bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving prediction of tacrolimus concentration using a combination of population pharmacokinetic modeling and machine learning in chinese renal transplant recipients
Authors: Wang Yu-Ping , Lu Xiao-Ling , Shao Kun , Shi Hao-Qiang , Zhou Pei-Jun , Chen Bing 
Published: May 2024

AimsThe population pharmacokinetic (PPK) model-based machine learning (ML) approach offers a novel perspective on individual concentration prediction. This study aimed to establish a PPK-based ML model for predicting tacrolimus (TAC) concentrations in Chinese renal transplant recipients.MethodsConventional TAC monitoring data from 127 Chinese renal transplant patients were divided into training (80%) and testing (20%) datasets. A PPK model was developed using the training group data. ML models were then established based on individual pharmacokinetic data derived from the PPK basic model. The prediction performances of the PPK-based ML model and Bayesian forecasting approach were compared using data from the test group.ResultsThe final PPK model, incorporating hematocrit and CYP3A5 genotypes as covariates, was successfully established. Individual predictions of TAC using the PPK basic model, postoperative date, CYP3A5 genotype, and hematocrit showed improved rankings in ML model construction. XGBoost, based on the TAC PPK, exhibited the best prediction performance.ConclusionThe PPK-based machine learning approach emerges as a superior option for predicting TAC concentrations in Chinese renal transplant recipients.
Safety and efficacy evaluation of halicin as an effective drug for inhibiting intestinal infections
Authors: Zhang Maolu , Lin Shuqian , Han Lianquan , Zhang Jiaming , Liu Shaoning , Yang Xiuzhen , Wang Ruiming , Yang Xiaohui , Yi Yunpeng 
Published: May 2024

Halicin, the first antibacterial agent discovered by artificial intelligence, exerts broad-spectrum antibacterial effects and has a unique structure. Our study found that halicin had a good inhibitory effect on clinical isolates of drug-resistant strains and Clostridium perfringens (C. perfringens). The safety of halicin was evaluated by acute oral toxicity, genotoxicity and subchronic toxicity studies. The results of acute toxicity test indicated that halicin, as a low-toxicity compound, had an LD50 of 2018.3 mg/kg. The results of sperm malformation, bone marrow chromosome aberration and cell micronucleus tests showed that halicin had no obvious genotoxicity. However, the results of the 90-day subchronic toxicity test indicated that the test rats exhibited weight loss and slight renal inflammation at a high dose of 201.8 mg/kg. Teratogenicity of zebrafish embryos showed that halicin had no significant teratogenicity. Analysis of intestinal microbiota showed that halicin had a significant effect on the intestinal microbial composition, but caused a faster recovery. Furthermore, drug metabolism experiments showed that halicin was poorly absorbed and quickly eliminated in vivo. Our study found that halicin had a good therapeutic effect on intestinal infection model of C. perfringens. These results show the feasibility of developing oral halicin as a clinical candidate drug for treating intestinal infections.
Callous-unemotional behaviors and conduct problems in Chinese preschoolers: the moderating roles of surgency and gender
Authors: Zhu Jingjing , Shu Xin , Li Zhuyi , Li Yan 
Published: May 2024

IntroductionConduct problems in children are related to callous-unemotional (CU) behaviors. However, results of the relationships between CU behaviors and conduct problems among preschoolers mainly focused on Western countries, no studies have examined whether CU behaviors predict conduct problem in Chinese preschoolers. The primary objective of the current study therefore was to examine the associations between CU behaviors and conduct problems as well as the moderating effects of surgency and child gender in Chinese preschool children.MethodsThe present study randomly selected 2,154 children (1,043 boys, Mage = 56 months, SD = 10.47) from six kindergartens in Shanghai, People’s Republic of China. Mothers rated children’s surgency and teachers reported children’s CU behaviors and conduct problems.ResultsResults demonstrated that CU behaviors were positively associated with conduct problems. Surgency and child gender significantly moderated these associations. Specifically, CU behaviors were positively associated with conduct problems, with a stronger effect found for high levels of surgency. CU behaviors had a positive association with conduct problems, with a stronger effect found for boys.DiscussionThis study indicate that temperament and gender characteristics influence conduct problems in preschoolers who exhibit high levels of CU behaviors. As well, the findings emphasize the significance of considering the meaning and implication of CU behaviors in Chinese culture.
Personality and teachers’ burnout stress: exploring the digital competence as personal job resource in allied health institutions
Authors: Hussain Zawar , Chenmei Cai , Saeed Muhammad , Hassan Nazia , Chiragh Fiza 
Published: May 2024

IntroductionJob burnout has severe consequences for teachers and students. This study aimed to measure the direct effects of personality traits on job burnout-stress syndrome among allied health educators. Furthermore, teachers’ digital competence was evaluated as a personal job resource for mitigating the negative impact of burnout.MethodsThis study examined direct relationships between work-related stress syndrome and personality traits, namely, extroversion, agreeableness, conscientiousness, emotional stability, and openness to experience. Data was collected from 334 allied health institution teachers through a self-reported questionnaire. Linear regression analysis was used to test for direct effects. Moderating effects were evaluated using Andrew F Hays PROCESS macro v2.16.3.ResultsAll five personality traits had a significant negative relationship to burnout and teachers’ digital competence moderated the relationship between personality traits and burnout. This study’s findings provide evidence, that personality is significantly related to job burnout among allied health educators.ConclusionThese empirical findings conclude that personality traits are related to burnout in the non-Western culture of Pakistan. Furthermore, teachers’ digital competence acts as a personal job resource and potential moderator in the current digital working environment. Therefore, future teachers should enrich their digital competencies for improved performance, and advanced digital competency courses should be included in their curriculum.
The impacts of learning motivation, emotional engagement and psychological capital on academic performance in a blended learning university course
Authors: Liu Yan , Ma Shuai , Chen Yue 
Published: May 2024

IntroductionThis study aims to explore the relationships among psychological capital, learning motivation, emotional engagement, and academic performance for college students in a blended learning environment.MethodThe research consists of two studies: Study 1 primarily focuses on validating, developing, revising, and analyzing the psychometric properties of the scale using factor analysis, while Study 2 employs structural equation modeling (SEM) to test the hypotheses of relationships of included variables and draw conclusions based on 745 data collected in a university in China.ResultsFindings revealed that intrinsic motivation, extrinsic motivation, emotional engagement, and psychological capital all impact academic performance. Extrinsic learning motivation has significant positive direct effects on intrinsic learning motivation, emotional engagement, and psychological capital. Intrinsic motivation mediates the relationship between extrinsic motivation and academic performance.DiscussionIn future blended learning practices, it is essential to cultivate students’ intrinsic learning motivation while maintaining a certain level of external learning motivation. It is also crucial to stimulate and maintain students’ emotional engagement, enhance their sense of identity and belonging, and recognize the role of psychological capital in learning to boost students’ confidence, resilience, and positive emotions.
Heterogeneous trajectories of perceived stress and their associations with active leisure: a longitudinal study during the first year of COVID-19
Authors: Kulbin Karel , Jõgi Anna-Liisa , Pulver Aleksander , Kask Kristjan 
Published: May 2024

IntroductionThere is a plethora of literature on the dynamics of mental health indicators throughout the COVID-19 pandemic, yet research is scarce on the potential heterogeneity in the development of perceived stress. Furthermore, there is a paucity of longitudinal research on whether active leisure engagement, which typically is beneficial in reducing stress, might have similar benefits during times of major disruption. Here we aimed to extend previous work by exploring the dynamics of change in stress and coping, and the associations with active leisure engagement over the first year of COVID-19.MethodsData from 439 adults (Mage = 45, SD = 13) in Estonia who participated in a longitudinal online study were analyzed. The participants were assessed at three timepoints: April–May 2020; November–December 2020; and April–May 2021.ResultsMean stress and coping levels were stable over time. However, latent profile analysis identified four distinct trajectories of change in stress and coping, involving resilient, stressed, recovering, and deteriorating trends. Participants belonging to the positively developing stress trajectories reported higher active leisure engagement than those belonging to the negatively developing stress trajectories.DiscussionThese findings highlight the importance of adopting person-centered approaches to understand the diverse experiences of stress, as well as suggest the promotion of active leisure as a potentially beneficial coping resource, in future crises.
Computer vision syndrome and ergonomic risk factors among workers of the Commercial Bank of Ethiopia in Addis Ababa, Ethiopia: an institutional-based cross-sectional study
Authors: Gasheya Kassahun Ayele , Belay Azanaw Asega , Abegaze Teferi , Zele Yifokire Tefera , Daba Chala 
Published: May 2024

BackgroundComputer vision syndrome (CVS) is the most pressing public health concern that affects vision and reduces quality of life and productivity, particularly in developing countries. Most of the previous studies conducted in Ethiopia focus on the knowledge and personal risk factors of bank workers. Moreover, ergonomic workstation design was not objectively assessed, which could hinder the implementation of effective intervention strategies. Therefore, this study aimed to determine CVS and ergonomic factors among commercial bank workers in Addis Ababa, Ethiopia.MethodsAn institutional-based cross-sectional study was carried out among 466 study participants from May 26 to July 24, 2022. A multistage sampling technique was applied to select the study participants. Data were collected via a standardized tool of CVS (CVS-Q). Besides, workstation ergonomics were pertinently assessed. The collected data was entered into EpiData version 3.1 and exported to SPSS version 26 for data analysis and cleaning. Multivariable logistics regression analysis was performed to identify factors associated with CVS. The variables with a p-value &lt; 0.05 were considered statistically significant factors.ResultsPrevalence of CVS was 75.3% (95% CI: 71.2–79.2%). Blurred vision, eye redness, and headache, 59.8%, 53.7%, and 50.7%, respectively, were frequently reported symptoms. Glare (AOR = 4.45: 95% CI: 2.45–8.08), 20–20–20 principle (AOR = 1.98, 95% CI: 1.06–3.67), wearing non-prescription eyeglasses (AOR = 4.17; 95% CI: 1.92–9.06), and poor workstation (AOR = 7.39; 95% CI: 4.05–13.49) was significantly associated with CVS.ConclusionThe prevalence of CVS was found to be high. Glare at work, ignoring the 20–20–20 principle, wearing non-prescription eyeglasses, and poor workstation ergonomic design were independent predictors of CVS. Therefore, comprehensive interventional activities like adhering to the 20–20–20 principle, avoiding the use of non-prescription glasses, minimizing glare, and improving workstation ergonomic setup are essential to prevent CVS.
Differences between parents’ and paediatricians’ perceptions of mild respiratory infections in childhood: contrast study
Authors: Ortiz-Gonzalez Luis , Delgado-Ojeda Jesús , Guisado-Rasco Mª Cinta , Santamaria-Orleans Alicia , Coronel-Rodríguez Cristobal 
Published: May 2024

IntroductionMild respiratory infections are a common reason for consultation in paediatrics, both in the emergency department and in primary care clinics. These conditions, mostly viral and self-limiting, have a significant impact on the healthcare system, school and work absenteeism, and family routines. Despite being common and banal illnesses from a medical perspective, they involve a significant concern in families. The main objective of the contrast study was to compare the perceptions of parents and paediatricians regarding mild respiratory infections in childhood and their impact on family conciliation.Materials and methodsTwo online, cross-sectional surveys were conducted among Spanish paediatricians and parents with children aged 6 months to 12 years, involving 504 paediatricians and 1,447 families, with questions on attitudes towards visits to the paediatric consultation, care burden of minor pathologies, work, and family conciliation, and treatment and prevention of these illnesses.ResultsResults showed significant differences in paediatricians’ and parents’ perceptions in many aspects. According to 34.5% of paediatricians and 27% of parents, families regularly go to the paediatrician without a scheduled visit. Only 4% of parents report having self-medicated their child, while paediatricians raise this percentage significantly to 48%. Regarding the question: “it is normal for a child to have an average of 4 colds a year,” only 25.5% of the surveyed families “strongly agree” unlike to 70.2% of paediatricians. 72.8% of paediatricians “strongly agree” with: “in my opinion, it is good for children to get sick to improve their immune system” reduced to 45.9% of parents. Consultations for minor pathologies represent a “high workload” for 60.9% of paediatricians, while this opinion is agreed by only 18.9% of the parents.ConclusionMild respiratory infections in childhood are perceived differently by paediatricians and parents. While paediatricians perceive them as a common and manageable phenomenon, parents tend to show higher concern and demand for medical attention. This study underlines the need to improve communication between paediatricians and parents to align perceptions, optimise the use of the health system resources, and improve the efficiency in the management of these common paediatric illnesses.
Co-creation of a novel approach for improving supply chain management for SARS-CoV-2 point of care diagnostic services in Mopani District, Limpopo Province: nominal group technique
Authors: Maluleke Kuhlula , Musekiwa Alfred , Nxele Siphesihle , Moetlhoa Boitumelo , Makena Langa , Nzuza Nkosingiphile , Lenders Alarice , Manentsa Ncomeka , Maswanganyi Tiyiselani , Dlangalala Thobeka , Mashamba-Thompson Tivani 
Published: May 2024

IntroductionEffective supply chain management (SCM) of point-of-care (POC) tests for diseases like severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) requires active participation from diverse stakeholders, government entities, and regulatory bodies. The responsibility for overseeing various aspects of POC tests, including procurement, quality assurance, storage, inventory management, distribution, and human resource capacity, lies with national, provincial, and local levels of government. This study aimed to collaboratively develop an innovative approach to enhance SCM for SARS-CoV-2 POC diagnostic services in resource-limited settings, using the Mopani District in Limpopo province, South Africa, as a case study.MethodsKey stakeholders were invited to participate in an online workshop using purposive sampling. The study employed the nominal group technique (NGT) for data collection, which consisted of two phases. Phase 1 focused on identifying barriers in the supply chain of COVID-19 rapid tests, while phase 2 aimed to devise strategies to overcome the priority barriers identified in phase 1. Participants used a Likert scale of 1–5 to rank barriers and strategies, and an overall ranking score was calculated for each. The participants were provided with the results of the ranking exercise for their feedback.ResultsEleven key stakeholders from national (n = 1), provincial (n = 4), and local government (n = 2) levels, research entities (n = 3), and non-governmental organizations (n = 1) took part in the study. Participants identified significant barriers in the supply chain, such as the availability of testing kits, unknown demand, information on SCM during a pandemic, methods of controlling stock, and procurement processes. Strategies suggested by key stakeholders included monitoring stock levels and optimizing stock visibility systems to improve test availability, enhancing information visibility and consistent data updates to address unknown demand and improve SCM during a pandemic, employing data capturing and digitization for effective stock control, and implementing demand planning and standardized procurement processes at the national level to enhance stock procurement.DiscussionThe successful collaboration with key stakeholders, facilitated by the NGT, resulted in the co-creation of a novel approach to enhance SCM for COVID-19 diagnostic services in resource-limited settings. This study holds the potential to support the provision of COVID-19 diagnostic services in such settings. A recommended follow-up study would assess the feasibility of implementing this approach.
Incidence and predictors of postoperative complications in Sub-Saharan Africa: a systematic review and meta-analysis
Authors: Yadeta Daniel Aboma , Manyazewal Tsegahun , Demessie Dereje Bayissa , Kleive Dyre 
Published: May 2024

BackgroundPostoperative complications remain a significant challenge, especially in settings where healthcare access and infrastructure disparities exacerbate. This systematic review and meta-analysis aimed to determine the pooled incidence and risk factors of postoperative complications among patients undergoing essential surgery in Sub-Saharan Africa (SSA).MethodPubMed/MEDLINE, EMBASE, CINAHL, Web of Science, and Google Scholar were searched from January 2010 to November 2022 for completed studies reporting the incidence and risk factors associated with postoperative complications among patients undergoing essential surgery in SSA. Severity of postoperative complications was ranked based on the Clavien-Dindo classification system, while risk factors were classified into three groups based on the Donabedian structure-process-outcome quality evaluation framework. Studies quality was appraised using the JBI Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI), and data were analyzed using Comprehensive Meta-Analysis (CMA) software. The study protocol adhered to the PRISMA guidelines and was registered in PROSPERO (CRD42023414342).ResultsThe meta-analysis included 19 studies (10 cohort and 9 cross-sectional) comprising a total of 24,136 patients. The pooled incidence of postoperative complications in SSA was 20.2% (95% CI: 18.7%–21.8%), with a substantial heterogeneity of incidence observed. The incidence varied from 14.6% to 27.5% based on the Clavien-Dindo classification. The random-effects model indicated significant heterogeneity among the studies (Q = 54.202, I = 66.791%, p &lt; 0.001). Contributing factors to postoperative complications were: structure-related factors, which included the availability and accessibility of resources, as well as the quality of both the surgical facility and the hospital.; process-related factors, which encompassed surgical skills, adherence to protocols, evidence-based practices, and the quality of postoperative care; and patient outcome-related factors such as age, comorbidities, alcohol use, and overall patient health status.ConclusionThe meta-analysis reveals a high frequency of postoperative complications in SSA, with noticeable discrepancies among the studies. The analysis highlights a range of factors, encompassing structural, procedural, and patient outcome-related aspects, that contribute to these complications. The findings underscore the necessity for targeted interventions aimed at reducing complications and improving the overall quality of surgical care in the region.Systematic Reviews Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42023414342).
Combined associations of regular exercise and work-related moderate-to-vigorous physical activity with occupational stress responses: a cross-sectional study
Authors: Abe Takafumi , Okuyama Kenta , Motohiro Atsushi , Shiratsuchi Daijo , Isomura Minoru 
Published: May 2024

ObjectiveThe association between work-related moderate-to-vigorous physical activity (MVPA) and higher levels of stress response is recognized, but whether this association is moderated by regular exercise remains unclear. This cross-sectional study investigated whether exercise-based physical activity (PA) associates with lower levels of stress responses moderated by work-related MVPA.MethodsThe study participants comprised 863 workers from 35 small and medium-sized enterprises in Shimane prefecture, Japan, collected through convenient sampling from April 2021 to August 2022. The Brief Job Stress Questionnaire was used to assess stress responses. Work-related MVPA and exercise-based PA were measured using questionnaires. Multiple linear regression was used to analyze the combined variables of work-related MVPA and exercise-based PA. The reference group had no weekly exercise-based PA and &gt;60 min of work-related MVPA.ResultsWhen work-related MVPA exceeded 60 min/day, flexibility activity or walking for ≥5 days/week (B = −3.53, 95% CI = −5.96, −1.11; B = −2.53, 95% CI = −4.90, −0.16) and muscle-strengthening activity 1–3 times/week (B = −3.52, 95% CI = −6.91, −0.12) were significantly associated with lower psychological stress response. Flexibility activity (B = −1.74, 95% CI = −3.01, −0.46) showed a similar link with physical stress response. When work-related MVPA was below 60 min/day, flexibility activity (B = −3.23, 95% CI = −6.01, −0.44; B = −3.29, 95% CI = −5.94, −0.63) or walking (B = −4.03, 95% CI = −6.62, −1.45; B = −3.10, 95% CI = −5.76, −0.44) practice 1–4 times/week and ≥5 times/week was significantly associated with lower psychological stress response.ConclusionExercise-based PA greatly and consistently associates with a lower level of stress responses moderated by work-related MVPA.