit , Esmael Altaher , Zabransky Markus 
Published: September 2024

Background: Recombinant human growth hormone (rhGH, somatropin) therapy is approved in children with Prader–Willi syndrome (PWS). Objectives: To report safety and effectiveness data for children with PWS treated with biosimilar rhGH (Omnitrope®, Sandoz) in the PAtients TReated with Omnitrope (PATRO) Children study. Design: PATRO Children was a multicenter, non-interventional, postmarketing surveillance study. Methods: Children with PWS received Omnitrope according to standard clinical practice. Adverse events (AEs) were monitored for the duration of Omnitrope treatment. Effectiveness outcomes were also assessed, including height standard deviation (SD) scores (HSDS). Results: As of July 2020 (study completion), 235 patients with PWS had been enrolled. At baseline, 95.7% ( n = 225) of patients were prepubertal and 86.4% ( n = 203) were rhGH treatment-naïve. At analysis, the median (range) treatment duration in the study was 56.8 (2.9–155.8) months. AEs were reported in 192 patients (81.7%) and were suspected as treatment-related in 39 patients (16.6%). Serious AEs (SAEs) were reported in 96 patients (40.9%) and were suspected as treatment-related in 22 patients (9.4%). The most frequent treatment-related SAEs were sleep apnea syndrome ( n = 11; 4.7%), tonsillar hypertrophy ( n = 4; 1.7%), and adenoidal hypertrophy ( n = 4; 1.7%). Development of scoliosis was considered treatment-related in two patients; development of impaired glucose tolerance in one patient and type 2 diabetes mellitus in another patient were considered treatment-related. Effectiveness outcomes were primarily assessed in 153 patients who completed 3 years of treatment. Among the 151 prepubertal patients (135 treatment-naïve), mean (SD) change from baseline in HSDS after 3 years was +1.50 (1.07) across all patients and +1.57 (1.07) for treatment-naïve patients. Conclusion: These data suggest that biosimilar rhGH is well tolerated and effective in patients with PWS managed in real-life clinical practice. Patients with PWS should continue to be closely monitored for well-known safety issues (including respiratory, sleep, and glucose metabolism disorders, and scoliosis) during rhGH treatment.
Rectal toxicity of 3-dimensional conformal radiation therapy following hydrogel spacer (Space OAR) injection for men with prostate cancer
Authors: Kawaguchi Gen , Ishida Kyohei , Nishiyama Hiroki , Ikeda Yohei , Hara Noboru , Nishiyama Tsutomu 
Published: September 2024

Purpose: To evaluate whether hydrogel spacer injection, which increases the distance between the prostate and rectum, prior to local radiation therapy for prostate cancer reduces rectal and bladder toxicity. Patients and methods: With institutional review board approval (05-004), we retrospectively reviewed rectal and bladder toxicity after local radiation therapy in patients with prostate cancer who were followed up for more than 1 year. Results: We included 156 patients who had received local radiation therapy. Their ages ranged from 63 to 86 years, with an average of 75 years. Most patients were treated only on the prostate and seminal vesicles. All prostate sites were irradiated as follows: whole pelvis with prostate in 10 patients, whole pelvis with prostate and metastatic sites in six, and prostate and metastatic sites in eight. Radiation therapy (70–74 Gy) was performed for the prostate. Irradiation of 45–46.8 Gy was applied to whole pelvic and para-aortic lymph nodes, with 54–60 Gy applied to bone metastatic sites. In one case, stereotactic body radiation therapy (36 Gy) was performed for a sacral bone metastatic site. The hydrogel spacer was injected in 39 patients. Rectal toxicity was reported in 21 patients without (17.9%) and 3 patients with (7.7%) the hydrogel spacer. Bladder toxicity was reported in five patients without and only one patient with the hydrogel spacer. Conclusion: Hydrogel spacer injection prior to local radiation therapy for prostate cancer reduces rectal radiation exposure, lowers the risk of rectal complications, and may be a promising method for boosting the irradiation dose in the future.