bluuebunny/crossref_metadata_2025_split huggingface dataset:
Morphoanatomical and Biochemical Changes in Seeds of Bagassa guianensis (Moraceae)
Authors: Becker Dhyene Rayne dos Santos , Herrera Raírys Cravo , Rocha Tainá Teixeira , Bezerra Delziane Araújo , Leão Fábio Miranda , Reis Alisson Rodrigo de Souza , Lobo da Costa Roberto Cézar , Oliveira Lenaldo Muniz de , Nascimento Marilza Neves do 
Published: May 2024

Bagassa guianensis Aubl. is a tree of high timber value (Moraceae family) native to the Amazon. In this study, we characterized the morphoanatomical and biochemical properties of Bagassa guianensis seeds at different levels of fruit control based on biometric, morphoanatomical, color and biochemical analyses. Four stages of seed development have been identified in the fruit of Bagassa guianensis. The seeds presented endosperm, being classified as albuminous. Seeds from fruits with 5 GY 4/4 colors and green pigmentation (stage I) presented fully formed embryos. According to PCA (principal component analysis) data, it was found that all stages of seed dominance had a significant effect and highly correlated with the biochemical properties of the seed. Despite the comparatively low biometric values, high levels of Total Soluble Sugars (3.58%), Total Soluble Proteins (2.12%) and Reducing Sugars (1.43%) were observed in seeds at this stage. On the other hand, the content of amino acids (0.87%) and starch (3.30%) was higher at late maturity. The highest amounts of starch were detected from stage II onwards (31.29 mg/g DM), when the seeds reached physiological maturity. Biochemical and morphological information from seeds are relevant for planning conservation, observation and restoration strategies, and this study on the species B. guianensis is essential.
HbA1c overestimates the glucose management indicator: a pilot study in patients with diabetes, chronic kidney disease not on dialysis, and anemia using isCGM
Authors: Gómez Medina Ana , González Camilo A. , Muñoz Oscar M. , Gómez Yalinne , Jaramillo Pablo E. , Henao Diana , Rodríguez Luis M. , Molina Yurany 
Published: May 2024

Introduction: There are multiple mechanisms by which HbA1c values can be altered in chronic kidney disease (CKD), which limits its usefulness as a strategy to assess glycemic control in this population. Methods: Concordance and agreement study between two diagnostic tests: HbA1c and glucose management indicator (GMI) measured by intermittently scanned continuous glucose monitoring (isCGM), based in a prospective cohort of patients with diabetes, CKD (glomerular filtration rate between 15 and 60 ml/min/1.73 m²), and anemia. The isCGM was performed for 3 months, and the GMI was compared with the HbA1c levels taken at the end of isCGM. Agreement was evaluated using Bland–Altman graph analysis and Lin’s concordance correlation coefficient (CCC). The concordance of the measures with good glycemic control (<7%) was also evaluated. Results: A total of 74 patients were enrolled (median age 68.5 years, 51.3% female, 64.9% with CKD stage 3, hemoglobin 11.1 ± 1.2 g/l). The Bland–Altman analysis shows a mean difference between GMI and HbA1c of 0.757 ± 0.687% (95% limits of agreement: −0.590 and 2.105). Difference was greater as the values of GMI and HbA1c increased. The agreement was poor [CCC 0.477; 95% confidence interval (CI): 0.360–0.594], as well as the concordance of values with good glycemic control according to GMI versus HbA1c (67.5% versus 29.7%, p < 0.001) (Kappa 0.2430; 95% CI: 0.16–0.32). Conclusion: The HbA1c overestimates the GMI values with highly variable ranges of difference, which prevents a precise correction factor. isCGM probably is a safer option for monitoring and decision-making in this population, especially in patients treated with insulin where the risk of hypoglycemia is greater.
Person-centered maternity care during childbirth and associated factors at public hospitals in central Ethiopia
Authors: Kabale Wogene Daro , Bekele Gemechu Gelan , Gonfa Dajane Negesse , Yami Amare Tesfaye 
Published: May 2024

Objectives: Person-centered maternity care during childbirth is crucial for improving maternal and newborn health outcomes. Therefore, this study was aimed at assessing the determinants of person-centered maternity care in Central Ethiopia. Methods: An institutional-based cross-sectional study was conducted in public hospitals in Central Ethiopia from 30 January to 1 March 2023. A systematic random sampling technique was employed to enroll the study participants. Data were collected through face-to-face interviews using a structured questionnaire. After data collection, it was checked for completeness and consistency, then coded and entered into Epi Data version 4.4.2 and exported to SPSS version 26 for analysis. Both bivariate and multivariable logistic regressions were used to identify associated factors. Results: In this study, a total of 565 participants were involved, resulting in a response rate of 98.77%. The respondents mean score for person-centered maternity care was 60.2, with a 95% CI of (59.1, 62.3). No formal education (β = −2.00, 95% CI: −4.36, −0.69), fewer than four antenatal contacts (β = −4.3, 95% CI: −5.46, −2.37), being delivered at night (β = 2.20, 95% CI: 1.56, 6.45), and complications during delivery (β = −6.00, 95% CI: −9.2, −0.79) were factors significantly associated with lower person-centered maternity care. Conclusion: This study revealed that person-centered maternity care is low compared with other studies. Consequently, it is imperative to prioritize initiatives aimed at enhancing awareness among healthcare providers regarding the benchmarks and classifications of person-centered maternity care. Moreover, efforts should be directed toward fostering improved communication between care providers and clients, along with the implementation of robust monitoring and accountability mechanisms for healthcare workers to prevent instances of mistreatment during labor and childbirth.
Teaching Students With Disabilities in Chinese Regular Education Classrooms: Outcomes and Influential Factors
Authors: Li (李佳宁) Jianing , Zan (昝飞) Fei , Chen June L. 
Published: May 2024

Purpose Learning in a regular classroom (LRC) has become the main educational placement for students with disabilities in China. This study investigates the outcomes of LRC and their influential factors from the teachers’ experiences and perspectives. Design/Approach/Methods Seven inclusive education teachers participated in semi-structured interviews. Thematic analysis was conducted to analyze the qualitative data. Findings The results show that social participation and contribution, physical presence, academic performance, self-concept, and independence are the key outcomes of LRC from inclusive education teachers’ experiences and perspectives. Moreover, the factors influencing the key desired outcomes include the severity of disabilities and problem behaviors, professional support, teaching practice, inclusive climate, and collaboration between schools and families. Originality/Value This study provides valuable insights into the outcomes and influential factors of inclusive education in the context of LRC in China. These findings inform efforts to improve inclusive education practices and enhance the educational experiences of students with special needs.
Screening for Food and Nutrition Insecurity in the Healthcare Setting: A Cross-Sectional Survey of Non-Medicaid Insured Adults in an Integrated Healthcare Delivery System
Authors: Byker Shanks Carmen , Gordon Nancy P. 
Published: May 2024

Objectives: Healthcare screening identifies factors that impact patient health and well-being. Hunger as a Vital Sign (HVS) is widely applied as a screening tool to assess food security. However, there are no common practice screening questions to identify patients who are nutrition insecure or acquire free food from community-based organizations. This study used self-reported survey data from a non-Medicaid insured adult population approximately one year after the start of the COVID-19 pandemic (2021). The survey examined the extent to which the HVS measure might have under-estimated population-level food insecurity and/or nutrition insecurity, as well as under-identified food and nutrition insecurity among patients being screened for social risks in the healthcare setting. Methods: Data from a 2021 English-only mailed/online survey were analyzed for 2791 Kaiser Permanente Northern California (KPNC) non-Medicaid insured members ages 35-85 years. Sociodemographics, financial strain, food insecurity, acquiring free food from community-based organizations, and nutrition insecurity were assessed. Data from respondents’ electronic health records were abstracted to identify adults with diet-related chronic health conditions. Data were weighted to the age × sex × racial/ethnic composition of the 2019 KPNC adult membership. Differences between groups were evaluated for statistical significance using adjusted prevalence ratios (aPRs) derived from modified log Poisson regression models. Results: Overall, 8.5% of participants reported moderate or high food insecurity, 7.7% had acquired free food from community-based organizations, and 13% had nutrition insecurity. Black and Latino adults were significantly more likely than White adults to have food insecurity (17.4% and 13.1% vs 5.6%, aPRs = 2.97 and 2.19), acquired free food from community-based organizations (15.1% and 15.3% vs 4.1%, aPRs = 3.74 and 3.93), nutrition insecurity (22.1% and 23.9% vs 7.9%, aPRs = 2.65 and 2.64), and food and nutrition insecurity (32.4% and 32.5% vs 12.3%, aPRs = 2.54 and 2.44). Almost 20% of adults who had been diagnosed with diabetes, prediabetes, ischemic CAD, or heart failure were food insecure and 14% were nutrition insecure. Conclusions: Expanding food-related healthcare screening to identify and assess food insecurity, nutrition insecurity, and use of community-based emergency food resources together is essential for supporting referrals that will help patients achieve optimal health.
Revisiting the Eswaran-Kotwal Model of Tenancy
Authors: Ghatak Maitreesh , Mookherjee Dilip 
Published: May 2024

Persistence of sharecropping tenancy, and increases in farm productivity resulting from regulations protecting tenant rights have been observed in many developing countries. This paper examines if these can be explained by alternative models of sharecropping with two sided efforts/investments, namely, complete contract models, either without wealth constraints ( Eswaran-Kotwal, 1985 ) or with a wealth constrained tenant ( Mookherjee, 1997 ; Banerjee-Gertler-Ghatak, 2002 ), and incomplete contract holdup models without wealth constraints (Grossman Hart, 1986). In the absence of wealth constraints, the complete contract model always results in (incentive constrained) surplus-maximizing productivity; thus, there can be no scope for tenancy regulations to raise productivity. In the incomplete contract model, tenancy regulations would raise productivity only if the tenant’s investments are more important than the landlord’s investment. But in that case, sharecropping tenancy would not persist in the absence of wealth constraints, as the tenant would have purchased the land right ex ante from the landlord. The model with wealth constraints helps explain both the persistence of tenancy and the productivity/surplus enhancing effects of tenancy regulations. JEL Classifications: D02, D23, OI2, OI3
The Evaluation of a 5-miRNA Panel in Patients with Periodontitis Disease
Authors: Baru O. , Pop L. , Raduly L. , Bica C. , Mehterov N. , Pirlog R. , Buduru S. , Braicu C. , Berindan-Neagoe I. , Badea M. 
Published: May 2024

Introduction: Side by side with tooth decay, periodontitis remains one of the most common oral diseases and is increasingly recognized as a serious public health concern worldwide. Objectives: The present study aims at comparing the levels of 5 specific miRNAs (miR-29b-3p, miR-34a-5p, miR-155-5p, miR-181a-5p, and miR-192-5p) in patients with periodontal disease and healthy controls. Methods: The pathogenic mechanism is related to the activation of immune response and significant alteration of coding and noncoding genes, including miRNA. The study includes 50 subjects (17 with periodontal disease and 33 healthy controls) with a mean age of 45.3 y. In both periodontitis patients and healthy controls, a panel of 5 miRNAs (miR-29b-3p, miR-34a-5p, miR-155-5p, miR-181a-5p, and miR-192-5p) is examined by determining their expression levels with quantitative reverse transcription polymerase chain reaction. Results: The periodontitis patients express high levels of all the investigated miRNAs. Receiver operating characteristic curve analysis shows an area under the curve (AUC) of 0.69 to 0.74 for individual transcripts with the highest AUC value observed for miR-192, followed by miR-181a. Conclusions: The study indicates that the 5-miRNA panel can be used as biomarker for periodontitis. In this way, all implantology procedures and treatment options for patients diagnosed with periodontitis can be improved for better long-term results, predictability, and follow-up frequency. Knowledge Transfer Statement: The discovery of a miRNA panel as a potential biomarker for periodontitis offers major opportunities for practical application. Our study can improve diagnostic accuracy; researchers can develop new theories on molecular mechanisms and biomarker discovery.
Multimodal mechanisms of pathogenic variants in the signal peptide of FIX leading to hemophilia B
Authors: Gao Meng , Chen Long , Yang Jinlong , Dong Shixia , Cao Qing , Cui Zihan , Dong Yanyan , Liu Hongli , Shen Yan , Yang Haiping , Hao Zhenyu , Zhang Lei , Li Weikai , Tie Jian-Ke , Shen Guomin 
Published: May 2024

Abstract
Signal peptide (SP) is essential for protein secretion, and pathogenic variants in the SP of factor IX (FIX) have been identified in hemophilia B (HB). However, the underlying mechanism for the genotype-phenotype correlation of these variants has not been well studied. Here, we systematically examined the effects of 13 pathogenic point variants in the SP of FIX using different approaches. Our results showed that these point variants lead to HB by missense variants and/or aberrant premessenger RNA (pre-mRNA) splicing. The missense variants in a hydrophobic core (h-region) mainly affected the cotranslational translocation function of the SP, and those in C-terminal containing cleavage site (c-region) caused FIX deficiency mainly by disturbing the cotranslational translocation and/or cleavage of the SP. Almost absolute aberrant pre-mRNA splicing was only observed in variants of c.82T&gt;G, but a slight change of splicing patterns was found in variants of c.53G&gt;T, c.77C&gt;A, c.82T&gt;C, and c.83G&gt;A, indicating that these variants might have different degrees of impact on pre-mRNA splicing. Although two 6-nt deletion aberrant pre-mRNA splicing products caused FIX deficiency by disturbing the SP cleavage, they could produce some functional mature FIX, and vitamin K could increase the secretion of functional FIX. Taken together, our data indicated that pathogenic variants in the SP of FIX caused HB through diverse molecular mechanisms or even a mixture of several mechanisms, and vitamin K availability could be partially attributed to varying bleeding tendencies in patients carrying the same variant in the SP.
Telephone consulting for ‘Personalised Care and Support Planning’ with people with long-term conditions: a qualitative study of healthcare professionals’ experiences during COVID-19 restrictions and beyond
Authors: McCann Sharon , Entwistle Vikki A. , Oliver Lindsay , Lewis-Barned Nick , Haines Rebecca , Cribb Alan 
Published: May 2024

Abstract
Background
Personalised Care and Support Planning (PCSP) replaces conventional annual reviews for people with long-term conditions. It is designed to help healthcare professionals (HCPs) and patients engage in conversations as equals and collaboratively plan actions oriented to each patient’s priorities, alongside biomedical concerns. Little is known about how the shift to remote consulting initiated with COVID-19 restrictions has impacted PCSP.

Aim
To investigate HCPs’ experiences of conducting PCSP conversations remotely and consider implications for the fulfilment of PCSP ambitions as remote consulting continues beyond COVID-19 restrictions.

Methods
19 semi-structured interviews with HCPs in England and Scotland; interpretive analysis.

Results
HCPs’ accounts made clear that COVID-19 restrictions impacted multiple aspects of PCSP delivery, not just the mode of conversation. Broader disruption to general practice systems for gathering and sharing information ahead of PCSP conversations, and moves to ‘wide window’ appointment times, made it harder for patients to be prepared for PCSP conversations. This constrained scope to achieve PCSP ambitions even with the best professional communication skills. Most remote PCSP conversations were conducted by telephone. In the absence of visual communication with patients, it was sometimes harder to achieve the ambitions of PCSP conversations, including to balance patient and professional agendas, fulfil key planning activities, and foster a relational ethos of equal, collaborative partnership. The challenges were particularly severe when working with new patients and people with complex clinical and social problems. Although options for telephone appointments now offer valued flexibility, sustained experience of struggling to achieve PCSP ambitions via remote consulting led some HCPs to lower their standards for judging a “good” PCSP conversation, and to diminished professional satisfaction.

Conclusions
There are significant challenges to fulfilling the ambitions of PCSP via telephone, especially when preparatory support is limited. This study provides grounds for scepticism about how compatible telephone appointments can be with this person-centred model of working, especially for people who are socially disadvantaged and live with complex health conditions. These threats to the provision of person-centred support for people with long-term conditions warrant careful attention going forward if the PCSP model and its benefits are to be sustained.
Household air pollution and urinary incontinence symptoms among older adults in LASI: a large-scale population-based study
Authors: Liu Xiaoyang , Ma Kai , Liu Shengzhuo , Song Pan , Yang Luchen , Liu Zhenghuan , Zhou Jing , Wang Linchun , Yan Xin , Yu Yunfei , Dong Qiang 
Published: May 2024

Abstract
Background
The effects of household air pollution on urinary incontinence (UI) symptoms and stress urinary incontinence (SUI) symptoms have not been studied. This study seeks to investigate the correlation between household air pollution and UI/SUI symptoms among middle-aged and elderly adults in India.

Methods
We employed data derived from individuals aged 45 years and older who participated in the inaugural wave (2017–2018) of the Longitudinal Aging Study in India (LASI). The assessment of household air pollution exposure and the occurrence of UI/SUI symptoms relied on self-reported data. The analytical approach adopted was cross-sectional in nature and encompassed a cohort of 64,398 participants. To explore relationships, we utilized multivariate logistic regression analysis, incorporating subgroup analysis and interaction tests.

Results
1,671 (2.59%) participants reported UI symptoms and 4,862 (7.55%) participants reported SUI symptoms. Also, the prevalence of UI/SUI symptoms is much higher among middle-aged and elderly adults who use solid polluting fuels (UI: 51.23% vs. 48.77%; SUI: 54.50% vs. 45.50%). The results revealed a noteworthy correlation between household air pollution and the probability of experiencing UI/SUI symptoms, persisting even after adjusting for all conceivable confounding variables (UI: OR = 1.552, 95% CI: 1.377–1.749, p < 0.00001; SUI: OR: 1.459, 95% CI: 1.357–1.568, p < 0.00001). Moreover, significant interaction effects were discerned for age, education level, tobacco consumption, alcohol consumption, and physical activity (p for interaction < 0.05).

Conclusions
The results of our study indicate that the utilization of solid fuels in the home increases the likelihood of developing urinary incontinence and stress urinary incontinence. As a result, we argue that there is an immediate need to reform the composition of cooking fuel and raise public awareness about the adverse effects of air pollution in the home.
Integrating Syrian refugees into Lebanon’s healthcare system 2011–2022: a mixed-method study
Authors: Honein-AbouHaidar Gladys , Bou-Karroum Lama , Parkinson Sarah E. , Majed Rima , Salameh Sabine , Daher Najla , Hemadi Nour , Fouad Fouad M. , El-Jardali Fadi 
Published: May 2024

Abstract
Introduction
The Lebanese government estimates the number of Syrian refugees to be 1.5 million, representing 25% of the population. Refugee healthcare services have been integrated into the existing Lebanese health system. This study aims to describe the integration of Syrian refugee health services into the Lebanese national health system from 2011 to 2022, amid an ongoing economic crisis since 2019 and the COVID-19 pandemic.

Methods
This paper employs a mixed-methods approach drawing upon different data sources including: 1- document review (policies, legislation, laws, etc.); 2- semi-structured interviews with policymakers, stakeholders, and health workers; 3- focus group discussions with patients from both host and refugee populations; and 4- health systems and care seeking indicators.

Results
Although the demand for primary health care increased due to the Syrian refugee crisis, the provision of primary health care services was maintained. The infusion of international funding over time allowed primary health care centers to expand their resources to accommodate increased demand. The oversupply of physicians in Lebanon allowed the system to maintain a relatively high density of physicians even after the massive influx of refugees. The highly privatized, fragmented and expensive healthcare system has impeded Syrian refugees’ access to secondary and tertiary healthcare services. The economic crisis further exacerbated limits on access for both the host and refugee populations and caused tension between the two populations. Our findings showed that the funds are not channeled through the government, fragmentation across multiple financing sources and reliance on international funding. Common medications and vaccines were available in the public system for both refugee and host communities and were reported to be affordable. The economic crisis hindered both communities’ access to medications due to shortages and dramatic price increases.

Conclusion
Integrating refugees in national health systems is essential to achieve sustainable development goals, in particular universal health coverage. Although it can strengthen the capacity of national health systems, the integration of refugees in low-resource settings can be challenging due to existing health system arrangements (e.g., heavily privatized care, curative-oriented, high out-of-pocket, fragmentation across multiple financing sources, and system vulnerability to economic shocks).