bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing students’ approaches to learning in selected Malawian nursing schools: a cross- sectional study
Authors: Chitokoto Dalitso Zolowere , Mbirimtengerenji Noel Dzinnenani , Kululanga Lucy Ida 
Published: January 2024

Abstract

Background
- Students’ approaches to learning are of essence in nursing education. This is because nursing is a profession where classroom learning leads to clinical performance. Although the literature recognizes student’s approaches to learning as a significant aspect affecting the quality of students’ learning, studies suggest that quality of learning has not been highly achieved in Malawian nursing colleges. Currently, there is a scarcity of empirical data on the learning approaches that Malawian nursing and midwifery technician students in nursing colleges employ. This study assessed the different approaches to learning among nursing and midwifery technician students in selected Malawian nursing colleges.
Methods
– This was a cross- sectional study that employed quantitative methods. The target population was nursing and midwifery technician students from Nkhoma College of Nursing, Ekwendeni College of Health Sciences and Malawi College of Health Sciences. A total of 251 students were sampled randomly from the three nursing colleges. Data was collected through a self-administered questionnaire (R-SPQ-2F) by Biggs. The data was analyzed using chi-square and binary logistic regression. In this study Cronbach’s alpha was 0.6.
Results
- Most students had used a deep approach to learning (M = 3.201, SD = 0.623) than the surface approach (M = 2.757, SD = 0.732). Being in the age category of 16–20 had more likelihood of adopting a surface approach to learning compared to other age categories (X2 = 7.669, DF 2, P = .02). Students from Malawi College of Health Sciences were more likely to adopt a surface approach to learning compared to students from Nkhoma Nursing College and Ekwendeni College of Health Sciences (X2 = 12.388, df = 2, P = .002).
Conclusion
A deep approach to learning emerged as the most preferred approach to learning which indirectly implies that most students attain meaningful learning. Age and environment are some of the key determinants associated with different learning approaches. More attention should be given to younger students during teaching and learning to promote deep learning.
Clinical outcomes and optical performance of a new segmental refractive extended depth-of-focus intraocular lens
Authors: Amaro David Rua , Bertelmann Eckart , von Sonnleithner Christoph 
Published: January 2024

Abstract

Background
The visual performance and the optical quality of a segmental refractive extended depth-of-focus (EDoF) intraocular lens (IOL) were evaluated in a prospective, single-arm, single-center study.
Methods
A total of 20 patients (40 eyes) after bilateral implantation of the refractive segmental EDoF Acunex Vario AN6V were included. Assessment procedure: refraction outcome, monocular and binocular uncorrected (UCVA) and distance-corrected visual acuity (DCVA), defocus curve, contrast sensitivity (CS), higher-order aberrations (HOAs) and patient satisfaction were evaluated 1 and 3 months after surgery.
Results
At 3-month follow-up, mean spherical equivalent was − 0.23 ± 0.32 D. Binocular uncorrected distance visual acuity (VA) at distance, intermediate and near was − 0.08 ± 0.06 logMAR at 4 m, -0.03 ± 0.06 logMAR at 66 cm and 0.16 ± 0.06 logMAR at 40 cm, respectively. The binocular defocus curve showed a VA better than 0.20 logMAR over a range from + 1.50 to − 2.45 D. Contrast sensitivity aligned with monofocal lenses, highlighting the lens's clinical value. Aberrometry showed minimal changes in corneal aberrations. NEI-RQL-42-Questionnaire showed a high patient satisfaction for daily activities and revealed reduced dependence on glasses, particularly for near and intermediate vision. The Acunex Vario AN6V demonstrated minimal dysphotopsias, making it a promising option for those seeking spectacle independence.
Conclusion
This segmental refractive EDoF IOL provides a high degree of spectacle independence for far and intermediate distances with functional near VA. Although inducing residual coma aberrations, it showed subjectively good results with little dysphotopsias.
Trial registration
This study protocol was reviewed and approved by ethics committee of Charité University, Berlin, Germany, with approval number EA4/126/20.
The effect of sexual behavior on HIV-1 seroconversion is mediated by the gut microbiome and proinflammatory cytokines
Authors: Peddada Shyamal , Lin Huang , Chen Yue , Arbor Grace , Price Meaghan , Morris Alison , Sun Jing , Palella Frank , Chew Kara , Brown Todd , Rinaldo Charles 
Published: January 2024

Abstract

The association between HIV-1 seroconversion and gut dysbiosis is well documented, and its association with sexual activity is also widely recognized. However, it is not known whether the gut dysbiosis mediates the effects of high-risk sexual behavior on HIV-1 seroconversion. In this report we focused on men who engaged in high-risk sexual behavior where they had receptive anal intercourse with multiple men. We demonstrate that proinflammatory cytokines, sCD14 and sCD163, and gut microbiota mediate the effects of this high-risk sexual behavior on subsequent HIV seroconversion. We discovered changes in the gut microbial ecology, prior to seroconversion, both in terms of the composition as well as inter-relationships among the commensal species. Furthermore, these changes correlate with future HIV seroconversion. Specifically, as the number of sexual partners increased, we discovered in a “dose-response” manner, a decrease in the abundance of commensal and short-chain fatty acid-producing species, A. muciniphila, B. caccae, B. fragilis, B. uniformis, Bacteroides spp., Butyricimonas spp., and Odoribacter spp, and an increase in proinflammatory species Dehalobacterium spp. and Methanobrevibacter spp. These changes were also observed among subsequent HIV seroconverters. Interestingly, we also discovered a reduction in correlations among these commensal and short-chain fatty acid producing bacteria in a “dose-response” manner with the number of sexual partners. Our mediation analysis not only provides a conceptual model for the disease process but also provides clues for future clinical interventions that will manipulate the gut microbiota to treat high-risk subjects to prevent HIV seroconversion.
Ezrin Thr567 phosphorylation participates in mouse oocyte maturation, fertilization, and early embryonic development
Authors: Xie Huihui , Xia Tiandong , Zhang Bochao , Cui Jiankun , Pan Fuqiang , Qian Wei , Yi Qing , Han Mengdi , Jia Yuke , Liao Hongyan , Cao Meng , Li Yanqiuhong , Li Yunsheng , Fang Fugui , Zhang Yunhai , Ling Yinghui , Liu Ya 
Published: January 2024

Abstract
Background
Ezrin is a membrane-cytoskeleton linker, involved in cell polarization, cell migration, cell division, signal transduction and some other cellular activities that play an important role in oocyte maturation, fertilization and early embryonic development. The phosphorylation of Thr567 is an important way to activate ezrin, it has been proved that p-ezrin Thr567 is expressed in oocytes and pre-implantation embryos in mouse. However, little is known about the impact of inhibiting ezrin Thr567 phosphorylation on oocyte maturation, fertilization and early embryonic development.
Methods
NSC668394 is a small molecule that specifically inhibits the phosphorylation of ezrin Thr567. Here, we investigated the effects of inhibiting ezrin Thr567 phosphorylation with NSC668394 on the mouse oocyte maturation, fertilization, and early embryo development.
Conclusion
The results show that adding NSC668394 to the in vitro culture medium significantly lowed mouse embryos development competence after 8-cell stage (P < 0.05). Further experiments revealed that inhibiting ezrin Thr567 phosphorylation during in vitro maturation or in vitro fertilization not only decreased the maturation rate and fertilization rate of mouse oocytes, but also reduced early embryos development competence after 8-cell stage. Microinjection of mRNA encoding ezrin T567D mutant partially rescued the developmental defects of mouse oocytes, fertilization, and early embryonic development caused by NSC668394. These results indicate that ezrin Thr567 phosphorylation plays an important role in mouse oocyte maturation, fertilization and early embryo development.
Characteristics, Management and Outcomes of Primary Hyperparathyroidism from 2009 to 2021: a single centre report from South Africa.
Authors: Govind Kamal , Paruk Imran M. , Motala Ayesha A. 
Published: January 2024

Abstract

Background: There has been a notable shift towards the diagnosis of less severe and asymptomatic primary hyperparathyroidism (PHPT) in developed countries. However, there is a paucity of recent data from sub-Saharan Africa (SSA), and also, no reported data from SSA on the utility of intra-operative parathyroid hormone (IO-PTH) monitoring. In an earlier study from Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa (2003–2009), majority of patients (92.9%) had symptomatic disease. The aim of this study was to evaluate the clinical profile and management outcomes of patients presenting with PHPT at IALCH.Methods: A retrospective chart review of patients with PHPT attending the Endocrinology clinic at IALCH between July 2009 and December 2021. Clinical presentation, laboratory results, radiologic findings, surgical notes and histology were recorded.Results: Analysis included 110 patients (87% female) with PHPT. Median age at presentation was 57 (44; 67.5) years. Symptomatic disease was present in 62.7% (n:69); 20.9% (n:23) had a history of nephrolithiasis and 7.3% (n:8) presented with previous fragility fractures. Mean serum calcium was 2.87 ± 0.34 mmol/l; median serum-PTH was 23.3 (15.59;45.38) pmol/l, alkaline phosphatase 117.5 (89;145.5) U/l and 25-hydroxyvitamin-D 42.9 (33.26;62.92) nmol/l. Sestamibi scan (n:106 patients) identified an adenoma in 83.02%. Parathyroidectomy was performed on 84 patients with a cure rate of 95.2%. Reasons for conservative management (n:26) included: no current surgical indication (n:7), refusal (n:5) or deferral of surgery (n:5), loss to follow-up (n:5) and assessed as high anaesthetic risk (n:4). IO-PTH measurements performed on 28 patients indicated surgical success in 100%, based on Miami criteria. Histology confirmed adenoma in 88.1%, hyperplasia in 7.1% and carcinoma in 4.8%. Post-operative hypocalcaemia developed in 30 patients (35.7%), of whom, 14 developed hungry bone syndrome (HBS). In multivariate analysis, significant risk factors associated with HBS included male sex (OR 7.01; 95% CI 1.28, 38.39; p 0.025) and elevated pre-operative PTH (OR 1.01; 95% CI 1.00, 1.02; p 0.008)Conclusions: The proportion of asymptomatic PHPT has increased at this centre over the past decade but symptomatic disease remains the dominant presentation. Parathyroidectomy is curative in the majority of patients. IO-PTH monitoring is valuable in ensuring successful surgery.
High histone crotonylation modification in bovine fibroblasts promotes cell proliferation and the developmental efficiency of preimplantation nuclear transfer embryos
Authors: Zhao Xiaoyu , Du Mengxin , Wu Shanshan , Du Zhiwen , Liu Shuqin , Yang Lei , Ma Haoran , Zhang Liguo , Song Lishuang , Bai Chunling , Su Guanghua , Li Guangpeng 
Published: January 2024

Abstract

Lysin crotonylation (Kcr), a recently discovered histone acylation modification, is intricately related to gene expression, cell proliferation, maintenance of stem cell pluripotency, and regulation of various biological processes, symbolizing gene transcriptional activity. During cell culture, the introduction of exogenous croconic acid disodium salt (Nacr) has been shown to modulate intracellular Kcr levels. While research on Kcr has proliferated, its role in cell growth and proliferation and potential regulatory mechanisms remains elusive compared to histone methylation and acetylation. Our investigation indicated that addition of 5 mM Nacr to cultured bovine fibroblasts improved the expression of genes associated with Kcr modification, ultimately promoting cell growth and stimulating cell proliferation. Donor cells cultured in 5 mM Nacr resulted in 38.1% blastocyst development of somatic cell nuclear transfer embryos, which was significantly higher than the control group (25.2%). This study is of great significance to reveal the crotonylation modification mechanism in fibroblast proliferation, so as to enhance the efficiency of somatic cell transfer.
Design of a circular tapered dielectric rod antenna for sub-THz applications
Authors: Adjeroud Faiza Mayouf , Laib Salah Eddine , Grid Hadjer , Mayouf Abdelhalim , Ayad Mouloud , Devers Thierry , Aittou Rania , Souissi Zahra 
Published: January 2024

Abstract
This article describes the design of a circular tapered dielectric rod antenna in the sub-terahertz (sub-THz) frequency range. The antenna is designed on a Taconic TLT-8 substrate with dimensions of 0.563mm x 0.563mm x 4.948mm. The advantages of this antenna include compactness, low loss characteristics, and ultra-wide bandwidth. The design considerations for sub-THz dielectric antennas, specifically addressing substrate selection and dielectric properties, geometric design parameters, feeding techniques, and polarization considerations. These design considerations have a significant impact on the performance and radiation characteristics of the antenna. The results obtained clearly show that the designed antenna meets all the requirements over the entire frequency band.
Oral antivirals for COVID-19 among patients with cancer
Authors: Guermazi Dorra , Arvanitis Panos , Vieira Kendra , Warner Jeremy L. , Farmakiotis Dimitrios 
Published: January 2024

Abstract
Purpose:
Immunocompromised individuals, such as those diagnosed with cancer, are at a significantly higher risk for severe illness and mortality when infected with SARS-CoV-2 (COVID-19) than the general population. Two oral antiviral treatments are approved for COVID-19: Paxlovid® (nirmatrelvir/ritonavir) and Lagevrio® (molnupiravir). There is a paucity of data regarding the benefit from these antivirals among immunocompromised patients with cancer, and recent studies have questioned their efficacy among vaccinated patients, even those with risk factors for severe COVID-19.
Methods:
We evaluated the efficacy and safety of nirmatrelvir/ritonavir and molnupiravir in preventing severe illness and death using our database of 457 patients with cancer and COVID-19 from Brown University-affiliated hospitals. 67 patients received nirmatrelvir/ritonavir or molnupiravir and were compared to 56 concurrent controls who received no antiviral treatment despite being eligible to receive it.
Results:
Administration of nirmatrelvir/ritonavir or molnupiravir was associated with improved survival and lower 90-day all-cause and COVID-19-attributed mortality (p<0.05) and with lower peak O2 requirements (ordinal odds ratio [OR] 1.52, 95% confidence interval [CI] 0.92-2.56).
Conclusion:
Acknowledging the small size of our sample as a limitation, we concluded that early antiviral treatment might be beneficial to immunocompromised individuals, particularly those with cancer, when infected with SARS-CoV-2. Larger-scale, well-stratified studies are needed in this patient population.
Acute respiratory failure due to pulmonary exacerbation in children with cystic fibrosis admitted in a pediatric intensive care unit: outcomes and factors associated with mortality
Authors: Drummond David , Roy Charlotte , Cornet Matthieu , Bucher Julie , Boussaud Véronique , Pimpec-Barthes Françoise Le , Pontailler Margaux , Raisky Olivier , Lopez Vanessa , Barbanti Claudio , Guillemain Romain , Renolleau Sylvain , Grimaud Marion , Oualha Mehdi , Blanquat Laure de Saint , Gaudelus Isabelle Sermet 
Published: January 2024

Abstract

Background.
Children with advanced pulmonary disease due to cystic fibrosis (CF) are at risk of acute respiratory failure due to pulmonary exacerbations leading to their admission to pediatric intensive care units (PICU). The objectives of this study were to determine short and medium-term outcomes of children with CF admitted to PICU for acute respiratory failure due to pulmonary exacerbation and to identify prognosis factors.
Methods.
This retrospective monocentric study included patients less than 18 years old admitted to the PICU of a French university hospital between 2000 and 2020. Cox proportional hazard regression methods were used to determine prognosis factors of mortality or lung transplant.
Results.
Prior to PICU admission, the 29 patients included (median age 13.5 years) had a severe lung disease (median Forced Expiratory Volume in 1 second percentage predicted at 29%). Mortality rates were respectively 17%, 31%, 34%, 41% at discharge and at 3, 12 and 36 months post-discharge. Survival rates free of lung transplant were 34%, 32%, 24% and 17% respectively. Risk factors found associated with mortality or lung transplant using the univariate analysis were female sex and higher pCO2 and chloride levels at PICU admission, and regarding pre admission characteristics: home respiratory and nutritional support, registration on lung transplant list and Stenotrophomonas maltophilia bronchial colonization.
Conclusion.
Children with CF admitted to PICU for acute respiratory failure secondary to pulmonary exacerbations are at high risk of death, both in the short and medium terms. Lung transplant is their main chance of survival and should be considered early.
Stigma and its associations with self-confidence and sexual relations in 4 types of premature ejaculation
Authors: Liu Jishuang , Bao Tong , Wang Qunfeng , Jiang Hui , Zhang Xiansheng 
Published: January 2024

Abstract

Background
Although men with premature ejaculation (PE) always show more negative emotions, including embarrassment, guilt and worry, this may be related to the stigma of PE. To investigated stigma and its associations with self-confidence and sexual relations in 4 PE syndromes, a survey was conducted in our hospital from December 2018 to December 2019 enrolled 350 men with self-reported PE and 252 men without self-reported PE. The stigma, self-confidence and sexual relations were assessed by the Social Impact Scale (SIS) and Self-Esteem and Relationship questionnaire (SEAR), respectively. Ejaculation control, sexual life satisfaction and distress caused by PE were evaluated by the Index of PE.
Results
In the 2 groups, men with self-reported PE scored higher of internalized shame and social isolation and lower of SEAR. The highest score of internalized shame and social isolation and the lowest score of SEAR appeared in men with lifelong PE (LPE). After age adjustment, the positive relationships were stronger between distress about PE and internalized shame;Whereas, the stronger negative associations were found between social isolation and sexual satisfaction. Importantly, the negative correlation between internalized shame and self-confidence was strongest in LPE. Similarly, the strongest association was observed between social isolation and sexual relationship. Therefore, stigma of PE has certain negative effects on self-confidence, self-esteem and sexual relations of men with PE.
Conclusion
Men with PE, especially LPE, have a high level of stigma and disharmonious sexual relations, and often lack self-confidence and self-esteem, which have a certain negative impact on their physical and mental health and life. These will be the key issues to be considered when we formulate a personalized treatment plan for PE.
Co-infection of Fowl Cholera with bacterial and viral infection in poultry flocks
Authors: Ookanti Srikanth , Bandla Sai Suresh , Y Vimala , B Mathivanan 
Published: January 2024

Abstract
This study explores the co-infection dynamics of Pasteurella multocida (P.multocida) in poultry, focusing on Avian Leukosis Virus (ALV), Mycoplasma gallisepticum (MG), and Chicken Anemia Virus (CAV). Co-infections pose significant challenges to poultry health, leading to increased morbidity and mortality rates. The combined impact of co-infection exacerbates respiratory issues, weakens the immune system, and leads to intricate clinical manifestations. Samples from poultry flocks in Telangana and Haryana states of India, suspected for fowl cholera, were collected during 2019–2021. The study confirms co-infections using conventional PCR techniques targeting specific gene regions. Clinical symptoms exhibited by infected birds are described for each pathogen. The epidemiology of co-infections is discussed, and the importance of understanding these dynamics for effective control and prevention strategies is emphasized. Results reveal consistent co-infections over the study period, highlighting the need for further investigations into associations with parasites, bacteria, fungi, or viruses. The study underscores the importance of comprehensive biosecurity measures, vaccination programs, and early detection for managing poultry co-infections and ensuring sustainable production.
Beyond traditional metrics: A novel method for measuring mood instability in bipolar disorder
Authors: Sperry Sarah , Yocum Anastasia , McInnis Melvin 
Published: January 2024

Abstract

Background: Clinical care for bipolar disorder (BD) has a narrow focus on prevention and remission of episodes with pre/post treatment reductions in symptom severity as the ‘gold standard’ for outcomes in clinical trials and measurement-based care strategies. The study aim was to provide a novel method for measuring outcomes in BD that has clinical utility and can stratify individuals with BD based on mood instability.
Methods: Participants were 603 with a BD (n=385), other or non-affective disorder (n=71), or no psychiatric history (n=147) enrolled in an intensive longitudinal cohort for at least 10 years that collects patient reported outcomes measures (PROMs) assessing depression, (hypo)mania, anxiety, and functioning every two months. Mood instability was calculated as the within-person variance of PROMs and stratified into low, moderate, and high thresholds, respectively.
Outcomes: Individuals with BD had significantly higher mood instability index’s for depression, (hypo)mania, and anxiety compared to psychiatric comparisons (moderate effects, p’s<.001) and healthy controls (large effects, p’s<.001). A significantly greater proportion of individuals with BD fell into the moderate (depression: 52·8%; anxiety: 51·4%; (hypo)mania: 48·3%) and high instability thresholds (depression: 11·5%; anxiety: 9·1%; (hypo)mania: 10·8%) compared to psychiatric comparisons (moderate: 25·5 – 26·6%; high: 0% - 4·7%) and healthy controls (moderate: 2·9% - 17·1%; high: 0% - 1·4%). Being in the high or moderate instability threshold predicted worse health functioning (p’s < .00, small to large effects).
Interpretation: Mood instability, as measured in commonly used PROMs, characterized the course of illness over time, correlated with functional outcomes, and significantly differentiated those with BD from healthy controls and psychiatric comparisons. Results suggest a paradigm shift in monitoring outcomes in BD, by measuring mood instability as a primary outcome index.