bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational health and safety practices and associated factors among workers in Ethiopia’s Metehara and Wonji sugar industries: a convergent parallel mixed design
Authors: Debela Mitiku Bonsa , Deyessa Negussie , Begosew Achenef Motbainor , Azage Muluken 
Published: February 2023

IntroductionInformation regarding workers’ practices concerning safety measures in Ethiopia’s sugar industries is inadequate.ObjectivesTo assess occupational health and safety practices and associated factors among workers in Ethiopia’s Metehara and Wonji sugar industries.DesignA convergent parallel mixed design.SettingMetehara and Wonji sugar industries in Ethiopia (December 2021 through May 2022).ParticipantsWe used a stratified random sampling method to select 1648 participants for the collection of quantitative data. We employed a purposive sampling method to carry out 20 in-depth interviews in order to gather qualitative data.Primary outcome measuresWe computed the extent of occupational health and safety practices using a 21-item questionnaire. Finally, results were graded as ‘good’ if ≥60% of them were answered correctly and ‘poor’ if <60% were correctly answered. We created a qualitative data interpretation from the subject’s perspective.ResultsThe percentage of good occupational health and safety practices was 29.6% (95% CI: 27% to 32%). Inappropriate provision of personal protective equipment (adjusted OR (AOR)=1.42, 95% CI: 1.10 to 1.83), a lack of strict safety regulation (AOR=1.64, 95% CI: 1.27 to 2.12), a lack of incentives (AOR=1.31, 95% CI: 1.04 to 1.66) and inadequate management support (AOR=1.19, 95% CI: 1.04 to 1.66) were identified as associated factors. Health service usage defects, inappropriate protective equipment use and failure to follow occupational safety commands were identified as challenges.ConclusionsOccupational health and safety measures were not used effectively. The qualitative component of this study confirmed that most participants expressed undesirable practices in occupational health and safety measures. Inappropriate protective device provisions, a lack of strict safety regulation, the absence of incentives and inadequate management support were found to be linked with the use of occupational health and safety measures. The contributing factors we identified potentially indicate areas for future intervention.
Policymakers’ perceived barriers and facilitators in the use of research evidence in oral health policies and guidelines: a qualitative study protocol
Authors: Verdugo-Paiva Francisca , Bonfill Xavier , Ortuño Duniel , Glick Michael , Carrasco-Labra Alonso 
Published: February 2023

IntroductionEvidence-informed oral health policies are crucial to improving patient and population outcomes, but policymakers and organisational leaders infrequently systematically incorporate research evidence. Although there is indirect evidence regarding challenges in other healthcare sectors, the use of evidence-informed oral health policies remains unstudied in oral health. This study aims to assess policymakers’ perceived needs, barriers and facilitators in using research evidence to inform policies in oral health.Methods and analysisThis is a qualitative study situated within a phenomenological paradigm. We will conduct semistructured interviews with policymakers (5–10) affiliated with key organisations conducting guidance, policy statements, guidelines or any knowledge transfer deliverables in oral health. Organisations will be sampled purposively and with no geographical restrictions. All interviews will be recorded, and an audio transcript will be generated. Subsequently, a researcher will review and validate the transcripts. Data will be analysed using thematic analysis supported by ATLAS.ti software.Ethics and disseminationEthical approval was not sought because the study protocol met the criteria for exemption from such review according to the Clinical Research Ethics Committee of the Hospital de la Santa Creu i Sant Pau and the Spanish legislation (Law 14/2007 of 3 July, on biomedical research). Informed consent will be obtained from all subjects involved in this study. The findings of this study will be shared with participating organisations for feedback, disseminated in conferences and published in a peer-reviewed journal adopting open science practices.Study registrationOpen Science Framework (DOI:10.17605/OSF.IO/W4KG7).
Implementation of the national Getting it Right First Time orthopaedic programme in England: a qualitative case study analysis
Authors: Aspinal Fiona , Ledger Jean , Jasim Sarah , Mehta Raj , Raine Rosalind , Fulop Naomi J , Barratt Helen 
Published: February 2023

ObjectiveTo describe the implementation and impact of the Getting it Right First Time (GIRFT) national orthopaedic improvement programme at the level of individual National Health Service (NHS) Trusts.DesignQualitative case studies conducted at six NHS Trusts, as part of a mixed-methods evaluation of GIRFT.SettingNHS elective orthopaedic surgery in England.Participants59 NHS staff.InterventionImprovement bundle, including bespoke routine performance data and improvement recommendations for each organisation, delivered via ‘deep-dive’ visits to NHS Trusts by a senior orthopaedic clinician.ResultsAlthough all case study sites had made improvements to care, very few of these were reportedly a direct consequence of GIRFT. A range of factors, operating at three different levels, influenced their ability to implement GIRFT recommendations: at the level of the orthopaedic team (micro—eg, how individuals perceived the intervention); the wider Trust (meso—eg, competition for theatre/bed space) and the health economy more broadly (macro—eg, requirements to form local networks). Some sites used GIRFT evidence to support arguments for change which helped cement and formalise existing plans. However, where GIRFT measures were not a Trust priority because of more immediate demands—for example, financial and bed pressures—it was less likely to influence change.ConclusionDynamic relationships between the different contextual factors, within and between the three levels, can impact the effectiveness of a large-scale improvement intervention and may account for variations in implementation outcomes in different settings. When designing an intervention, those leading future improvement programmes should consider how it sits in relation to these three contextual levels and the interactions that may occur between them.
Global, regional and national prevalence of copper, selenium and zinc deficiencies in women of childbearing age: protocol for systematic review and meta-analysis
Authors: Costa Priscila Ribas , Carvalho Thais , Pitangueira Jacqueline Costa Dias , Santana Mônica Leila Portela , Kinra Sanjay , Potvin Louise 
Published: February 2023

IntroductionMicronutrient deficiencies are common in low-income and middle-income countries and are usually related to inadequate food intake, poor diet quality and low bioavailability. Copper, selenium and zinc are essential minerals in several enzymatic reactions and their deficiencies are associated with worse prognosis in pregnancy, compromising maternal health as well as her offspring. Thus, the objective of the present systematic review will be to describe the prevalence of copper, selenium and zinc deficiencies in women of childbearing age.Methods and analysisThe search will be performed by independent reviewers. The bases used will be PubMed/MEDLINE, Science direct, Lilacs, Adolec, Scopus, EMBASE, CINAHL, Web of Science, CENTRAL, IMSEAR, PAHOS, WPRIM, IMEMR, AIM for grey literature OpenGrey and OVID. National data will be searched in BDTD. A first search will be performed and a second search will be performed just before submission. Risk of bias assessment will be performed using the Joanna Briggs group prevalence study checklist. Combinable studies will be performed meta-analysis. Heterogeneity will be tested using Cochran’s Q test and quantified by the inconsistency test (I²). In the presence of high heterogeneity, meta-analysis will be performed using the random effects model with Stata metaprop. Summary prevalence will be generated for each outcome, presented in Forest plot figures.Ethics and disseminationThis systematic review will be solely based on published and retrievable literature, no ethics approval will be obtained. Our dissemination strategy will involve the presentation in scientific meetings, as well as the publication of article(s), posters and presentations in congresses.PROSPERO registration numberCRD42020165352.
Improving diagnostic antimicrobial stewardship in respiratory tract infections: a protocol for a scoping review investigating point-of-care testing programmes in community pharmacy
Authors: Saha Sajal K , Promite Shukla , Botheras Carly L , Manias Elizabeth , Mothobi Nomvuyo , Robinson Suzanne , Athan Eugene 
Published: February 2023

IntroductionDiagnostic uncertainty regarding the cause of respiratory tract infections (RTIs) multiplies the problem of unnecessary use of antibiotics and antimicrobial resistance in primary care. Point-of-care testing (POCT) programmes have been recognised as a potential stewardship strategy to optimise antimicrobial use in primary care. There is a need for greater understanding of community pharmacy-based POCT programmes in reducing the unnecessary use of antimicrobials in patients with RTIs. This review systematically maps out evidence around the effectiveness, feasibility and implementation challenges of POCT programmes in community pharmacy to improve safe antimicrobial use in RTIs.Methods and analysisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and the Arksey and O’Malley methodology framework will guide the reporting of this review. We will systematically review studies with either randomised controlled trial, non-randomised controlled trial, before–after study, observational study or pilot feasibility study design. Medline, Emcare, PubMed, Health Technology Assessment, Cochrane Central Register of Controlled Trials and Google Scholar databases will be used to search for articles. Three reviewers will independently screen, review and select studies with POCT programmes involving community pharmacists for antimicrobial stewardship in RTIs. Summary statistics and random effects model, if data permit, will be used to summarise the effectiveness, feasibility and cost-effectiveness of the POCT programme. The Consolidated Framework for Implementation Research will capture POCT implementation drivers.Ethics and disseminationThis review study does not require research ethics approval. Findings will be disseminated through national and international conferences, seminars and publication in a peer-reviewed journal.
Fibroblast growth factor 23 in children with or without heart failure: a prospective study
Authors: Elzayat Rania Salah , Bahbah Wael Abbas , Elzaiat Reham Salah , Elgazzar Basim Abdelfattah 
Published: February 2023

BackgroundElevated fibroblast growth factor 23 (FGF23) levels have been associated with mortality in adults with heart failure (HF), but data on FGF23 levels in paediatric HF are limited. In this prospective cohort study, we aimed to assess the prognostic value of FGF23 in children with chronic HF.MethodsWe prospectively enrolled 40 children with chronic HF and 20 matched healthy controls. In each patient, a complete diagnostic workup was performed, including transthoracic echocardiography to evaluate cardiac systolic and diastolic functions. Serum FGF23, renal function tests, parathyroid hormone, serum calcium and phosphate were measured in patients and controls. N-terminal probrain natriuretic peptide (NT-proBNP) was measured in patients. The severity of symptoms was assessed using the modified Ross HF classification for children. Patients were followed for 1 year, and clinical worsening events such as death and HF hospitalisation were recorded.ResultsPatients with HF had significantly higher FGF23 levels compared with controls (355.68±97.27 pg/mL and 60.20±11.04 pg/mL, respectively; p<0.001). Three patients died and 11 were admitted with HF. In comparison with patients without clinical worsening events, these 14 patients exhibited significantly higher FGF23 levels (320.04±89.56 pg/mL and 421.86±75.50 pg/mL, respectively; p<0.001). FGF23 was positively correlated with NT-proBNP and left ventricular end-diastolic diameter and negatively correlated with ejection fraction and fractional shortening. The ability of FGF23 to predict clinical worsening events in patients was analysed using a receiver operating characteristic curve. The optimal cut-off point was 375 pg/mL, with 85.71% sensitivity, 84.62% specificity, positive predictive value of 75.0, negative predictive value of 91.7 and area under the curve (AUC) of 0.878. Multivariable regression analysis revealed that FGF23 is the only independent predictor of clinical worsening events in children with chronic HF.ConclusionFGF23 levels were elevated in children with chronic HF and increased significantly as Ross score class increased. FGF23 levels increased in patients who experienced clinical worsening events.
Long COVID in the Belgian Defence forces: prevalence, risk factors and impact on quality of daily functioning
Authors: Mazibas Hava , Speybroeck N , Dhondt E , Lambrecht S , Goorts K 
Published: February 2023

IntroductionLong COVID (LC) is a medical condition first described and documented through anecdotes on social media by patients prior to being recognised by WHO as a disease. Although >50 prolonged symptoms of LC have been described, it remains a diagnostic challenge for military providers and therefore threatens operational readiness.MethodsOn 9 September 2021, an online survey was emailed to 2192 Belgian Defence personnel who had previously tested PCR positive for SARS-CoV-2 between 17 August 2020 and 31 May 2021. A total of 718 validated responses were received.Descriptive analyses determined the prevalence of LC and 10 most common symptoms and their duration following infection. In the explanatory analyses, risk factors related to LC were identified. To establish the health-related impact of LC on quality of life (HRQoL), we used the results from the EuroQol 5 Dimension 5 Level questionnaire.ResultsThe most frequent symptoms that were reported for >3 months were fatigue, lack of energy and breathing difficulties.47.35% of the respondents reported at least one persistent symptom, while 21.87% reported more than 3 symptoms lasting for at least 3 months after the initial COVID-19 infection. Most patients with LC suffered from symptoms of a neuropsychiatric nature (71.76%).LC was significantly associated with obesity; pre-existing respiratory disease and blood or immune disorders. Physical activity of >3 hours per week halved the risk of LC.The total QoL is reduced in patients with LC. Considering the five dimensions of the questionnaire, only the self-care dimension was not influenced by the presence of LC.ConclusionsAlmost half of Belgian Defence personnel developed LC after a confirmed COVID-19 infection, similar to numbers found in the Belgian population. Patients with LC would likely benefit from a multidisciplinary rehabilitation approach that addresses shortness of breath, fatigue and mood disturbance.
Adipokine profile in long-term juvenile dermatomyositis, and associations with adipose tissue distribution and cardiac function: a cross-sectional study
Authors: Marstein Henriette Schermacher , Witczak Birgit Nomeland , Godang Kristin , Olarescu Nicoleta Christina , Schwartz Thomas , Flatø Berit , Molberg Øyvind , Bollerslev Jens , Sjaastad Ivar , Sanner Helga 
Published: February 2023

ObjectivesIn long-term juvenile dermatomyositis (JDM), altered adipose tissue distribution and subclinical cardiac dysfunction have been described. Our aims were to compare adipokine levels in patients with JDM after long-term disease with controls, and explore associations between adipokines and (1) adipose tissue distribution and (2) cardiac function.MethodsThe study cohort included 59 patients with JDM (60% female, mean age 25.2 years, mean disease duration 16.9 years), and 59 age/sex-matched controls. Updated Pediatric Rheumatology International Trials Organization criteria for clinically inactive JDM were used to stratify patients into active (JDM-active) or inactive (JDM-inactive) disease groups. Lipodystrophy was clinically assessed in all patients. In all study participants, we measured adipose tissue distribution by dual-energy X-ray absorptiometry and cardiac function by echocardiography. Serum adipokines (adiponectin, apelin-12, lipocalin-2, leptin, visfatin and resistin) were analysed using ELISA.ResultsPatients with JDM had higher leptin levels compared with controls (p≤0.01). In JDM-active, apelin-12 and visfatin were higher compared with JDM-inactive (p≤0.05). In JDM-total and JDM-active, lower adiponectin correlated with lipodystrophy and total fat mass. Also, systolic dysfunction correlated with: lower adiponectin in JDM-total, JDM-inactive and JDM-active, and with lower apelin-12 in JDM-total and JDM-active and resistin in JDM-active (all p≤0.05). Lower adiponectin correlated with diastolic dysfunction in JDM-total and JDM-active.ConclusionAfter long-term disease, leptin levels were unfavourably regulated in patients with JDM compared with controls, and apelin-12 and visfatin in JDM-active versus JDM-inactive. We found associations between adipokines and both adipose tissue distribution and cardiac systolic function in all patients with JDM, which was most prominent in patients with active disease.
Understanding the Impact of Peer Instruction in CS Principles Teacher Professional Development
Authors: Hamlen Mansour Karla , Jackson Debbie K. , Bievenue Lisa , Voight Adam , Sridhar Nigamanth 
Published: February 2023

In a nationwide initiative to increase computer science Education in K-12, many teachers were recruited to CS teaching positions but without adequate preparation, which can lead to lack of confidence and feelings of isolation [
35
,
54
]. In response to these issues, the purpose of this study was to determine the effectiveness of a newly developed summer professional development program with follow-up support with the goal of improving teacher confidence and informing teacher beliefs about computer science. This training featured peer instruction and an emphasis on computer science principles. It took place over three years, and was used to prepare teachers from over 50 schools across a midwestern state. Using Hierarchical Linear Modeling, data analysis from 57 teachers and 871 students showed that teacher confidence and content knowledge increased significantly, and to a greater extent for those who began with the lowest levels of confidence. Students also made significant knowledge gains from before to after taking the class. Student gains were higher for those whose teachers were more confident in their ability to teach computer science.
Risk Factors for Mortality in Sepsis Patients without Lactate Levels Increasing Early
Authors: He Miao , Huang Jialin , Li Xingxing , Liang Shunda , Wang Qing , Zhang Hong 
Published: February 2023

Objectives. Our purpose was to investigate the influencing factors for mortality in sepsis patients without lactate levels increasing in the early stage. Methods. We conducted a retrospective observational study involving 830 adult sepsis patients admitted to ICU. We calculated time-weighted lactate (LacTW), a dynamic value that incorporates both the magnitude of change and the time interval of such change, to represent lactate levels in the first 24 hours. ROC curve was used to find the cutoff of LacTW for predicting mortality, and the influencing factors for lactate levels and mortality in the low lactate group were further studied. The primary outcome was hospital mortality. Results. Among 830 patients, LacTW > 1.975 mmo/L was found to be the cutoff threshold for predicting mortality (AUC = 0.646,

P

< 0.001). The following indexes related to organ dysfunction influenced LacTW: acute physiology and chronic health evaluation II (APACHE II) score (

P

< 0.001), activated partial thromboplastin time (APTT) (

P

= 0.002), total bilirubin (

P

= 0.012), creatinine (

P

= 0.037), with hypotension (

P

< 0.001), chronic kidney disease (

P

= 0.013), and required continuous renal replacement therapy (CRRT) (

P

< 0.001). Of the 394 patients in the low lactate group, age (

P

= 0.002), malignancy (

P

< 0.001), lactate dehydrogenase (

P

= 0.006), required treatment such as mechanical ventilation (

P

< 0.001), CRRT (

P

< 0.001), vasoactive drugs (

P

< 0.001), and glucocorticoid (

P

< 0.001), and failure to reach the target fluid resuscitation of 30 ml/kg within 6 hours (

P

= 0.003) were independently associated with hospital mortality. Conclusions. Due to the lower incidence of early organ dysfunction, lactate levels are not increased or delayed in some septic shock patients in the early stage, thus affecting the alertness of clinicians and the timeliness and adequacy of fluid resuscitation, and finally affects the prognosis.
First‐Pass Effect With Aspiration Thrombectomy With the Penumbra System in Patients With Acute Ischemic Stroke: A Core Laboratory–Adjudicated Subset Analysis of the COMPLETE Registry
Authors: Fifi Johanna T. , Matsoukas Stavros , Hassan Ameer E. , Zaidat Osama O. 
Published: February 2023

Background
In patients with acute ischemic stroke, minimizing the time to revascularization can minimize neuronal death. First‐pass effect (FPE), defined as successful or complete revascularization of an occluded target vessel with 1 pass of a mechanical thrombectomy device(s), reduces the time to revascularization. The objective of this study was to determine the FPE rate, compare cases in which FPE was versus was not achieved, and determine predictors of good functional outcome at 90 days, in patients with large‐vessel occlusion acute ischemic stroke treated with the Penumbra System (Penumbra, Inc).

Methods
This study is a subset analysis of the COMPLETE (International Acute Ischemic Stroke Registry With the Penumbra System Aspiration Including the 3D [3‐Dimensional] Revascularization Device) registry, a global, prospective, multicenter, observational registry. FPE rates were calculated. Subgroups who achieved versus did not achieve FPE were compared. Variables independently associated with good functional outcome at 90 days were determined.

Results

A total of 648 patients were included. FPE was achieved with a revascularization definition of modified thrombolysis in cerebral infarction score 2b to 3 in 56.8% of patients, with modified thrombolysis in cerebral infarction score 2c to 3 in 41.5%, and with modified thrombolysis in cerebral infarction score 3 in 31.8%. The percentage of patients who achieved good functional outcome at 90 days was higher for patients who achieved FPE than for patients who did not (
P
<0.01). Achieving FPE with modified thrombolysis in cerebral infarction score 2b to 3 was an independent predictor for good functional outcome at 90 days (adjusted odds ratio, 1.64;
P
=0.045).

Conclusions
For aspiration thrombectomy with the Penumbra System, achieving FPE was associated with a significantly higher rate of good functional outcome.