bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of the WHO Eye care competency framework
Authors: Yu Mitasha , Keel Stuart , Mariotti Silvio , Mills Jody-Anne , Müller Andreas 
Published: March 2023

Abstract
Background
The eye care workforce, particularly in lower resource settings, face challenges of limited integration into the health system, limited workforce capacity, mismatch of workforce to population need and poor quality of care. In recognition of these challenges, coupled with a gap in existing tools, provides a strong rationale for the development of the Eye care competency framework (ECCF).
Methods
A mixed methods approach was utilised to develop and validate the ECCF. Content was developed by extracting relevant components of existing frameworks used both within and outside of eye care. A diverse technical working group provided feedback and guidance on the structure, design, and content to create a preliminary draft. Competencies and activities were validated using a modified-Delphi study, and the framework was then piloted at four sites to understand how the tool can be implemented in different settings.
Results
The final version of the ECCF included eight outcomes, nine guiding principles, and content of each of the key elements, including the six domains, 22 competencies, 21 activities, 193 behaviours and 234 tasks, and the knowledge and skills that underpin them. 95/112 participants from the six WHO regions completed the modified-Delphi study, yielding an average of 96% agreement across the competencies and activities in the ECCF. The pilot showcased the versatility and flexibility of the ECCF, where each of the four sites had a different experience in implementing the ECCF. All sites found that the ECCF enabled them to identify gaps within their current workforce documentation.
Conclusions
The ECCF was developed using a collaborative approach, reflecting the opinions of participants and stakeholders from all around the world. The comprehensive competencies and activities developed in the ECCF encompass the diverse roles of eye care workers, and thus encourage multi-disciplinary care and better integration into the health system. It is recommended that eye care workforce planners and developers use the ECCF to support workforce development and focus on the quality and scope of eye care service provision.
Impact of feed, light and access to manipulating material on tail biting in pigs with intact tails
Authors: Wallgren Per , Johansson Magnus , Wallgren Torun , Susic Zeljko , Sigfridson Kerstin , Johansson Sven-Erik 
Published: March 2023

Abstract
Background
Tail biting is a welfare issue that also has economic consequences due to infections and illthrift. This study aimed to reduce tail injuries in a high-performing non-tail-docking pig herd with increasing incidences of tail injuries.
Results
During eleven years preceding the trial, the annual incidence of tail injuries registered at slaughter had increased from 3% to 10%. It was positively correlated to a high weight gain and negatively correlated to day length. The overall incidence of tail injuries during the four years preceding the trial was 9.2% with significant differences between four identical buildings for fatteners (I<II<III<IV). During the adaption period of 6 months and trial period of 12 months, all pigs consumed a feed with increased levels of amino acids, trace elements and fibres, and the four buildings achieved different illumination strategies: I standard fluorescent tubes with an invisible flickering of 30-40% for 14 hours per day; II non-flickering led light for 14 hours per day; III standard fluorescent tubes for 2 hours per day (control); IV similar as III, but with free access to hay silage. During the adaption period, the incidence of tail injuries decreased significantly in all buildings and corresponded to 5.4%. The largest decrease (from 11.4 to 4.3%) was obtained in IV with free access to hay silage. During the trial, the mean incidence of tail injuries decreased to 3.0%. There were no differences in treatment incidences of individual pigs due to tail biting between buildings, but the use of enriched pellets due to anxiety in pens was lowest in II. The incidence of tail injuries in I was significantly higher than in II and III.
Conclusions
The incidence of tail biting in fast growing non-tail-docked pigs was successfully reduced by supplementing the feed with amino acids, trace elements, vitamins and fibres. Additional manipulative material accelerated that process and non-flickering illumination may have an impact in preventing tail biting. The results obtained argue for the un-necessity of tail-docking pigs, provided that the needs of the pigs in terms of feed ingredients, stocking density and access to manipulative materials are fulfilled.
Impact of the COVID-19 Pandemic Crisis on Turnover Intention Among Nurses in Emergency Departments in Thailand: A Cross Sectional Study
Authors: Sungbun Songwut , Naknoi Siripan , Somboon Panjasilpa 
Published: March 2023

Abstract
Background: During the COVID-19 pandemic in Thailand, a large volume of COVID-19 patients was referred to hospital emergency departments (EDs). This increased job demand and job strain among ED nurses, resulting in a high risk for intention to leave their organization. This study had two aims: 1) to investigate turnover intention during the COVID-19 pandemic among ED nurses; and 2) examine the effect of organization resources, maladaptive regulation, and job burnout on nurses’ turnover intention.
Method: This cross sectional study investigated 322 ED nurses. We divided participants into two groups: dark-red zone areas (pandemic crisis areas) and non-red zone areas (non-pandemic crisis areas). Descriptive statistics, Pearson’s correlation analysis, and multiple linear regression (stepwise method) were used to analyze factors that predicted turnover intention.
Results: Most participants were female and the mean age was 34.54 years. Overall, the mean score for the Turnover Intention Scale was 18.27±4.69 and 72.8% of ED nurses in dark-red zone areas desired to leave their organization. During the pandemic, motivation, exhaustion, and cognitive impairment positively influenced turnover intention among ED nurses in dark-red zone areas. Low availability of organization resources was associated with an increase in the turnover intention rate. Maladaptive regulation, exhaustion, and cognitive impairment positively influenced turnover intention among ED nurses in non-red zone areas.
Conclusion: Exhaustion and cognitive impairment are important dimensions of burnout that are associated with turnover intention among ED nurses. We suggest that promoting safe workplace environments and implementing interventions to reduce job demand and job strain for ED nurses may reduce turnover intention.
Salmonella Durban meningitis : case report and genomics study
Authors: Diasi Christelle Nanga , Ceyssens Pieter-Jan , Vodolazkaia Alexandra , Mukovnikova Marina , Dorval Sarah , Mattheus Wesley , Bauraind Olivia 
Published: March 2023

Abstract
Background

Bacterial meningitis caused by non-typhoid Salmonella can be a fatal condition which is more common in developing countries than in developed ones.

Case presentation

We report the case of a Salmonella meningitis in a Belgian six-month old male infant. The first clinical examination was reassuring but after a few hours his general state was deteriorating which led to a blood test and a lumbar puncture. The cerebrospinal fluid analysis was compatible with a bacterial meningitis which was later identified by the NRC (National Reference Center) as Salmonella enterica serovar Durban.

Conclusions

This serovar of Salmonella is extremely uncommon. An extended genomic analysis showed relatedness to historical cases with a connection to Guinea. In this paper, we describe the clinical presentation, the genomic typing and probable sources of infection.
Determinants of COVID-19 vaccine uptake among Nigerians: evidence from a cross- sectional national survey
Authors: OJO Temitope Olumuyiwa , OJO Ayodeji Oluwole , OJO Olajumoke Elizabeth , AKINWALERE Bosede Olufunmilayo , AKINWUMI Adebowale Femi 
Published: March 2023

Abstract
Objectives. This study assessed the factors influencing COVID-19 vaccine uptake among Nigerian households. Data from the COVID-19 High-Frequency Phone Survey of Households that was collected in late 2021-2022 by the National Bureau of Statistics was used for this study. Relevant data were analyzed using descriptive statistical tools and the multivariate binary logistic regression model.
Results: Out of 2370 respondents, only 32.8 percent of the respondents were vaccinated against COVID-19. Respondents living in urban areas (34.4%) had a higher level of COVID-19 vaccine uptake relative to those living in rural Nigeria (30.9%). Results from the Multivariate Regression model revealed that older adults, public servants, and those who obtained vaccine information from health workers, government, and the mass media were more likely to be vaccinated. The study also found respondents living in North Central, North East, South West and South South regions had higher odds of being vaccinated.
Conclusions: The study recommends increased media campaigns and advocacy for COVID-19 vaccination in the South East and North West regions. Younger persons should be targeted with COVID-19 information given that those aged 18-29 years were less likely to be vaccinated.
Composition and evolution of the gut microbiota of growing puppies is impacted by their birth weight
Authors: Garrigues Quentin , Apper Emmanuelle , Rodiles Ana , Rovere Nicoletta , Chastant Sylvie , Mila Hanna 
Published: March 2023

Abstract
Low birth weight puppies present an increased risk of neonatal mortality, morbidity, and some long-term health issues. Yet it has not been investigated if those alterations could be linked to the gut microbiota composition and evolution. 57 puppies were weighed at birth and rectal swabs were performed at 7 time points from birth to 56 days of age. Puppies were grouped into four birth weight quartiles, with individuals from the first quartile (Q1) presenting the lowest birth weight and the fourth quartile (Q4) the highest. 16S rRNA gene sequencing was used to highlight differences in the fecal microbiota. During the first three weeks, the relative abundance of facultative anaerobic bacteria such as E. coli, C. perfringens and Tyzzerella was higher in Q1 feces, but they catch back with the other groups afterwards. Q4 puppies showed higher abundances of Faecalibacterium and Bacteroides during the neonatal period, suggesting an earlier maturation of their microbiota. The results of this study suggest that birth weight impact the initial establishment of the gut microbiota in puppies. Mainly, a lower initial oxygen level in the gut of Q1 puppies may cause the proliferation of opportunistic bacteria. Innovative strategies would be desired to deal with altered gut microbiota in low birth weight puppies aming to improve their survival and long term health.
Race and Income Inequality: A Case of the U.S.A
Authors: Fawaz Fadi , Bradds Jackson , Taylor Rima 
Published: March 2023

Abstract
Racial inequality in the U.S. is typically described in terms of categorical discrimination. We use released data from the U.S. from 1973- 2019 to show income inequality by perceived skin color and racial self-identification and examine which measure better captures racial disparities. We document color and racial hierarchies across the Americas, revealing some unexpected patterns. Whereas blacks at times have higher mean incomes than other racial populations. Results complicate theoretical debates about U.S. racial exceptionalism and methodological debates about how best to measure income. Rather than supporting one measure over another, our analysis underscores race’s multidimensionality.
We employ a fixed effects regression model to uncover structural change in the Kuznets curves for the U.S. aggregate, Black, White, Asian, and Hispanic American segments of the population. Unlike to prior studies, we find that the Kuznets curves does not switch to a U-shape. We found conclusive evidence linking income inequality to race.
JEL Codes: C13, C30, E25, O51
Sustainability Performance of Rural Municipalities in Germany
Authors: Karami Mahdi , Madlener Reinhard 
Published: March 2023

Abstract
This study assesses the sustainability performance of rural municipalities, proposing a novel sustainability benchmarking system. For this purpose, the performance of selected rural municipalities in Germany along the dimensions energy & environment (E), quality of life (Q), local economy (L),and digitalization (D) is examined based on a predefined set of indicators. This benchmarking tool can assist local communities and provide them with insights on how to improve their sustainability performance. We find that the data available to explain the performance of rural communities in Germany is relatively scarce and unevenly spread. Most databases and sustainable development reportsare updated only every couple of years and often do not report the performance of rural municipalities but only larger (more urban) ones. Our study contributes to the sustainability literature by examining the most general sustainability policies, indicators, and rating systems at the rural level. Adding digitalization as a technological value makes our approach more comprehensive than many others, and accounts for the important new dimension of societal transition. The recommendations provided can be of interest for municipalities seeking to either learn from each other or have some systematic, repeatable self-assessment and thus sustainability guidance over time.
Genome-wide identification of the auxin transporter gene families in sweet potato (Ipomoea batatas) and their expression during tuberization
Authors: Mathura Sarah R. , Sutton Fedora , Bowrin Valerie 
Published: March 2023

Abstract
Auxin is a plant phytohormone that is essential for the initiation of tuberization in sweet potato (Ipomoea batatas (L.) Lam.). Auxin exerts these effects via polar auxin transport facilitated by various auxin influx and efflux carriers. It is unclear which members of the auxin transporter families: PIN, PILS, AUX/LAX, and ABCB, are involved in sweet potato tuber initiation and development. Therefore, a genome-wide analysis of the I. batatas auxin transporter genes was conducted, and their expression patterns during storage root initiation and development were analyzed. Five IbLAX, 16 IbPIN, 12 IbPILS, and 34 IbABCB family members were identified. These genes showed high conservation among families based on their intron-exon structure, motif composition, and phylogenetic analysis. Additionally, the promoter regions of these genes had various cis-acting regulatory elements involved in hormone, light, and developmental responses. The auxin transporter genes were expressed in various sweet potato tissues, and many were differentially expressed during storage root development. IbLAX1, IbPIN13, IbPILS7, IbABCB1, and IbABCB14 showed up-regulated expression during tuber initiation. This study characterizes these auxin transporter gene families for the first time. These results are an important reference for validation studies to determine the specific functions of these genes and their auxin transporting capability.
The saclayvirus Aci01-1 very long and complex fiber and its receptor at the Acinetobacter baumannii surface
Authors: Pourcel Christine , Ouldali Malika , Tavares Paulo , Essoh Christiane 
Published: March 2023

Abstract
The Acinetobacter baumannii bacteriophage Aci01-1 that belongs to the genus Saclayvirus of the Caudoviricetes order has an icosahedral head and a contractile rigid tail. We report that Aci01-1 has, attached to the tail conical tip, a remarkable 146 nm-long flexible fiber with seven beads and a terminal knot. Its putative gene coding for a 241.36 kDa tail fiber protein is homologous to genes in Aci01-1-related and unrelated phages. We also identified a putative receptor of the phage on the bacteria capsule that is hypothesized to interact with the Aci01-1 long fiber.
Construction of immune score and its prognostic value in invasive lobular carcinoma of the breast using computational pathology analysis
Authors: Wang Liye , Sun Peng , Xu Fei , Zheng Qiufan , Jiang Kuikui , Hong Ruoxi , Wang Shusen 
Published: March 2023

Abstract

Background
Previous studies have shown that high level of TILs in invasive lobular carcinoma (ILC) is associated with poor prognosis, contrary to that in TNBC and HER2-positive breast cancer. We aimed to systematically explore the expression of various tumor-infiltrating immune cell markers and immune checkpoints in ILC and their relationship with prognosis.
Methods
The expression of immune cell markers CD4, CD8, CD20, CD56, CD68, FOXP3 and immune checkpoints PD-1, PD-L1 and CTLA-4 in the microenvironment were detected by immunohistochemistry and their densities were quantified by computational pathology analysis. Then, the LASSO cox regression model was used to construct an immune score (IS) and further evaluate its prognostic value. We further explored the prognostic value of CD68 and FOXP3 with the transcriptome data of ILC patients in the METABRIC database.
Results
In our ILC cohort, the low density of CD4, CD8, CD20, CD56, CD68, FOXP3, PD-1 and PD-L1 had significantly longer disease-free survival (DFS) and overall survival (OS), however, the low density of CTLA-4 was associated with shorter DFS and OS. Based on this, each patient was given a binary score (0 for low, 1 for high) for each immune cell type (CD68 and FOXP3). Patients with low-IS had significantly prolonged DFS (HR 0.19, 95%CI 0.06-0.64, p < 0.0001) and OS (HR 0.14, 95%CI 0.03-0.56, p< 0.0001). Multivariate analysis revealed that IS was an independent prognostic indicator for DFS and OS. Further analysis showed that IS may increase the prognostic value of TNM stage. We further explored the prognostic role of CD68 and FOXP3 in the transcriptional level and the corresponding ISm in the METABRIC dataset, and found that low proportion of CD68 and FOXP3 and their ISm were associated with longer OS, and ISm was also an independent prognostic factor for OS. Furthermore, we revealed the possible mechanisms that the level of tumor-infiltrating immune cells in ILC influence prognosis.
Conclusions
We systemically evaluated the densities of six immune cells and three immune checkpoints and further constructed an IS model, which is a promising biomarker to distinguish the prognosis in ILC patients.
Does the Combination of Intrathecal Fentanyl and Morphine Improve Clinical Outcomes in Patients Undergoing Lumbar Fusions?
Authors: Villavicencio Alan , Taha Hash Brown , Burneikiene Sigita 
Published: March 2023

Abstract
Intrathecal morphine (ITM) has been widely effective in improving postoperative outcomes in patients undergoing a multitude of surgeries, including lumbar spine fusion. A major limitation of ITM administration is the increase in the incidence of respiratory depression in a dose-dependent manner. One way to bypass this is to use a more potent opioid with a shorter half-life, such as fentanyl. This is a retrospective analysis of patients who underwent one- or two-level transforaminal lumbar interbody fusions. The patients received one of two interventions: 0.2mg intrathecal duramorph/morphine (ITM group; n = 70), 0.2mg duramorph + 50 mcg fentanyl (ITM + fentanyl group; n = 68) and the control group (n = 102). Primary outcomes included postoperative pain (Visual Analog Scale) and opioid intake (MED – morphine equivalent dosage, mg) for postoperative days (POD) 1–4. Secondary outcomes included opioid-related side effects. One-way analyses of variance and follow-up post-hoc Tukey’s honest significant difference statistical tests were used to measure treatment effects. Significantly lower POD1 pain scores for both the ITM and ITM + fentanyl groups vs. control were detected, with no difference between the ITM vs. ITM + fentanyl groups. Similar results were found for POD1 MED intake. A multivariate regression analysis controlling for confounding variables did not attenuate the differences seen in POD1 pain scores while revealing that only the ITM + fentanyl predicted a decrease in POD1 MED intake. No differences were seen for postoperative opioid-related side effects. Our study provides support for supplementing a low dose of both intrathecal morphine and fentanyl to improve postoperative outcomes.
Novel SCN9A variant associated with congenital insensitivity to pain.
Authors: Yammine Tony , Aprahamian Raffi , Souaid Mirna , Salem Nabiha , Awwad Johnny , Farra Chantal 
Published: March 2023

Abstract
Background
Congenital insensitivity to pain (CIP) is a rare autosomal recessive syndrome characterized by lack of pain perception with a wide spectrum of clinical signs such as anosmia and hyposmia. SCN9A gene variants were found to be associated with CIP. We here report on a family with three CIP affected patients referred for genetic investigations.
Methods and Results
Whole exome sequencing analysis revealed the presence of a novel nonsense, homozygous SCN9A pathogenic variant: SCN9A (NM_001365536.1): c.4633G > T, p.(Glu1545*) in exon 26.
Conclusion
Our three Lebanese patients had CIP, urinary incontinence and normal olfactory function while two of them also presented with osteoporosis and osteoarthritis; this association of features has not been previously reported in the literature. We hope that this report would contribute to a better delineation of the spectrum caused by SCN9A pathogenic variants.
Potential effects of Electrotherapy on acquiring of malaria infection in Khartoum state
Authors: Mohamed¹ MusabAbduljalil , Elamin¹ Elamin Abdelkareem , Elbashier² Mohamed Mobarak , Mohamed Musab Abduljalil , Mohamed Hozifa Awadelkream Edriss 
Published: March 2023

Abstract
Objective: Electrotherapy is the electrical stimulation of tissues for therapeutic purposes the therapy uses specific wave length and frequency from the electromagnetic spectrum to produce desired physiological and chemical changes in the body. Insusceptibility to get malaria infection among patients treated with electrotherapy was locally observed, therefore the study was aimed to detect the potential effect of electrotherapy on acquiring of malaria infection in order to assess the management of the disease in Khartoum state.
Result: The study involved both sexes with 55males and 46 females, the percentage of males not being infected with malaria after electrotherapy sessions(84%) is more than females(67%) out of the total number, Interestingly one of the patients undergoing the electrotherapy sessions had diagnosed with severe malaria with mental disturbance, the symptoms of the severe malaria decreased from him and his condition improved after submitting to electrotherapy sessions. The exposing percentage of patients who did not acquire malaria after electrotherapy sessions was approximately 80% with P.value(0.203) compared to those infected with malaria after electrotherapy sessions. The study results suggests the potential hypothesis of existence of effect of electrotherapy on acquiring malaria infection, the study recommended to carry out further experimental in-vitro and in-vivo studies to prove and explain the mechanism of effect in order to assist in treatment and management of the disease.