bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delayed nephrectomy compared to early nephrectomy is associated with less feeding tube dependency and offers otherwise comparable outcome in infants with congenital nephrotic syndrome
Authors: Suihko Aino , Tainio Juuso , Tuokkola Jetta , Ylinen Elisa , Hölttä Tuula , Jahnukainen Timo 
Published: February 2024

Abstract
Background
The only effective treatment for severe forms of congenital nephrotic syndrome is nephrectomy and kidney transplantation (KT). Optimal timing of nephrectomy is unclear.
Methods
The influence of early (Group 1, n = 13) versus delayed (Group 2, n = 10) nephrectomy on patient outcome was evaluated. The key laboratory results, growth, number of thromboembolic events and infections, KT-related complications, and ability to eat after KT were compared between the two groups.
Results
Patients in group 1 were significantly younger at nephrectomy compared to group 2 (278 vs. 408 days, p = 0.007) and the dialysis time was significantly (p < 0.001) longer, 261 vs. 36 days, respectively. The occurrence of thromboembolic events or septicemia before KT did not differ between the groups. In group 1, eating difficulties and need for enteral tube feeding were more common than in group 2. Enteral tube feeding dependency at discharge, 3 months, and 6 months post-KT were 100%, 92%, and 69% in group 1 and 90% (p = 0.244), 50% (p = 0.022), and 20% (p = 0.019) in group 2, respectively. Motor development was considered normal before KT and 12 months after the KT in 30.8% and 84.6% of the patients in group 1 and in 80% (p = 0.019) and 90% (p = 0.704) in group 2, respectively.
Conclusions
Infants with delayed nephrectomy seem to have comparative outcome but less feeding tube dependency and better motor development during the first post-KT months compared to infants with early nephrectomy.
Health-related quality of life and complications of corticosteroid treatment in patients with immune thrombocytopenia in two teaching hospitals in Ethiopia: A cross-sectional study
Authors: Beyene Dessale Abate , Sisay Eskinder Ayalew , Fentie Atalay Mulu , Gebremedhin Amha 
Published: February 2024

Abstract
Background
Treatment of immune thrombocytopenia (ITP) is difficult and has a significant impact on health-related quality of life (HRQoL), and prolonged use of corticosteroids may have a negative impact on HRQoL. The prepuse of this study was to evaluate the impact of ITP on HRQoL in patients with ITP at Tikur Anbessa Specialized Hospital (TASH) and St. Paul's Hospital Millennium Medical College (SPHMMC).
Methods
The institutional-based cross-sectional study was conducted from November 15, 2022 to March 15, 2023 to recruit 214 study participants. Descriptive statistics were used to summarize the sociodemographic data and clinical and treatment-related characteristics. Linear regression analysis models were also used to identify predictive factors for HRQoL. A p-value of less than 0.05 was generally considered statistically significant.
Results
Most of the study participants were female 161(75.5%). Regarding treatment, the majority 172(80.4%) of study participants were taking prednisolone only, and 143(66.8%) of study participants had at least one side effect of corticosteroids during the entire treatment period. Predictive factors for a higher impact of ITP on HRQoL; all correlated variables explained 36.5% (adjusted R-squared = 0.365, P < 0.0001) of the variance and had a moderate impact on HRQoL. Of these, 15.4% of the variance (adjusted R-squared = 0.154, β = 0.392, P < 0.0001) was accounted for by emotion-related corticosteroid side effects. Furthermore, predictive factors for an increasingly higher impact of ITP on HRQoL were the development of emotionally related corticosteroid side effects (β = 0.392, 95% CI: 5.160–9.961, P < 0.001), the presence of fatigue during the assessment (β = 0.326, 95% CI: 4.394–9.475, P < 0.001), patients not taking cotrimoxazole prophylaxis treatment (β = 0.236, 95% CI: 2.236–6.570, P < 0.001), living far from the hematology clinic (outside Addis Ababa) (β = 0166, 95% CI: 1.107–5.114 P = 0.003), having epistaxis and wet purpura (mucosal bleeding) (β = 0.191, 95% CI: 0.091–4.259, P = 0.001), and skin symptoms (petechiae and ecchymosis) (β = 0.041, 95% CI: 0.091–4.259 P = 0.041) during diagnosis.
Conclusion
The impact of ITP on their energy levels and work life was high compared to the impact of ITP on daily life. The side effects of corticosteroids also affect the HRQoL of ITP patients.
Patient safety culture and associated factors of regional public hospitals in Addis Ababa.
Authors: Yayehrad Teshome , Getachew Yeneneh , Muluken Workineh 
Published: February 2024

Abstract
Background
Patient safety culture is influenced by the values, attitudes, competencies, and behaviors of healthcare providers. Globally, millions of adverse events occur annually, with a significant burden on low- and middle-income countries.
Methods
A cross-sectional study was conducted from June 3 to July 30, 2023. A structured questionnaire was used to survey 494 randomly selected healthcare professionals. The collected data was analyzed using binary logistic regression, where variables with a p-value ≤ 0.05 were considered statistically significant. Model adequacy was assessed using the Hosmer and Lemeshow goodness of fit test.
Result
The overall level of good patient safety culture was 48.8% (95% CI: 44.3–53.1) among the participants, with a response rate of 93.3%. Factors significantly associated with patient safety culture, as identified through factor analysis, included having 6–10 years of experience (AOR = 1.81, 95% CI = 1.13–2.88), having more than 11 years of experience (AOR = 3.49, 95% CI = 1.27–9.56), reporting adverse events (AOR = 2.47, 95% CI = 1.37–4.45), participating in patient safety programs (AOR = 3.64, 95% CI = 1.91–6.92), and working in obstetrics and pediatric wards (AOR = 0.47, 95% CI = 0.23–0.94) and (AOR = 0.21, 95% CI = 0.097–0.44), respectively.
Conclusion
The overall level of good patient safety culture in regional public hospitals was found to be low (< 75%). Factors such as having 6–10 years of experience, having more than 11 years of experience, reporting adverse events, participating in patient safety programs, and working in obstetrics and pediatric wards were significantly associated with patient safety culture.
Risk Behaviors and Practices Toward Dental Health of School Children at Selected Primary Schools in Rwanda
Authors: Mukabizimana Janviere , Kayiranga Dieudonne , Katende Godfrey , Munyemana Jean Bosco 
Published: February 2024

Abstract

Background and Aim:
Dental diseases present a global health issue, impacting both individuals and economies. Despite preventive measures, dental diseases remain neglected, contributing to systemic health issues and socioeconomic burdens. This study aimed to assess the risk behaviors and oral health practices among Rwandan school children in urban and rural communities.
Materials and Methods
A quantitative cross-sectional approach was employed, collecting data from two public primary schools. Data analysis was conducted using SSP version 21.
Results
The study reveals variations in dental health behaviors and practices between urban and rural populations. High frequency in sugar consumption, less time spent brushing, and inappropriate timing for dentist visits have been identified as the main risk behaviors toward dental health. Practices related to poor dental health include the use of inappropriate materials for tooth brushing, a long time before changing them, and non-standardized techniques used to brush teeth. Urban children had higher frequencies of dentist visits than rural children (p = 0.026). However, children from urban areas have the habit of consuming sugary drinks compared to their rural counterparts (p = 0.002). Additionally, significant differences in materials used for brushing teeth were observed, with urban children using toothbrushes and toothpaste, while rural children use charcoals (p = 0.001). The time for changing toothbrushes was statistically significantly different in these two groups (p = 0.011).
Conclusion
Children from urban areas have a higher frequency of sugar consumption compared to children from rural areas. Most children from rural areas have never visited a dentist, and the majority of them reported using things other than toothbrushes to clean their teeth. The findings indicate the need to enhance educational efforts about dental care by involving parents, the community, schools, and health facility levels.
Effects of different combinations of mechanical stress intensity, duration, and frequency on the articular cartilage in mice
Authors: Wakimoto Yoshio , Mimura Yasushi , Inoue Shota , Nomura Masato , Moriyama Hideki 
Published: February 2024

Abstract

Background
Understanding how healthy articular cartilage responds to mechanical stress is critical. Moderate mechanical stress has positive effects on the cartilage, such as maintaining cartilage homeostasis. The degree of mechanical stress is determined by a combination of intensity, frequency, and duration; however, the best combination of these parameters for knee cartilage remains unclear. This study aimed to determine which combination of intensity, frequency, and duration provides the best mechanical stress on healthy knee articular cartilage in vitro and in vivo.
Methods and results
In this study, 33 male mice were used. Chondrocytes isolated from mouse knee joints were subjected to different cyclic tensile strains (CTSs) and assessed by measuring the expression of cartilage matrix-related genes. Furthermore, the histological characteristics of mouse tibial cartilages were quantified using different treadmill exercises. Chondrocytes and mice were divided into the control group and eight intervention groups: high-intensity, high-frequency, and long-duration; high-intensity, high-frequency, and short-duration; high-intensity, low-frequency, and long-duration; high-intensity, low-frequency, and short-duration; low-intensity, high-frequency, and long-duration; low-intensity, high-frequency, and short-duration; low-intensity, high-frequency, and short-duration; low-intensity, low-frequency, and long-duration; low-intensity, low-frequency, and short-duration. In low-intensity CTSs, chondrocytes showed anabolic responses by altering the mRNA expression of COL2A1 in short durations and SOX9 in long durations. Furthermore, low-intensity, low-frequency, and long-duration treadmill exercises minimized chondrocyte hypertrophy and enhanced aggrecan synthesis in tibial cartilages.
Conclusion
Low-intensity, low-frequency, and long-duration stress is the best combination for healthy knee cartilage to maintain homeostasis and activate anabolic responses. Our findings provide a significant scientific basis for exercise and lifestyle instructions.
SiOC matrix nanocomposite films with self-gradient properties fabricated by laser sintering of hybrid nanoparticles
Authors: Chen Xiangyu , Qiu Lu , Zhang Mengsen , Huang Jia , Tao Zhi 
Published: February 2024

Abstract
The reinforced ceramics, known as ceramic matrix composites (CMCs), is playing an important role in modern advanced industrial applications. However, the fabrication of CMCs with both high toughness and high stiffness, which are normally considered mutually exclusive, is still challenging. Here, we develop a gradient property SiOC composite film reinforced with nanoscale tungsten-based particles using a novel avenue of the integration of hybrid nanoparticles inkjet printing and selective laser sintering. Mechanical results of SiOC-WOx films exhibit the stiffness-toughness co-enhancement, including a twofold improvement in hardness and modulus, and an over 3.8-fold better fracture toughness performance than its matrix. Moreover, owing to the metal-to-ceramic gradient properties, the films exhibit interfacial bonding strengths up to 86.6 MPa and operate stably even at 1050 ℃. Characterization results show that the excellent mechanical and interfacial performance is attributed to the significant gradient composition and uniformly dispersed self-assembled nanoscale reinforcing particles. The success of SiOC-WOx CMC films demonstrates the potential to accelerate the discovery of revolutionary nanocomposites using hybrid nanoparticles and bottom-up additive manufacturing processes.
Fine-scale spatial analysis of two plant-insect interactions: effects of landscape, resource distribution, and other insects
Authors: Pocull Guillem , Baskett Carina 
Published: February 2024

Abstract

Context
Biotic resource exploitation is a critical determinant of species’ distributions. However, it is difficult to quantify resource exploitation patterns through space and time, complicating their incorporation in spatial ecology studies. Therefore, understanding the local drivers of spatial patterns of resource exploitation may contribute to better large-scale species distribution models.
Objectives
We investigated (1) how the resource exploitation patterns of two trophic interactions (plant-insect) are explained by insect behaviour, resource aggregation, and potential insect-insect interactions. We also analyzed how (2) resource patch size and (3) resource accessibility in a heterogeneous landscape affected host exploitation patterns.
Methods
We quantified nectar robbing by insects in the genus Bombus (bumblebees) and frugivory by Brachypterolus vestitus larvae (Antirrhinum beetle) on Antirrhinum majus L. (wild snapdragons) in the Pyrenees Mountains, Catalonia, Spain. We tested hypotheses about resource exploitation by integrating spatial analyses at multiple scales.
Results
Both trophic interactions were aggregated, explained by the aggregation of their resource. At some scales, nectar robbing is more aggregated than the resource. Trophic interaction abundance is proportional to resource patch size, following the ideal free distribution model. Landscape features do not explain the locations exploited. Nectar robbing and frugivory occur together more often than expected.
Conclusions
Our findings suggest that multiple biotic and ecological spatial factors may simultaneously affect resource exploitation at a local scale. These findings should be considered when developing agricultural projects, management plans and conservation policies.
Exploration of Barriers to Treatment for Patients with Eating Disorders in Chile
Authors: Castañeda Felipe , Cerda Jaime , Jara Raúl , Riestra Francisca , Urrejola Pascuala , Vogel Melina , Gumucio María Elena , Irribarra Verónica , Álvarez Jorge , Díaz María Alejandra , Kompatzki Paula , Costa Daniela 
Published: February 2024

Abstract

Background
Eating disorders (EDs) are associated with high morbidity and mortality, affecting predominantly young people and women. A delay in starting treatment is associated with chronic and more severe clinical courses; however, evidence on barriers and facilitators of access to care in Latin America is scarce. We aimed to identify barriers and facilitators of ED treatment in Chile from the perspective of patients, relatives, and health professionals.
Methods
Qualitative approach through semi-structured interviews with patients, their relatives, and health professionals. Participants were recruited from two ED centers in Santiago, Chile (one public and one private). Analysis was mainly based on Grounded Theory, using MAXQDA software.
Results
40 interviews were conducted (n = 22 patients, 10 relatives, and 8 health professionals). The mean age of patients was 21.8 years, while the mean duration of untreated ED was 91.4 months (median 70 months). Five categories emerged with intersections between them: patient (P), family and social environment (FSE), health professionals (HP), healthcare system (HCS), and social and cultural context (SCC). Relevant barriers appeared within these categories and their intersections, highlighting a lack of professional knowledge or expertise, cultural ignorance or misinformation regarding EDs, and patient's ego-syntonic behaviors. The main facilitators were patients’ and relatives’ psychoeducation, recognition of symptoms by family members, and parents taking the initiative to seek treatment.
Conclusions
This study provides information regarding access to treatment for patients living with EDs in Chile. A practical public health approach should consider the multi-causality of delay in treatment and promoting early interventions.
Factors associated with quality of intrapartum care in Kenya: a complex samples analysis of the 2022 Kenya demographic and health survey
Authors: Nuwabaine Lilian , Amwiine Earnest , Sserwanja Quraish , Kawuki Joseph , Amperiize Mathius , Namulema Angella , Asiimwe John Baptist 
Published: February 2024

Abstract
Background
Quality of intrapartum care remains a key intervention for increasing women’s utilization of skilled birth attendants in health facilities and improving maternal and newborn health. This study aimed to investigate the factors associated with the quality of intrapartum care using the 2022 Kenya Demographic and Health Survey (KDHS).
Methods
Secondary data from the 2022 KDHS of 11,863 participants, who were selected by multistage stratified sampling, was used. Quality of intrapartum care was considered if a mother had a facility-based delivery, received skilled assistance during birth, and the baby immediately placed on the mother’s breast by skilled birth attendant within 1 hour after birth. We conducted multivariable logistic regression to determine the factors associated with quality of intrapartum care using SPSS (version 20).
Results
Of the 11,863 women who had recently given birth, about 52.6% had received quality intrapartum care. As part of the intrapartum care, 88.2% gave birth in a health facility, 90.4% obtained assistance from skilled birth attendants, and 59.8% had their babies placed on the breast by delivery assistants within 1 hour after birth. Women who had attained secondary education (aOR = 1.46, 95% CI: 1.23–1.90), were working (aOR 1.24, 95% CI: 1.00-1.53), had > = 3 living children (aOR = 1.31 ,95% CI: 1.02–1.68), took 31–60 minutes to reach the health facility (aOR = 1.49, 95% CI: 1.41–1.95), were assisted during child birth by doctors (aOR = 19.86, 95% CI: 2.89-136.43) and nurses/midwives/clinical officers (aOR = 23.09, 95% CI: 3.36-158.89) had higher odds of receiving quality intrapartum care. On the other hand, women in the richest wealth index (aOR = 0.64, 95% CI: 0.42–0.98), those who gave birth through cesarean section (AOR = 0.27, 95% CI: 0.20–0.36) and those whose current age of their child was > = 2years (AOR = 0.76, 95% CI: 0.60–0.96) were less likely to receive quality intrapartum care.
Conclusions
About half of the women received quality clinical intrapartum care in Kenya, with demographic characteristics seeming to be the main drivers of quality intrapartum care. There is need to empower women through increasing access to education and developing initiatives for their economic independence, as well as facilitating their increased access to skilled birth attendants to improve the quality of intrapartum care.
Zinc-methionine but not organic selenium influence on antioxidant indices, acini gland size, royal jelly production and the relative expression of hsp90 and trx genes in honey bee during the hot season
Authors: Rasouli-Nadergoli Khalil , Sadeghi Ali Asghar , Shawrang Parvin , Chamani Mohammad 
Published: February 2024

Abstract
The aim of this study was to evaluate the effect of organic zinc and selenium on the antioxidant indices, acini size, royal jelly production and relative expression of hsp90 and trx genes in honey bees under heat stress. Thirty colonies were exposed to heat stress (40°C for at least 4 hours per day) and randomly divided into six treatments. Treatments were syrup with: C) the control group receiving the syrup without additives, T1: 2500 µg /L of zinc, T2: 5000 µg /L of zinc, T3: 500 µg /L selenium and T4: 1000 µg /L selenium. Organic zinc increased (P < 0.05), but selenium supplementation decreased (P < 0.05) the activities of thioredoxin peroxidase and catalase. Organic zinc and selenium supplements decreased (P < 0.05), the relative gene expression of hsp90, but increased (P < 0.05) gene expression of trx as compared to the control. The lowest acini size was observed in C and the greatest acini size was observed in T2 (P < 0.05). Acini size increased (P < 0.05) as dose of organic zinc increased, but not for selenium doses. It was concluded that supplementation of zinc at dose of 5000 µg /L and selenium at dose of 500 µg /L has beneficial effects on producing royal jelly colonies.
Atlantoaxial Facet Fixation Using Cervical Facet Cage: Technical Case Report and Review of the Literature
Authors: Anand Sharath Kumar , Shanahan Regan M. , Alattar Ali A. , Phillips H. Westley , Okonkwo David O. , McDowell Michael M. 
Published: February 2024

Abstract
In 1994, the use of interfacet spacer placement was for joint distraction, reduction, and fusion to supplement atlantoaxial or occipitocervical fixation. Here we present a unique case of bilateral atlantoaxial interfacet fixation using cervical facet cages (CFC) in a pediatric patient with basilar invagination. In addition, we review the literature on atlantoaxial facet fixation. We present a 12-year-old boy with Wiedemann-Steiner syndrome who presented with multiple episodes of sudden neck jerking, described as in response to a sensation of being shocked, and guarding against neck motion, found to have basilar invagination with cervicomedullary compression. He underwent an occiput to C3 fusion with C1-2 CFC fixation. We also conducted a literature review identifying all publications using the keywords: “C1” AND “C2” OR “atlantoaxial” AND “facet spacer” OR “DTRAX.” The patient demonstrated postoperative radiographic reduction of his basilar invagination from 6.4 mm to 4.1 mm of superior displacement above the McRae line. There was a 4.5 mm decrease in the atlantodental interval secondary to decreased dens retroflexion. His post-operative course was complicated by worsening of his existing dysphagia but was otherwise unremarkable. His neck symptoms completely resolved. We illustrate the safe use of CFC for atlantoaxial facet distraction, reduction, and instrumented fixation in a pediatric patient with basilar invagination. Review of the literature demonstrates numerous materials can be safely placed as a C1-C2 interfacet spacer including bone grafts, titanium spacers, and anterior cervical discectomy and fusion cages. We argue that CFC may be included in this arsenal even in pediatric patients.