bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of CONFIVAC, an intervention to enhance Paediatric Nurses and Paediatricians skills to promote vaccination: a mixed-methods cluster randomised clinical trial
Authors: Roel Elena , Henderson Elisabet , Valmayor Sara , Porthé Victoria , Asensio Alba , Ramírez-Morros Anna , Bruna Xavier , Pasarín M Isabel , Rius Cristina , Díez Elia , Group CONFIVAC Research 
Published: February 2025

Abstract

Background
Vaccine hesitancy (VH) poses a significant challenge to achieving optimal vaccination coverages worldwide. Paediatric healthcare workers (PHCWs) are fundamental in promoting vaccination but often lack adequate training to address VH. We designed CONFIVAC, an evidence-based training program developed using intervention mapping to enhance PHCWs' knowledge, self-efficacy, and skills in managing VH and fostering a culture of immunization in primary care. This study aimed to evaluate its effectiveness.
Methods
We conducted a mixed methods study including a cluster-randomized controlled trial with142 PHCWs in Barcelona and Central Catalonia, Spain from October 2023 to February 2024 and a qualitative study using a thematic analysis. Paediatric teams were randomized into intervention (CONFIVAC) and control (standard care) arms. CONFIVAC included 12 hours of online and in-person training on vaccine knowledge, communication strategies, and organizational tools. Outcomes were assessed through self-administered questionnaires at baseline (T0) and four months later (T1). Key outcomes included vaccine-promoting behaviours (presumptive communication, anticipation of upcoming vaccines, and explicit vaccine recommendations) and self-perception of adequate training to handle VH. We performed logistic regression models to estimate odds ratios (OR) with 95% confidence intervals using an intention-to-treat approach. Focus groups provided qualitative insights.
Results
At T1, PHCWs in the intervention arm were more likely to use presumptive communication (aOR: 4.05 [2.30;7.15]) and anticipate upcoming vaccines (aOR: 2.64 [1.50;4.65]) than controls. Explicitly recommending vaccination when encountering cases of VH did not reach statistical significance (aOR: 1.75 [0.89;3.44]). Self-perception of adequate training was higher in the intervention arm (aOR: 3.85 [2.10;7.03]). Satisfaction with the training was high, and focus group participants reported improved communication strategies, more empathy towards VH families, and increased confidence in managing VH situations.
Discussion
CONFIVAC enhanced PHCWs' vaccine-promoting behaviours and self-efficacy, demonstrating the value of accessible, evidence-based training programs to support vaccination efforts in routine practice.
Trial registration
ClinicalTrials NCT06489236
Accessing to additional diversity in Mycobacterium tuberculosis through long-read sequencing: Impact on redefinition of transmission clusters
Authors: Serrano Sergio Buenestado , Vallejo-Godoy Silvia , Martínez-Lirola Miguel , Cabezas Teresa , Muñoz Patricia , Pérez-Lago Laura , de Viedma Darío García 
Published: February 2025

Abstract

Whole-genome sequencing, supported on short-read-sequencing, has revolutionized the precision to track Mycobacterium tuberculosis (MTB) transmission. However, the high GC content (65%) and repetitive regions (10%) of the MTB genome challenge short-read mapping and assembly, leading to the exclusion of certain genomic regions from the analysis. Long-read-sequencing can overcome these limitations, giving access to these regions, generally uninterrogated. Our study aims to evaluate the potential of long-read sequencing in redefining long-term MTB transmission clusters, previously characterized by short-read sequencing. We selected 78 cases from eight long-term clusters (5–17 years; 7 to 16 cases), from a population-based genomic epidemiology program in Almería, Spain. The clusters were carefully selected to ensure cases i) infected by identical strains, ii) exhibiting pairwise-SNP-based distances from 1 to 16 SNPs and iii) distributed along different branches in the genomic networks. Long-read analysis increased the distances of each cluster from the reference by an average of 258 SNPs and intercluster distances by 113 SNPs. Within-cluster diversity also increased, with pairwise distances rising from 1 to 22 SNPs across 1–7 network branches. In one cluster, the acquisition of diversity led to overpass the 12-SNP threshold. Additionally, in four clusters, 1–2 cases previously classified as infected by identical strains were now reclassified due to the identification of additional SNP differences. Thanks to the identification of new diversity between the cases we could reconstruct transmission links and propose new epidemiological interpretations among the cases in cluster.
Varved sediments of Lake Gorzyńskie, western Poland: a new archive of climatic and environmental changes during the Late Glacial and the Holocene in central Europe
Authors: Kril Maria , Bonk Alicja , Żarczyński Maurycy , Zolitschka Bernd , Tylmann Wojciech 
Published: February 2025

Abstract

In this study, we present a newly discovered varved sediment site located in western Poland, where such records are scarce. The sediment profile from Lake Gorzyńskie is 10.45 meters long and covers the last ca. 13,250 years. Using varve counting and varve thickness measurements together with radiometric dating (14C, 210Pb, 137Cs), a robust age-depth model was developed. Sediment lithology, varve microfacies, and statistical analysis of the chemical composition allow the identification of six depositional phases: the late Allerød (≈ 13,250–12,675 cal BP), the Younger Dryas (12,675–11,600 cal BP), the early Holocene (11,600–9,100 cal BP), the main part of the Holocene (9,100–2,250 cal BP), and two phases of the late Holocene (2,250–750 cal BP, 750 cal BP–present). The Younger Dryas is remarkably well recorded with a pronounced increase in allochthonous deposition followed by stable sedimentation during the early Holocene and by increased variability since 9,100 cal BP. Short-term fluctuations coinciding with known paleoclimatic events such as the Preboreal Oscillation and the 10.3 k climate event, are also evident. Distinct changes during the late Holocene are associated with increasing human impact. The Lake Gorzyńskie sediment record offers not only insights into long-term trends of the environmental history in western Poland but also into short-term paleoclimate variability since the Late Glacial.
Postpartum women’s prospective acceptability of long-acting HIV prevention approaches in Kenya: A qualitative study
Authors: Concepcion Tessa , Kinuthia John , Otieno Felix A , Akim Eunita , Aketch Helen , Gómez Laurén , John-Stewart Grace , Suh Bih Moki , Nzove Emmaculate M , Ngumbau Nancy , Mogaka Jerusha N , Obatsa Sarah , Odhiambo Ben O , Omom Caroline , Strong Marin , Wagner Anjuli D , Watoyi Salphine , Pintye Jillian 
Published: February 2025

Abstract

Background
New long-acting pre-exposure prophylaxis (LA-PrEP) options offer an alternative to daily oral PrEP, which poses difficulties for adherence, especially during pregnancy and postpartum. Yet, limited data exist on LA-PrEP acceptability among pregnant and postpartum women. We aimed to evaluate its acceptability and identify strategies to enhance it.
Methods
We conducted an exploratory qualitative study with postpartum women in five public health facilities in Kisumu and Siaya Counties, Kenya. In-depth interviews (IDIs) were conducted with women expressing high, low, and mixed LA-PrEP interest throughout pregnancy and postpartum. Inductive and deductive content analysis was used, and themes of acceptability were explored using the Theoretical Framework of Acceptability (TFA).
Results
We conducted 70 IDIs with postpartum women between August 2023 and March 2024. The majority (62.9%) expressed consistently high interest in LA-PrEP. Most viewed LA-PrEP, especially every two-month injectables, as highly acceptable due to reduced pill burden, side effects, and dosing frequency. Concerns were raised regarding injectable PrEP safety for the baby during pregnancy and suitability of using the vaginal ring during delivery. Participants emphasized the importance of education on the safety of these methods during pregnancy and breastfeeding, and strategies for improving adherence, such as mobile reminders. Overall, women preferred LA-PrEP options over daily oral PrEP for convenience, effectiveness, and privacy, with healthcare provider education seen as crucial.
Discussion
We found high acceptability of LA-PrEP options among postpartum women with experience taking PrEP during pregnancy. The findings reveal diverse preferences and key factors influencing acceptability, including safety, discretion, and convenience.
Clinical trial number
Not applicable
Translation of PhET Simulations in Ibibio Language: Enhancing Seamless and Culturally Responsive Learning of Mathematics in Akwa Ibom State, Nigeria.
Authors: Akpan Ekemini T. , Udoh Ememobong O. , vieyra Rebecca E. 
Published: February 2025

Abstract

Innovative virtual learning applications are needed to develop twenty first century skills, and mathematical literacy among students in Mathematics Education. This paper assessed the effects of PhET interactive simulation with culturally responsive approach on students’ academic achievements in the concept of special angles in secondary schools. Mayer’s multimedia instructional design principles were adopted to localized the PhET interactive simulation in Ibibio Language(L1). The study was quasi-experimental, with three treatment groups purposively sampled. The findings shown that students taught the concept of special angles using PhET interactive simulations with culturally responsive approach obtained significantly higher academic achievement scores when compared to their counterpart taught the same concept using Interactive Lecturing Approach. Although the study yielded a high statistical power, there was no practical significant difference on students’ academic achievements when taught special angles using PhET interactive simulations with culturally responsive approach, and when taught the same concept using PhET interactive simulations without culturally responsive approach. Gender exerted a nonsignificant influence on students’ academic achievements among the groups. Hence, using PhET interactive simulations with embodied and embedded mother tongue features enhanced academic achievement of students, and contextual instructional delivery in Mathematics. Also, the study underpins situated understanding of Mathematical concept, leading to optimal learning experiences. In the same vein, it fosters the enculturation of mathematical concepts and ethnomathematics, glocalization of ethnopadological technique, and reverted the extinctions of mother tongue in the Nigerian culture. It was recommended that virtual and culturally responsive strategies should be adopted by instructors to diversify instructional delivery in Mathematics Education.
Atorvastatin induced gynecomastia in a dyslipidemic patient.
Authors: Alomari Omar , Işık Arzu Cennet , Ertan Sinem Nur , Karagöz Ali 
Published: February 2025

Abstract

Statins, widely used for lowering low-density lipoprotein cholesterol (LDL-C) and triglyceride levels, have demonstrated significant cardiovascular benefits. However, recent case reports have associated statins with gynecomastia, a condition characterized by benign breast tissue enlargement in males. Gynecomastia can cause significant discomfort and emotional distress. We present the case of a 66-year-old male who developed gynecomastia after two months of atorvastatin therapy at 20 mg/day. The patient, with a history of recent coronary artery bypass graft surgery, experienced pain, sensitivity, and growth in both mammary glands. Clinical examination and imaging revealed an increase in fibroglandular tissue, with no cystic or solid lesions. Laboratory tests ruled out other potential causes, including liver disease, hormonal imbalances, and the use of other medications known to cause gynecomastia. After switching the patient’s medication from atorvastatin to rosuvastatin 10 mg/day, a follow-up showed a reduction in pain, sensitivity, and mammary gland enlargement. This case underscores the importance of considering drug-induced gynecomastia when evaluating male patients on statin therapy. While rare, statin-induced gynecomastia is reversible upon discontinuation or modification of the treatment. Clinicians should be aware of this potential side effect to prevent unnecessary investigations and alleviate patient distress.
Undernutrition and associated factors among older adults living in Bahir Dar City, Northwest Ethiopia.
Authors: Admas Yibeltal Wolelaw , Yihenew Addisu , Mekuria Belayneh Addis , Bekele Gebremariam , Gebru Gebremeskel Birhanie , Ejigu Yeshambel , Kebede Awoke , Demissie Berihun Assefa 
Published: February 2025

Abstract

Introduction: In any society, older adults are among the vulnerable and high-risk groups in health status. In this age group undernutrition is a major health concern, multifactorial, and has serious negative consequences including decreased resistance to infection, declined functional status, loss of independence, and affected quality of life but it is inadequately recognized and addressed. Despite their growing numbers and nutritional needs, older people in Ethiopia have been given little attention, and there are limited studies done about undernutrition in this population in Northern Ethiopia. Hence, this study aimed to assess the prevalence of undernutrition and its associated factors among older adults living in Bahir Dar City, Northwest Ethiopia, 2024.
Methods: A community-based cross-sectional study design was conducted from September 5 to November 25, 2024. A multistage sampling technique was employed to recruit a total of 579 study participants aged 60 and above. The MNA-SF tool was used to assess undernutrition. The data was collected through the Kobo toolbox using face-to-face interviews, entered into Microsoft Excel, and then exported to SPSS version 25 for analysis. Variables having a p < 0.25 at bivariable logistic regression were included in the multivariable logistic regression. Finally, variables with a p-value < 0.05 at a 95% CI and adjusted odds ratio were statistically significant in multivariable logistic regression.
Results: Among the 567 participants enrolled, the overall prevalence of undernutrition was 24.5% (95% CI: 21.0–28.3). Being female (AOR = 1.81, CI 1.19-2.76), age 80 years and older (AOR = 1.73, CI 1.03-2.91), being unable to read and write (AOR= 3.06, CI 1.54-6.08), being widowed (AOR = 1.63, CI 1.00-2.63) and smoking (AOR = 1.88, CI 1.19-2.99) were significantly associated with undernutrition.
Conclusion and recommendation: This study found that the prevalence of undernutrition among older adults in the study area was high, making it an important public health issue. Being female, age 80 years and older, being widowed, being unable to read and write, and smoking were factors associated with undernutrition. Therefore, we suggest that education focus on very old and female older adults in improving dietary practice, incorporating behavioral supports to assist in the cessation of smoking to ensure healthy aging.
Biparametric MRI and Strain Elastography for Improving Cognitive Targeting in Prostate Cancer Detection
Authors: Patil Akshay , Venugopal Anand 
Published: February 2025

Abstract

Background: One of the most prevalent cancers in males is prostate cancer, which can be difficult to diagnose because of its ambiguous early signs. Aiming to improve detection accuracy, transrectal ultrasonography (TRUS) in conjunction with strain elastography and biparametric MRI (bpMRI) is an emerging diagnostic approach.
Methods: A tertiary centre in coastal region of Karnatakacarried out this retrospective analysis between March 2022 and December 2024. Thirty-two male patients, ages 45 to 85, whose digital rectal examination revealed palpable anomalies or elevated PSA levels were included in the study. For the assessment of prostate lesions, patients underwent both bpMRI and TRUS/strain elastography. Histopathology results were used as the reference standard to compare the diagnostic performance of these modalities. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were all included in the data analysis.
Results: Of the 32 cases, 56.25% were diagnosed as malignant and 43.75% as benign. The sensitivity and specificity for TRUS/strain elastography were 94.44% and 50%, respectively, compared to 76.47% and 53.33% for bpMRI. Combining both modalities improved specificity to 76.67%. Lesions classified as PI-RADS 4 on bpMRI were the most common in clinically insignificant cancer, while PI-RADS 5 lesions were predominant in clinically significant cases.
Conclusion: TRUS/strain elastography demonstrated superior sensitivity compared to bpMRI in detecting prostate cancer. However, bpMRI contributed to better specificity, especially when combined with TRUS/strain elastography. This combined approach provides a promising method for improving the cognitive targeting of prostate cancer lesions, especially in clinically significant cases.
Prevalence, factors and optimization strategies for contraceptive uptake: A cross-sectional study among adolescents living with HIV at a tertiary hospital in Northern Uganda
Authors: Ajilong Harriet 
Published: February 2025

Abstract

Background: In sub-Saharan Africa, contraceptive use among adolescents ranges from 21–42%, with an unmet need of 53–64%. Therefore, client-centered delivery strategies should be explored to improve contraceptive uptake among adolescents living with HIV in Uganda.
Methods: An exploratory mixed methods study that was conducted in adolescents living with HIV aged 12-19 years at Gulu Regional Referral hospital in Northern Uganda. Structuredquestionnaires were used to obtain information on contraceptive use, and the most convenient mode of delivery. Selected key informants identified specific delivery strategies potentially associated with higher contraceptive uptake.
Results: Of the 193 respondents who participated in the study, 108(56%) were females with a mean age of 15 years. Ever use of modern contraceptives was low at 16% because only a small percentage (approximately 20%) were sexually active. Most participants, 54/193 (40%) preferred accessing contraceptives from the adolescent clinic from health workers and peer supporters. Factors associated with increased contraceptive use were tertiary level education and employment. From qualitative analysis participants recommended the separation of adolescent services, peer support and community outreaches to improve uptake.
Conclusion:The contraceptive prevalence rate among HIV-positive adolescents is still low. Contraceptive use is higher among educated or employed adolescents. Services should be provided at adolescent-friendly clinics by trained health workers and peers during school holidays to optimize uptake.
The Potential Roles of 77C&gt;T Variant and Growth Hormone-Releasing Hormone Elevation in Pituitary Adenoma Cases Associated with Acromegaly
Authors: Turki Thualfiqar Ghalib , Sahan Khadija abbas 
Published: February 2025

Abstract

Background: Acromegaly (ACM) is an endocrine disorder characterized by the elevation of growth hormone-releasing hormone (GHRH), growth hormone (GH), and insulin-like growth factor-1 (IGF-1).
Objectives: This study aims to elucidate the correlation between the 77C>T (rs368475481) variant in the GHRH gene and elevated growth hormone-releasing hormone levels in patients with acromegaly.
Materials and Methods: This study, conducted from January to August 2024, analyzed 80 samples from Iraqi acromegaly patients collected at the Diabetic National Center, Al-Mustansiriyah University, alongside 80 samples from healthy individuals. Growth hormone and insulin-like growth factor-1 levels were quantified using chemiluminescence immunoassay, while growth hormone-releasing hormone levels were measured by enzyme-linked immunosorbent assay (ELISA). The 77C>T (rs368475481) SNP was detected via Sanger sequencing to assess genetic variation between acromegaly patients and healthy controls.
Results: The serum levels of GHRH, GH, and IGF-1 were elevated in acromegaly patients compared to controls. The genetic results indicate the presence of the rs368475481 variation in the amplified fragment of the GHRH gene (a 791 bp amplicon including exons 2 and 3, and intron 2), with the CC homozygous genotype observed in 80 (100%) of controls and 40 (50%) of acromegaly patients. The CT heterozygous genotype was present in 40 (50%) of acromegaly patients.
Conclusion: The elevated levels of growth hormone-releasing hormone and the GHRH 77C>T rs368475481 polymorphism in the GHRH gene were shown to be associated with pituitary adenomas, which cause acromegaly.
Soziotechnische Systemgestaltung im Kontext generativer KI: Eine empirische Untersuchung
Authors: Spirgi Lukas , Seufert Sabine , Delcker Jan , Heil Joana 
Published: February 2025

Das Aufkommen von ChatGPT hat disruptive Auswirkungen auf die Hochschulbildung. Nach dem sozio-technischen Systemdesign sind Hochschulen als Organisationen zu verstehen, in denen technische und soziale Subsysteme interagieren. Den Kern des Systemdesigns bildet dabei die (neue) Aufgabenteilung bei der Interaktion zwischen Menschen und Maschine. Diese Studie untersucht generative KI (ChatGPT) als soziotechnische Innovation in der Hochschulbildung, indem sie die ethischen Grundsätze für die Nutzung von KI sowie die Häufigkeit und Art der Nutzung von ChatGPT durch Studierende analysiert. Die befragten Studierenden (???? = 699) zeigen große Unsicherheiten sowie Bedenken hinsichtlich der ethischen Nutzung von ChatGPT. Die Studierenden nutzen ChatGPT vor allem als Hilfe beim wissenschaftlichen Schreiben und vereinzelt als Lernhilfe (≈ 10 %). Weibliche Studierende nutzen ChatGPT signifikant weniger als männliche Studierende. Die durchgeführte Clusteranalyse ergibt drei Typen: gelegentliche Nutzer:innen (≈ 50 % aller Studierenden), regelmäßige Nutzer:innen (≈ 35 %) und intensive Nutzer:innen (≈ 15 %). Die Ergebnisse der Studie liefern einen Diskussionsbeitrag zur Hochschulentwicklung aus der Perspektive der soziotechnischen Systemgestaltung.