bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of improved sanitation facilities: Does socioeconomic inequality still persist in India?
Authors: Kumar Pradeep , Hasan Nihal , Rajak Rahul 
Published: June 2024

Abstract

Background
Despite the significant improvement in sanitation coverage, utilization of improved sanitation still does not reach the optimal level across all socioeconomic groups in India. Given this backdrop, this study examines the socioeconomic status-related inequality in the utilization of improved sanitation facilities among Indian Households.
Methods
The study utilized fifth round of National Family Health Survey (NFHS); a national representative cross-sectional survey of India conducted in 2019-21. Logistic regression was applied to estimate the effect of various predictors on utilization of improved sanitation facilities. We also used decomposition analyse to identify the factors responsible for utilization of improved sanitation.
Results
The results indicate that 69% of Indian households utilized improved sanitation facilities. The study highlights that young and unmarried household heads, lower education, poor wealth status of household, living in rural areas, and marginalized castes had lower access to improved sanitation facilities. The multivariate regression analysis suggested that households belonging to richer [AOR: 13.99; 95%, CI: 13.64–14.34] and richest [AOR: 46.73; 95%, CI: 45.00–48.52] wealth quintiles have 14 and 47-times higher odds of having sanitation facility than households which belong to poorest quintile respectively. The decomposition analysis suggested that 11 to 18% of inequality was explained by the geographical region of household and caste of household head. The concentration curve of utilization of improved sanitation was more concentrated in Central and East India households (Concentration Index: 0.51 and 0.47), which has reduced to 0.17 and 0.22 during NFHS-4 to NFHS-5. We also found that 68 districts in India had less than 50 percent utilization of improved sanitation facilities.
Conclusion
The study concludes that households with a better socioeconomic status were more able to access improved sanitation. Thus, inclusive strategies are needed to reduce socioeconomic inequality at the micro level and strengthen ongoing policies.
Retrospective analysis of the incidence of and risk factors for mortality from intertrochanteric fracture in elderly patients treated with cementless bipolar hemiarthroplasty:2-year follow-up
Authors: Li Jiachen , Yang Zhaohui 
Published: June 2024

Abstract

Purpose
The objective of this study was to explore the risk factors for mortality in elderly patients with intertrochanteric fractures treated with proximal femoral nail fixation(PFNA) or cementless bipolar hemiarthroplasty(CBH), as well as in patients with CBH based on subgroups of follow-up time.
Patients and Methods:
A total of 231 patients who underwent PFNA or CBH at our hospital between January 2016 and October 2021 were included. We first compared the two surgical procedures, and then compared the mortality and survival groups treated with CBH based on the subgroups of follow-up time in univariate, logistic regression, and Kaplan-Meier survival estimates
Results
In our study, the survival rate and average survival time of the joint replacement group were greater than those of the intramedullary nailing group(p<0.05), and the time from surgery to implantation in the joint replacement group was significantly shorter(p<0.05). However, the need for blood transfusion was greater in the joint replacement group(p<0.05), and the Harris score of the joint replacement group was also greater than that of the intramedullary nailing group(p<0.05). The survival rates in the CBH group at the 6-month, 1-year and 2-year follow-ups were 90.4%, 84.2% and 78.9%,respectively.Univariate analysis of the CBH group showed that gender was associated with mortality at the 6-month(p<0.05), 1-year(p<0.05), and 2-year follow-ups(p<0.05), and we found that ICU admission time was a risk factor for mortality at both 1-year and 2-year follow-ups(p<0.05), which was also consistent with the logistic regression analysis.
Conclusion
Gender was an independent risk factor for mortality in all follow-up time subgroups. In addition, the amount of perioperative hemoglobin and albumin loss should be considered and measures should be taken during the perioperative period.
Level of Evidence:
therapeutic level III according to the OCEBM levels of the Evidence Working Group.
Weight loss in patients with severe obesity after bariatric surgery – The potential role of the chrono-nutrition, chronotype and the circadian misalignment: a study protocol of the ChronoWise prospective Cohort
Authors: Rodrigues Joana , Magalhães Vânia , Santos Maria Paula , Reis Cátia , Pichel Fernando , Soares Paulo , Santos Jorge , Vilela Sofia 
Published: June 2024

Abstract

Background
Despite the potential effectiveness of bariatric surgery in promoting weight loss, a considerable proportion of patients still face the challenge of achieving optimal post-surgery outcomes. The timing of eating, in addition to the content of what is eaten, as well as chronotype and social jetlag (a marker of circadian misalignment), have been implicated in weight regulation. However, the current understanding of these chrono-related behaviours in individuals undergoing bariatric surgery is still scarce. Thus, this study aims to evaluate the role of chrono-nutrition, chronotype, and circadian misalignment in the weight-loss trajectory among individuals living with severe obesity who underwent bariatric surgery.
Methods
The ChronoWise project is a prospective single-centre cohort study designed to follow patients experiencing bariatric surgery at the Santo António Local Health Unit (ULSSA), Porto, Portugal. Participants will be recruited and evaluated at pre-surgery and followed-up over 3 and 6 months after surgery. The baseline evaluation will be conducted face-to-face during the hospital stay and by telephone or video call on the subsequent evaluations, following standard procedures. Data collection includes sociodemographics, food intake, chrono-nutrition behaviours, sleep time behaviour, sleep quality, screen time, physical activity and exercise behaviours, anthropometric measurements, and biochemical parameters. The ‘Munich Chronotype Questionnaire’ will be used to assess chronotype and social jet lag. Chrono-nutrition dimensions will be measured by the ‘Chrononutrition Profile - Questionnaire' in all evaluations. Weight and height will be self-reported and retrieved from medical registries. trajectories of weight-loss will be obtained.
Discussion
This study will add important evidence on the role of chrono-nutrition, chronotype and social jetlag profile in weight-loss outcomes after bariatric surgery. Identifying novel approaches to change the paradigm of post-surgical weight management towards a tailored treatment aligned with circadian rhythm may be useful to strengthen the existing treatments and improve patients’ response to bariatric surgery.
Adverse Childhood Experiences and Pediatric Solid Organ Transplant Outcomes: Single Center Study
Authors: McGurn Iliana B , Piburn Kim , Lopez Eliot , Ayroso-Guardiola Irma , Ranch Daniel 
Published: June 2024

Abstract

Adverse childhood experiences (ACE) are linked to several health issues in adulthood. It is not known how ACE may impact solid organ transplant outcomes. We hypothesized that ACE are associated with adverse outcomes. We administered a 10-item inventory ACE questionnaire to 48 patients transplanted as children and transitioned to adult services. Mean age was 23 years, 54% were female, 19% White. Primary outcome was a current functioning graft. 60.4% reported an ACE score of > 0, 22.9% reported an ACE score of > 3. There was no association between an ACE score > 0 (P = 0.3715) or > 3 (P = 0.5757) and graft loss. In this single center study, we did not find an association between ACE and adverse transplant outcomes in young adult transplant patients. Further studies are needed to elucidate the relationship between childhood trauma and long-term transplant outcomes.
Multi-Omics Insights into Grapevine Ecodormancy to Budburst Transition: Interplay of Gene Expression, miRNA Regulation, and DNA Methylation
Authors: Shinde Harshraj , Raihan Tajbir , Anand Lakshay , Perry Sharyn , Geneve Robert , Lopez Carlos Rodriguez 
Published: June 2024

Abstract

In grapevine, the transition from a dormant bud to budburst is a critical developmental process related to vegetative and reproductive growth. We generated a time series analysis (five sampling time points) and used transcriptome, small RNA, and whole-genome bisulfite sequencing to characterize this transition. Ecodormant buds took an average of 17 days to budburst. Transcriptome analysis identified a total of 7002 differentially expressed genes across all sampling times and revealed that the brassinosteroid metabolism and the linoleic acid metabolism pathways are upregulated and downregulated respectively across all time points. Gene expression cluster analysis identified the activation of the photosynthesis pathway and photosynthesis related genes during this transition. miRNA expression analysis identified a steady increase in expression of two miRNAs, miR159a and miR159b during the transition from dormancy to budburst. Our analysis suggests that these two miRNAs promote budburst by repressing the expression of auxin responsive genes. Finally, a continued increase in CG methylation levels was observed during the dormancy to budburst transition. Differential methylation analysis, considering dormant buds as the control stage, yielded 6354 differentially methylated regions across the genome. Two glucosidase genes exhibited increases in promoter methylation and a corresponding decrease in gene expression in our analysis. This study provides a multi-omics view of grapevine bud transition from dormancy to bud burst and unveils the interacting genetic and epigenetic networks regulating this process.
Achieving Excellence: The Role of Leadership Styles in Fostering Work Performance and Autonomy in Nurses’ decision-making
Authors: Alanazi Fadiyah Jadid , Mersal Fathia Ahmed 
Published: June 2024

Abstract

Background
Leadership is essential to nursing because it influences autonomy in nurses’ decision-making and work performance. Efficient leadership styles have been demonstrated to significantly influence patient outcomes, nursing practice, and organizational success. On the contrary, inadequate leadership can impede nurses' autonomy in decision-making, limit their job satisfaction, and ultimately hinder the quality of patient care.
Study Aim
This study aims to evaluate the role of leadership styles in fostering work performance and autonomy in nurses’ decision-making at Northern Region Hospitals.
Methodology
A descriptive exploratory design was used in this study with a sample size of 102 participants.
Results
The results showed a linear relationship between Transformational leadership style and subjective measures of leader work performance and autonomy in nurses' decision-making. The study results indicated that most staff nurses defined their leader's style as transformational leadership, followed by transactional leadership and then laissez-faire leadership.
Conclusion
In conclusion, Leadership must enhance and foster autonomy in nurses' decision-making ability. Leaders must improve their leadership style to positively impact autonomy in nurses’ decision-making and improve patients' healthcare. All managers down to the lowest channel must exercise a key leadership role to influence nurses to become good and independent leaders. This study involves nursing practice and nursing management. Nurse managers should receive training on the different leadership philosophies and how to apply the style that best advances the organization’s objectives.
Endovascular fenestration in aortic type-A dissection with hepatic malperfusion syndrome: a case report
Authors: Weiss Daniel Arvid , Jannusch Kai , Wilms Lena Marie , Dalyanoglu Hannan , Ullrich Tim , Antoch Gerald , Minko Peter , Ziayee Farid 
Published: June 2024

Abstract

Background: Fenestration of the dissection membrane in aortic dissection is a viable treatment option for abdominal malperfusion syndrome. While open surgical approaches are commonly chosen for type-A (DeBakey I and II) dissections, endovascular treatment gains importance in type-B dissections, particularly for patients unsuitable for surgery or in a combined approach.
Case presentation: We present a case of an acute type-A (DeBakey I) aortic dissection in a patient who underwent a David-Procedure combined with a partial aortic arch replacement and was subsequently treated for hepatic malperfusion syndrome using an endovascular approach.
Conclusions: The interdisciplinary approach led to a favorable clinical outcome, suggesting that endovascular treatment should be considered for patients with type-A dissection and abdominal malperfusion syndrome.
What’s for lunch? Eliciting preferences for food on university campus: discrete choice experiment protocol
Authors: Pokhilenko Irina , Afentou Nafsika , Fu Lin , Hiligsmann Mickael , Witthoft Cornelia , Hefni Mohammed , Nzefa Leonie Dapi , Randelli Filippo , Elias Anna Julia , Bartos Krisztina , Csobod Éva Csajbókné , Ouguerram Khadija , Parnet Patricia , Ruiz-de-Maya Salvador , Ferrer-Bernal Elvira , Frew Emma 
Published: June 2024

Abstract

Background. Food choices are influenced by habits, experiences, as well as various socioeconomic factors. Understanding these drivers can mitigate negative effects of poor nutrition and yield societal benefits. Preference elicitation methods like discrete choice experiments help understand people’s food preferences revealing factors influencing choices the most, such as nutritional content or cost of a meal. This information can be helpful in developing tailored meal-based interventions and informing food policies. Universities, as anchor institutions, are increasingly concerned with health, wellbeing, and sustainability of their students and staff. Yet, there is limited evidence on food preferences in university settings. This paper outlines a discrete choice experiment protocol to compare lunch preferences among university staff and students across six European countries, aiming to inform campus food policies.
Methods. Attributes and levels were derived from a systematic literature review of preference-based studies focused on the drivers of meal choices and validated in the focus group with students and staff from participating universities. The attributes in the discrete choice experiment include nutritional content, price, time to access a meal, sensory properties of a meal, naturalness of the ingredients, and meal size. The survey was piloted in think-aloud interviews with students and staff in participating universities. We will collect preference data, along with data on participants’ sociodemographic characteristics, food-related behaviour, opinions about food, experience of food insecurity, physical activity, and body composition, using an online survey. Preference data will be analysed using random parameter logit and latent class models.
Discussion. This study will be the first to investigate lunch preferences of university students and staff across six European countries, informing campus food policies. While campus food systems may not always align with students’ and staff preferences, incorporating them into policy-making can enhance satisfaction and well-being. Strengths include an international focus, inclusion of complementary variables, and involvement of potential respondents in all phases of developing this research. Acknowledging limitations, such as varying lunch habits, the study aims to provide valuable insights for improving university food policies and overall community well-being.
Spatiotemporal Distribution Characteristics of Glacial Lakes and their outburst flood risk assessment in the Central Asian Tienshan Mountains
Authors: Chen Yaning 
Published: June 2024

Abstract

Global warming has accelerated the melting of mountain glaciers and intensified the formation and expansion of glacial lakes. This phenomenon has led to an increased risk of glacier lake outburst floods (GLOFs), posing a severe threat to downstream residents of the water supply and water conservancy facilities. Glacial lake outburst floods have become a significant concern in mountain hazard research. The present paper uses multi-temporal Landsat sequence remote sensing images, Sentinel-2A/2B image data, and a semi-automatic water body extraction algorithm with global-local threshold segmentation to extract glacial lake boundaries in the Tienshan Mountains of Central Asia from 1990 to 2023, analyzing their spatial and temporal characteristics. An improved GLOF hazard and risk assessment model is used to evaluate hazard and risk levels under various current and future scenarios. The results show that during the study period, the number and area of glacial lakes increased 148% (from 1,837 to 4,557) and 64.32% (from 119.73 km2 to 205.73 km2), with moraine lake expansion predominating. Spatially, glacial lakes are mainly distributed in Central and Western Tienshan, accounting for 75% of the entire Tienshan region. In Western Tienshan, the high or very high risk of GLOF is 3-4 times that of other areas, while in Eastern Tian Shan, about half the glacial lakes have high or higher GLOF hazard levels, and in Northern Tienshan, only 30.91% have high hazard levels. By the middle of the 21st century, with further climate warming, GLOF risk and potential threats will continue to increase, especially in Western Tienshan. This study can provide scientific data for water resource utilization and a foundation for disaster prevention and reduction in the region’s downstream areas.
Exploring the Potential of Deep Learning Models Integrating Transformer and LSTM in Predicting Blood Glucose Levels for T1D Patients
Authors: He JianFeng , Su Heng , Xiong Xin , Yang XinLiang , Cai Yunying , Xue Yuxin 
Published: June 2024

Abstract

Type 1 diabetes (T1D) is an increasingly common chronic disease, and its incidence continues to rise globally, posing huge challenges to the public health system. At the same time, due to the need for long-term strict diet control and blood sugar monitoring, the management process of diabetes is relatively complicated, which brings a lot of inconvenience to patients' daily life. Predicting blood glucose concentration (BGC) in T1D patients can help avoid abnormal blood glucose events and improve blood glucose management in T1D patients. However, accurate blood glucose prediction remains challenging because blood glucose levels are affected by multiple factors such as insulin injections, diet, and exercise. In this study a combined deep learning (DL) model of Transformer and long short-term memory network (LSTM) for blood glucose prediction in T1D patients is proposed, which fully integrates the advantages of Transformer and LSTM. For the proposed method Transformer captures sequence relationships globally, while LSTM focuses on local and long-term dependencies, thereby improving the overall performance of the model. In this study the clinical data set of 13 T1D patients for more than 4 weeks are provided by the First Renmin Hospital of Yunnan Province, and the 360-day blood glucose data set of 10 adult T1D patients generated by the UVa/Padova simulator. The prediction performance and clinical evaluation were performed using root mean square error (RMSE), mean absolute error (MAE), and Clark error grid analysis (EGA), respectively. The performance of the model on clinical data sets is 30-min prediction horizon (PH) (RMSE=10.157, MAE=6.377), 60-min PH (RMSE=10.645, MAE=6.417), 90-min PH (RMSE=13.537, MAE=7.283), 120-min PH (RMSE= 13.986, MAE= 6.986). The performance of the model on the simulated data set is 15-min PH (RMSE=1.793, MAE=1.376), 30-min PH (RMSE=2.049, MAE=1.311), 60-min PH (RMSE=3.477, MAE=1.668). The units of RMSE and MAE are mg/dl. In addition, Clark Grid Analysis (EGA) analysis showed that more than 96% of BGC predictions remained within the clinical safety zone during the PH period of up to 120 minutes in the clinical data set, validating its clinical feasibility.
Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders
Authors: Panadero Talia J. , Gabrielian Sonya , Seamans Marissa J. , Gelberg Lillian , Tsai Jack , Harris Taylor 
Published: June 2024

Abstract

Background.
Permanent supportive housing (PSH) is an evidence-based practice for reducing homelessness that subsidizes permanent, independent housing and provides case management—including linkages to health services. Substance use disorders (SUDs) are common contributing factors towards premature, unwanted (“negative”) PSH exits; little is known about racial/ethnic differences in negative PSH exits among residents with SUDs. Within the nation’s largest PSH program at the Department of Veterans Affairs (VA), we examined relationships among SUDs and negative PSH exits (for up to five years post-PSH move-in) across racial/ethnic subgroups.
Methods.
We used VA administrative data to identify a cohort of homeless-experienced Veterans (HEVs) (n = 2,712) who were housed through VA Greater Los Angeles’ PSH program from 2016–2019. We analyzed negative PSH exits by HEVs with and without SUDs across racial/ethnic subgroups (i.e., African American/Black, Non-Hispanic White, Hispanic/Latino, and Other/Mixed [Asian, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander, and multi-race]) in controlled models and accounting for competing risk of death.
Results.
In competing risk models, HEVs with at least one SUD had 1.3 times the hazard of negative PSH exits compared to those without SUDs (95% CI: 1.00, 1.61). When stratifying by race/ethnicity, Other/Mixed race residents with at least one SUD had 6.4 times the hazard of negative PSH exits compared to their peers without SUDs (95% CI: 1.61–25.50). Hispanic/Latino residents with at least one SUD had 1.9 times the hazard compared to those without SUDs, also indicating a strong relationship with negative PSH exits; however, this association was not statistically significant (95% CI: 0.85–4.37). Black residents with at least one SUD had 1.2 times the hazard compared to those without SUDs (95% CI: 0.85–1.64), indicating no evidence of an association with negative PSH exits. Similarly, Non-Hispanic White residents with at least one SUD had 1.1 times the hazard compared to those without SUDs (95% CI: 0.75–1.66).
Conclusions.
These findings suggest relationships between SUDs and negative PSH exits differ between race/ethnic groups and suggest there may be value in culturally specific tailoring and implementation of SUD services for these subgroups.