bluuebunny/crossref_metadata_2025_split huggingface dataset:
Availability, pricing, and affordability of essential medicines for pediatric population in Malawi
Authors: Chiumia Francis Kachidza , Chithope-Mwale Cynthia , Abikoloni Felix , Matchaya Vanessa , Gaviyawo Tadala , Khuluza Felix 
Published: April 2024

Objective:Lack of access to essential medicines negatively impacts on the quality of healthcare delivery and increases morbidity and mortality, especially to the vulnerable pediatric population. We assessed the availability, pricing, and affordability of pediatric formulations in Malawi.Methodology:The study was conducted in 76 health facilities (public, faith-based and private pharmacies, and clinics) from the northern and southern regions of Malawi from March to May 2023. We adapted the WHO/HAI method for the assessment of both availability and pricing of medicines. Data on availability were collected from stock card records using a WHO/HAI template and medicine prices were provided by the pharmacy personnel who were managing the facilities. Availability of medicines was calculated as the percentage of facilities which had a stock of the respective medicine at the time of data collection while medicine prices was assessed by calculating the median prices of each medicine. To assess the affordability of the medicines, we calculated the number of days it takes for a person who is receiving the government-set minimum wage to work to pay for a treatment course of common indications. The study was approved by the KUHES ethics committee under the numbers U.12/22/3900 and U.12/22/3903.Results and conclusion:The overall availability of pediatric medicines was 38.1% for public health facilities, 53.7% for private retail pharmacies and drug stores, 49.5% for private clinics and 48.3% for Christian Health Association of Malawi (CHAM) facilities. We found the illegal availability of prescription-only medicines of up to 54% in medicine stores. Medicine median prices were higher in the private clinics followed by retail pharmacies and drugs stores. CHAM had the lowest median prices for medicines of all the sectors. More than 50% of medicines were found to be affordable as less than a day’s wage was required to purchase the treatment. We found poor availability of pediatric formulation among public, CHAM, and private sectors in Malawi. This may affect the quality of care among pediatric patients and therefore contribute to morbidity and mortality in Malawi. The supply of medicines and health commodities needs to consider needs of special populations such as children to achieve universal health coverage.
Associations between challenging parenting behavior and creative tendencies of children: the chain mediating roles of positive emotion and creative self-efficacy
Authors: Shi Dasheng , Wang Yidi , Jin Ruining , Chu Lin 
Published: April 2024

BackgroundParenting behavior has been reported to be closely associated with children’s creativity, yet the association between challenging parenting behavior and children’s creative tendencies, as well as the potential mechanisms connecting the two, remains ambiguous. Based on the Social Cognitive Theory and the Self-efficacy Theory, this study aims to examine the correlation between Chinese parents’ challenging parenting behaviors and their children’s creative tendencies, as well as the chain mediating role of children’s positive emotions and creative self-efficacy.MethodsIn total, 2,647 families were surveyed with questionnaires completed by parents on the Challenging Parenting Behaviors Scale and by children on the Positive/Negative Emotions Scale, the Creative Self-efficacy Scale, and the Williams Creative Tendency Test Scale, and analyzed using structural equation modeling (SEM) in SPSS 22.0 and Mplus 8.3.ResultsThe findings indicate that challenging parenting behavior has a positive correlation with children’s positive emotions, creative self-efficacy, and creative tendencies. Through positive emotions, creative self-efficacy, and a chain mediated pathway between these two variables, challenging parenting behaviors increase children’s creative tendencies.ConclusionThe favorable impacts of challenging parenting behaviors on children’s creative tendencies, with the mediating effects of children’s positive emotions and creative self-efficacy, may help Chinese parents better grasp the mechanisms underlying this association.
Unraveling the enigma: housekeeping gene Ugt1a7c as a universal biomarker for microglia
Authors: Kim Wonju , Kim Minji , Kim Beomsue 
Published: April 2024

BackgroundMicroglia, brain resident macrophages, play multiple roles in maintaining homeostasis, including immunity, surveillance, and protecting the central nervous system through their distinct activation processes. Identifying all types of microglia-driven populations is crucial due to the presence of various phenotypes that differ based on developmental stages or activation states. During embryonic development, the E8.5 yolk sac contains erythromyeloid progenitors that go through different growth phases, eventually resulting in the formation of microglia. In addition, microglia are present in neurological diseases as a diverse population. So far, no individual biomarker for microglia has been discovered that can accurately identify and monitor their development and attributes.SummaryHere, we highlight the newly defined biomarker of mouse microglia, UGT1A7C, which exhibits superior stability in expression during microglia development and activation compared to other known microglia biomarkers. The UGT1A7C sensing chemical probe labels all microglia in the 3xTG AD mouse model. The expression of Ugt1a7c is stable during development, with only a 4-fold variation, while other microglia biomarkers, such as Csf1r and Cx3cr1, exhibit at least a 10-fold difference. The UGT1A7C expression remains constant throughout its lifespan. In addition, the expression and activity of UGT1A7C are the same in response to different types of inflammatory activators’ treatment in vitro.ConclusionWe propose employing UGT1A7C as the representative biomarker for microglia, irrespective of their developmental state, age, or activation status. Using UGT1A7C can reduce the requirement for using multiple biomarkers, enhance the precision of microglia analysis, and even be utilized as a standard for gene/protein expression.
A prospective longitudinal approach to examine the association between social position in childhood, adolescence, and adulthood with the control of hypertension during adulthood
Authors: Barradas Susana , Lucumi Diego I. , Mentz Graciela , Agudelo Diana Maria 
Published: April 2024

IntroductionHypertension is one of the main concerns in public health, since it is related with increased morbidity, and potential years of life lost in addition to loss of quality of life. This study aimed to assess: (1) the distribution of indicators of life course SEP in a cohort of Colombian patients with hypertension and (2) to assess the association of life course SEP and control of hypertension among this cohort of patients.MethodsData were obtained using the baseline survey of 258 patients from the Social Determinants and Inequities in the Control of Blood Hypertension Program (ProDSICHA). Mother occupation and housing conditions were measured with the Event History Calendar. Mother educational level was measured with the questionnaire developed by the Project on Ethnicity and Race in Latin America (PERLA). Socioeconomic position during adulthood was measured using education, occupation, and income level based in the MacArthur Network.ResultsThe group with a higher lifelong social position and the group of lower lifelong social position showed better control of hypertension (OR = 1.21; p &lt;0.05; OR = 1.33; p &lt; .05, respectively) compared to those whose social position throughout life varied the most. No statistical differences were found in the relations between single lifetime social position variables, and hypertension control in the three time points analyzed.DiscussionThese findings warrant further research to deeper our understanding on the role of a multidimensional and cumulative approach of social position in hypertension control.
Factors associated with patients’ healthcare-seeking behavior and related clinical outcomes under China’s hierarchical healthcare delivery system
Authors: Guo Lizhu , Du Xin , Wu Huanqi , Xia Shijun , Du Jing , Kong Xiangrong , Yang Xiaohui , Wang Chi , Dong Jianzeng , Ma Changsheng , Engineer Lilly 
Published: April 2024

IntroductionThe hierarchical healthcare delivery system is an important measure to improve the allocation of medical resources and promote equitable distribution of basic medical and health services. It is one of the key factors in the success or failure of China’s medical reform. This study aims to analyze the factors influencing patients’ healthcare-seeking behaviors, including socioeconomic and clinical outcomes, under China’s hierarchical healthcare delivery system, and to provide potential solutions.MethodsPatients receiving outpatient treatment in the past 14 days and inpatient care in the past 1 year were investigated. The multivariate logistic regression was used to analyze the influencing factors of patient’s medical treatment behavior selection, and to compare whether the clinical outcomes of primary medical institutions and grade A hospitals are the same.ResultsNine thousand and ninety-eight person-times were included in the study. Of these, 4,538 patients were outpatients, 68.27% of patients were treated in primary medical institutions; 4,560 patients were hospitalized, 58.53% chose to be hospitalized in grade A hospitals. Provinces and cities, urban and rural areas, occupation, education level, medical insurance type, income, whether there are comorbid diseases, and doctors’ medical behavior are the factors affecting the choice of medical treatment behavior. Patients who choose primary medical institutions and grade A hospitals have different control levels and control rate for the blood pressure, blood lipids, blood glucose.ConclusionUnder the hierarchical diagnosis and treatment system, the patients’ choice of hospital is mainly affected by their level of education, medical insurance types, and the inpatients are also affected by whether there are comorbid conditions. Clinical outcomes of choosing different levels of hospitals were different.
Association between mild depressive states in polycystic ovary syndrome and an unhealthy lifestyle
Authors: Li Lingling , Kang Zhiyuan , Chen Ping , Niu Baihan , Wang Yaohui , Yang Liping 
Published: April 2024

ObjectivePolycystic Ovary Syndrome (PCOS) is a prevalent and frequently encountered gynecological disorder. Its high variability and the complexities associated with its management often lead to psychological stress in affected women, manifesting in symptoms of depression. Embracing a healthy lifestyle is fundamental in PCOS treatment. Consistent adherence to a healthy lifestyle not only aids in improving PCOS symptoms but also plays a role in enhancing mental well-being. However, there is currently limited research examining the extent of depression, its prevalence, and its correlation with lifestyle among individuals with PCOS. Therefore, this study aims to explore the impact of lifestyle factors on the depressive state of individuals with PCOS.MethodsThis cross-sectional study gathered data from 411 individuals with PCOS at a comprehensive hospital in Henan, China. Depression status was assessed using the Hamilton Depression Scale, and demographic information as well as lifestyle habits were simultaneously collected. Univariate and multivariate analyses using logistic regression were conducted to identify risk factors associated with the depressive state in PCOS.ResultsAmong the surveyed 411 individuals with PCOS, approximately 49.4% exhibited symptoms of depression, with 83.7% experiencing mild depressive symptoms. A disease duration of 1–3 years, the presence of acne, and unhealthy lifestyle factors such as high-fat diet, staying up late, lack of exercise, and mental stress emerged as significant risk factors for the onset of depressive symptoms.ConclusionDepressive symptoms in individuals with PCOS are predominantly mild. The risk of comorbid depression in PCOS is associated with the presence of acne, frequent high-fat diet, regular staying up late, lack of exercise, and mental stress.
Post-COVID-19 syndrome, who at risk and why: an insight from Qatar 2022
Authors: Adli Nada , Bala Mohamed , Bougmiza Mohamed Iheb , Al-Kuwari Mohamed Ghaith , Al-Khenji Abdul Hameed , Selim Nagah 
Published: April 2024

BackgroundDespite the recovery from the COVID-19 pandemic, many people experience post-COVID-19 syndrome, which negatively impacts their health and function. This condition has become a significant public health problem that requires immediate attention.ObjectiveTo study the prevalence, clinical characteristics, and predictors of post-COVID-19 Syndrome in Qatar during 2022.MethodsAn analytic cross-sectional study was conducted among COVID-19 confirmed cases from January 2022 to July 2022 in Qatar. A simple random sample was employed to include (n = 588) participants from the list of cases and invited to participate in a telephone survey. The World Health Organization’s standard case definition for PCS was adopted.ResultsOut of 368, the prevalence of post-COVID-19 syndrome was 43.2% (n = 159). Most PCS cases were females (67.9%; n = 108), married (73.6%; n = 117), and university and higher educational level (83.6%; n = 133). However, 78.7% (n = 125) reported poor to moderate levels of social support. Only 30.2% (n = 48) of PCS patients had a history of chronic diseases, and 5.7% (n = 9) required hospital admission during acute illness. Among PCS cases, the most commonly reported symptoms were fatigue (75.5%), followed by anxiety (49.1%), forgetfulness (46.5%), mood alteration (45.3%), and general weakness (39.6%). The logistic regression revealed that female gender (AOR: 2.58 95%CI: 1.58–4.225, p &lt; 0.0001), university and high educational level (AOR: 2.2, 95%CI: 1.256–3.98, p &lt; 0.006), poor level of social support (AOR: 2.45; 95%CI: 1.55–4.13; p &lt; 0.002), were significant predictors for PCS.ConclusionPost-COVID-19 syndrome may go under-recognized. More efforts are needed to raise awareness and mobilize the resources to respond to this ongoing public health problem.
Insights into microorganisms, associated factors, and the oral microbiome in infective endocarditis patients
Authors: Ismail Ayden , Yogarajah Amieth , Falconer Joseph Luke , Dworakowski Rafal , Watson Samuel , Breeze Jonathan , Gunning Margaret , Khan Habib , Hussain Azhar , Howard James P. , Cheong Phoebe , Shah Mira , Nibali Luigi , Sousa Vanessa 
Published: April 2024

IntroductionInfective Endocarditis (IE) is a rare, life-threatening infection of the endocardium with multisystem effects. Culprit microorganisms derived from different niches circulate through the bloodstream and attach to the endocardium, particularly the heart valves. This study aimed to investigate culprit microorganisms among a cross-sectional cohort of IE patients, their associated factors, and to explore the potential relationship to the oral microbiome.MethodsIn this observational study, we undertook a cross-sectional analysis of 392 medical records from patients diagnosed with IE. The primary outcome of this study was to analyse the association between the IE culprit microorganisms and the underlying anatomical types of IE (native valve (NVE), prosthetic valve (PVE), or cardiac device-related (CDE)). Secondary outcomes encompassed a comparative analysis of additional factors, including: the treatment approaches for IE, and the categorisation of blood cultures, extending to both genus and species levels. Additionally, we cross-referenced and compared the species-level identification of IE bacteraemia outcome measures with data from the expanded Human Oral Microbiome Database (eHOMD).ResultsA culprit microorganism was identified in 299 (76.28%) case participants. Staphylococcal infections were the most common (p &lt; 0.001), responsible for 130 (33.16%) hospitalisations. There were 277 (70.66%) cases of NVE, 104 (26.53%) cases of PVE, and 11 (2.81%) cases of CDE. The majority of PVE occurred on prosthetic aortic valves (78/104, 75%), of which 72 (93.5%) were surgical aortic valve replacements (SAVR), 6 (7.8%) were transcatheter aortic valve implants, and one transcatheter pulmonary valve implant. Overall, underlying anatomy (p = 0.042) as well as the treatment approaches for IE (p &lt; 0.001) were significantly associated with IE culprit microorganisms. Cross-reference between IE bacteraemia outcomes with the eHOMD was observed in 267/392 (68.11%) cases.ConclusionsThis study demonstrated that IE patients with a history of stroke, smoking, intravenous drug use, or dialysis were more likely to be infected with Staphylococcus aureus. CDE case participants and patients who had previous SAVR were most associated with Staphylococcus epidermidis. IE patients aged 78+ were more likely to develop enterococci IE than other age groups. Oral microorganisms indicated by the eHOMD are significantly observed in the IE population. Further research, through enhanced dental and medical collaboration, is required to correlate the presence of oral microbiota as causative factor for IE.
Benefits and Difficulties of Implementing Family-Farming Food Purchases in the Brazilian National School Feeding Program
Authors: Tuliende Mónica Isabel Eduardo Domingos , Martinelli Suellen Secchi , Soares Panmela , Fabri Rafaela Karen , Bianchini Vitória Uliana , Cavalli Suzi Barletto 
Published: April 2024

Objectives: To explore the opinions of Brazilian National School Feeding Program (NSFP) nutritionists concerning the benefits and difficulties of implementing family-farming food purchases for the school feeding program.Methods: Exploratory and descriptive qualitative study conducted through the analysis of inductive content of open interviews carried out with technically responsible nutritionists of the School Feeding Program of 21 municipalities in Southern Brazil.Results: The qualitative analysis of the interviews resulted in 17 codes grouped into four categories that show the opinion of nutritionists on the benefits and difficulties of purchasing family-farming food: 1. increasing the visibility of rural areas and 2. improving the quality of food provided in school meals; 3. low product availability and 4. limited infrastructure for production and delivery.Conclusion: According to nutritionists, purchasing family-farming food in NSFP can increase the supply of healthy food in schools and stimulate rural development. However, efforts are needed to adjust institutional food demands for local food production and improve infrastructure for food production and distribution.
Sensing at the Nanoscale Using Nitrogen-Vacancy Centers in Diamond: A Model for a Quantum Pressure Sensor
Authors: Paudel Hari P. , Lander Gary R. , Crawford Scott E. , Duan Yuhua 
Published: April 2024

The sensing of stress under harsh environmental conditions with high resolution has critical importance for a range of applications including earth’s subsurface scanning, geological CO2 storage monitoring, and mineral and resource recovery. Using a first-principles density functional theory (DFT) approach combined with the theoretical modelling of the low-energy Hamiltonian, here, we investigate a novel approach to detect unprecedented levels of pressure by taking advantage of the solid-state electronic spin of nitrogen-vacancy (NV) centers in diamond. We computationally explore the effect of strain on the defect band edges and band gaps by varying the lattice parameters of a diamond supercell hosting a single NV center. A low-energy Hamiltonian is developed that includes the effect of stress on the energy level of a ±1 spin manifold at the ground state. By quantifying the energy level shift and split, we predict pressure sensing of up to 0.3 MPa/Hz using the experimentally measured spin dephasing time. We show the superiority of the quantum sensing approach over traditional optical sensing techniques by discussing our results from DFT and theoretical modelling for the frequency shift per unit pressure. Importantly, we propose a quantum manometer that could be useful to measure earth’s subsurface vibrations as well as for pressure detection and monitoring in high-temperature superconductivity studies and in material sciences. Our results open avenues for the development of a sensing technology with high sensitivity and resolution under extreme pressure limits that potentially has a wider applicability than the existing pressure sensing technologies.
Treatise of the Golden Lion: An Exploration of the Doctrine of the Infinite Dependent Arising of Dharmadhātu
Authors: Xiong Ye 
Published: April 2024

Among the texts of Huayan Buddhism, the study of the Treatise of the Golden Lion remains at the level of literal translation. Neither the core doctrines of the Treatise nor the original contexts of its delivery have received much scholarly attention. This paper first contextualizes the preaching background of the Treatise and its relevant doctrines, and then conducts a section-by-section explanation of the Treatise with special consideration given to the intention of Fazang and his manner of preaching. The doctrines of the ten mysterious gates and the six characteristics, along with the manifestation of the distinctive teaching of one vehicle, constitute the key components of the preaching. They are the representation and revelation of the doctrine of the infinite dependent arising of dharmadhātu.
Molecular and Entomological Characterization of 2023 Dengue Outbreak in Dhading District, Central Nepal
Authors: Rimal Sandesh , Shrestha Sabin , Paudel Sunita Wagle , Shah Yogendra , Bhandari Govinda , Pandey Kishor , Kharbuja Anjana , Kapandji Merveille , Gautam Ishan , Bhujel Rajshree , Takamatsu Yuki , Bhandari Rudramani , Klungthong Chonticha , Shrestha Sanjaya Kumar , Fernandez Stefan , Malavige Gathsaurie Neelika , Pandey Basu Dev , Urano Takeshi , Morita Kouichi , Ngwe Tun Mya Myat , Dumre Shyam Prakash 
Published: April 2024

In 2023, Nepal faced its second largest dengue outbreak ever, following a record-breaking number of dengue cases in 2022, characterized by the expansion of infections into areas of higher altitudes. However, the characteristics of the 2023 circulating dengue virus (DENV) and the vector density remain poorly understood. Therefore, we performed DENV serotyping, clinical and laboratory assessment, and entomological analysis of the 2023 outbreak in central Nepal. A total of 396 fever cases in Dhading hospital suspected of being DENV positive were enrolled, and blood samples were collected and tested by different techniques including PCR. Of these, 278 (70.2%) had confirmed DENV infection. Multiple serotypes (DENV-1, -2, and -3) were detected. DENV-2 (97.5%) re-emerged after six years in Dhading while DENV-3 was identified for the first time. Dengue inpatients had significantly higher frequency of anorexia, myalgia, rash, diarrhea, nausea, vomiting, abdominal pain, and thrombocytopenia (p < 0.05). In this area, Aedes mosquitoes largely predominated (90.7%) with the majority being A. aegypti (60.7%). We also found high levels of Aedes index (20.0%) and container index (16.7%). We confirmed multiple DENV serotype circulation with serotype re-emergence and new serotype introduction, and high vector density in 2023. These findings call for the urgent initiation and scaling up of DENV molecular surveillance in human and mosquito populations for dengue control and prevention in Nepal.