bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of stress and its relevance on psychological well-being of the teaching profession: A scoping review
Authors: Bidi Shilpa Badrinath , Alapati Varalakshmi , Jenifer Dmello Venisha , Weesie Edwin , Gil Mathew Thomas , Shenoy Sandeep S , Kurian Simmy , Rajendran Ambigai 
Published: April 2023

Background: Well-being among teachers contributes toward quality work and better student support. Teachers’ well-being persists to be a concern in school settings; there is a lacuna in understanding the concept of well-being among them. This scoping review identifies the stress factors and map their association with the psychological well-being of teachers employed in schools. Additionally, to identify the methodology and the interventions used in reducing teachers' stress and their relevance on their psychological well-being. Methods: First, Pubmed, Web of Science, and Scopus databases were searched for eligible studies with MeSH terms for stress factors, well-being, and teachers from 2010 to 2022. Identified studies were screened thoroughly and excluded or included based on prior established criteria. Data from the included studies were extracted and summarized according to the study protocol. Results: Among the 60 studies that met our inclusion criteria, the majority were quantitative, with cross-sectional studies. Several studies focused on emotional exhaustion, depersonalization, and diminished personal accomplishment aspect among teachers. Almost half of the included studies focused on organizational and social pressures such as administration workload, classroom management issues, lack of supervisor and team support, students’ behaviour, and pressure from parents. The most used interventions to overcome stress were coping strategies and mindfulness training intervention tools. Conclusions: The findings from the current scoping review will reveal the different stressors which impact psychological well-being. Focus on the most used interventions to overcome stress among schoolteachers. This will also provide recommendations to regulators and management to identify the factors causing stress among teachers and their relevance to their psychological well-being, overcome employee turnover and absenteeism issues. Also, different alternatives available to reduce the stress may benefit the stakeholders and policymakers to confirm a suitable intervention that will benefit the teaching profession.
Perspectives and factors associated with informal human milk sharing: a mixed-methods systematic review protocol
Authors: Vickers Niamh , Matthews Anne , Paul Gillian 
Published: April 2023

Background: The practice of informal human milk sharing is a relatively new phenomenon and poses significant questions in the domain of infant feeding. Informal human milk sharing is a means of donating human milk from another lactating individual who is not the child’s biological parent, in a casual manner, that is, without the involvement of health professionals or agencies. The advent of digital technology has facilitated the donation and receipt of human milk through digital online platforms and thus has amplified this modern practice. This research aims to comprehensively examine and synthesize evidence about the motivations, barriers, facilitators and perspectives of individuals who both donate (donors) and the primary care givers of the infants who receive (recipients) human milk informally to provide to infants. Methods: A mixed-methods systematic review will be undertaken. This review will consider qualitative, quantitative and primary mixed-methods studies which report on the factors associated with informal milk sharing, and on donors and recipients’ perspectives of the practice. Primary mixed-method studies will be included if the individual qualitative and quantitative components can be extracted. Three databases will be searched for studies on informal human milk sharing published from inception of the database. Study quality will be evaluated using the standardized JBI critical appraisal tools, selected based on the methodology in each individual study. Data extraction will be conducted using the JBI mixed methods data extraction form followed by data transformation, synthesis and integration. This mixed-methods systematic review will follow a convergent integrated approach in accordance with JBI guidance. Discussion: Informal human milk sharing is a novel practice in the domain of infant feeding. This review will enable a thorough understanding of this practice from both the donors and recipients’ perspective and will have implications for healthcare professionals, policy and future clinical decision-making. Protocol registration number: PROSPERO CRD42023405653
Choice with Affirmative Action
Authors: Doğan Battal , Yildiz Kemal 
Published: April 2023

A choice rule with affirmative action decides on the recipients of a limited number of identical objects by reconciling two objectives: respecting a priority ordering over the applicants and supporting a minority group. We extend the standard formulation of a choice problem by incorporating a type function and a priority ordering and introduce monotonicity axioms on how a choice rule should respond to variations in these parameters. We show that monotonic and substitutable affirmative action rules are the ones that admit a bounded reserve representation. As a prominent class of choice rules that satisfy the monotonicity axioms, we characterize lexicographic affirmative action rules that are prevalent both in the literature and in practice. Our axiomatic approach provides a novel way to think about reserve systems and uncovers choice rules that go beyond lexicographic affirmative action rules. This paper was accepted by Yan Chen, behavioral economics and decision analysis. Funding: B. Doğan gratefully acknowledges financial support from the British Academy/Leverhulme Trust [Grant SRG1819\190133].
The design and psychometric evaluation of the Supportive-Care Needs Scale (ZOKH-SCNS29) in patients living with cancer
Authors: Khoshnood Zohreh , Bagherian Samaneh , Iranmanesh Sedigheh , Dehghan Mahlagha , Rafati Foozieh 
Published: April 2023

Background: Understanding the needs of cancer patients and planning to meet these needs is a major concern of the health system. Aim: The present study aimed to design and conduct a psychometric evaluation of supportive-care needs scale in patients with cancer. Methods: This study was conducted in both qualitative and quantitative stages. In the qualitative phase, the questionnaire items were generated by analysing the data from 16 interviews, after which, face, content and construct validity were tested. To construct the validity, the questionnaire was completed by 229 cancer patients. The reliability of the questionnaire was assessed by internal consistency. Data were analysed using SPSS (version 18). Findings: In this study, 4 factors were extracted from 29 items through exploratory factor analysis: ‘Need to be understood by the spouse and family’ (10 items), ‘Need to manage existential and psychological challenges’ (7 items), ‘Need to manage lack of knowledge about the disease’ (7 items), ‘Need organisational-therapeutic support ‘(5 items). These factors accounted for 50.1%. of the total variance. Internal consistency was 0.88, and also the Cronbach's alpha coefficient was also 0.89 after construct validity for the scale items’. The Cronbach's alpha was 0.91 after the construct validity. Conclusion: The findings of the present study showed that this supportive care needs scale is a valid and reliable scale for identifying the supportive care needs of patients with cancer.
Comparison of fast quality of transmission estimation methods for C + L + S optical systems
Authors: Souza André , Costa Nelson , Pedro João , Pires João 
Published: April 2023

Due to the high potential of multi-band transmission (MBT) systems as a short- to medium-term solution to the ever-increasing demand for fiber capacity, one of the recent areas of research concerns the development of fast but still accurate models to estimate the quality of transmission (QoT) in these systems, since this capability will be paramount for efficient and cost-effective network planning and operation. However, accurately evaluating the QoT of MBT systems with moderate computational complexity is challenging, mainly because stimulated Raman scattering (SRS) becomes a major transmission impairment. Although several models have been proposed in the literature, to the best of the authors’ knowledge, there is a lack of a comprehensive comparison of the advantages and main limitations of the available methodologies. Therefore, this work analyzes the computational time and accuracy of several QoT estimation methods suitable for MBT systems [closed-form interchannel SRS Gaussian noise (ISRS-GN) and four-wave mixing (FWM) models], focusing on transmission systems comprising a total transmission bandwidth of up to 20 THz, which includes not only the C- and L-bands but also a part of the complete S-band. We also propose a modification to the FWM model to take into account the SRS effect in the calculation of the nonlinear interference, referred to as the enhanced FWM (eFWM) model. We show that the closed-form ISRS-GN model has the best trade-off between computational complexity (speed) and accuracy for launch powers per channel up to 4 dBm in a system with 10 spans and with span lengths varying from 50 km to 100 km. However, this method shows generalized signal-to-noise ratio estimation errors as high as 1.5 dB for higher launch powers. Similar conclusions were drawn when using the models to optimize the launch powers in the reference Italian backbone network, i.e., using the closed-form ISRS-GN model leads to more accurate optimized launch powers. However, in this case, the impact on the network-wide average channel capacity of using the launch power optimized using the different approaches is negligible.
“If I don’t take my treatment, I will die and who will take care of my child?”: An investigation into an inclusive community-led approach to addressing the barriers to HIV treatment adherence by postpartum women living with HIV
Authors: Pepper Katy 
Published: April 2023

IntroductionInitiatives to support adherence to HIV treatment in South Africa are often centred on service delivery thereby avoiding key challenges to adherence: stigma and poverty. In contrast, this study aims to demonstrate the strength of an inclusive research and programme approach to improving the lives of people living with HIV and simultaneously ARV adherence.MethodsParticipatory Action Research combined with a visual participatory method (Photovoice) was used by postpartum women to share their experience of taking ARVs. The research was analysed from an interpretative and critical paradigm where both the women and a non-governmental organisation collaborated in the data collection, analysis and interpretation of the findings. Together, they then disseminated the findings and used a community-led approach to create a programme addressing these barriers effectively.FindingsTwo main barriers to ARV adherence emerged: the anticipated stigma associated with issues of disclosure and poverty epitomized by alcohol abuse, gender-based violence and hunger. The women and the NGO staff successfully presented their findings at conferences and collaborated to develop a programme of support for all women living with HIV in the area. The programme addresses each of the issues raised by the co-researchers and is run via a community-led process where the participants lead on design, implementation, and monitoring and ultimately will revise the programme as needed.DiscussionThe inclusive approach of this study enabled these postpartum women to portray the intersectional nature of both HIV stigma and poverty that affects their lives. By working with the local NGO to develop a programme based on these insights, they were able to tailor specific interventions to the issues women living with HIV face in their area. In doing so, they aim to improve the lives of people living with HIV by demonstrating a more sustainable way to impact ARV adherence.ConclusionCurrently, health service insistence on measuring ARV adherence does not address the core barriers to taking ARVs and misses the opportunity to focus on the long term health and well-being of people living with HIV. In contrast, locally targeted participatory research and programme development based on inclusivity, collaboration and ownership do address the fundamental challenges of people living with HIV. In doing so, it can have a greater impact on their long term well-being.
Effect of aluminum accumulation on bone and cardiovascular risk in the current era
Authors: Carbonara Cinthia E. M. , Roza Noemi A. V. , Quadros Kelcia R. S. , França Renata A. , Esteves André B. A. , Pavan Celia R. , Barreto Joaquim , dos Reis Luciane M. , Jorgetti Vanda , Sposito Andrei C. , Oliveira Rodrigo Bueno 
Published: April 2023

Background
The prevalence of aluminum (Al) intoxication has declined over the past 3 decades. However, different groups still report on the diagnosis of Al in bone. Prolonged and low-intensity exposures to Al may not be captured by serum Al measurements, preventing its proper diagnosis. We hypothesize that bone Al accumulation may be related to bone and cardiovascular events in the current Era.

Aims
To detect the diagnosis of bone Al accumulation; to explore bone and cardiovascular consequences of Al accumulation.

Methods
This is a sub-analysis of The Brazilian Registry of Bone Biopsy, a prospective, multicentre cohort, with a mean follow-up of 3.4 years, including patients with CKD undergoing bone biopsy; bone fracture and major cardiovascular events (MACE) were adjudicated; Al accumulation was identified by solochrome-azurine staining; history of previous Al accumulation was registered based on information provided by the nephrologist who performed the bone biopsy; bone histomorphometry parameters, clinical data, and general biochemistry were registered.

Results
275 individuals were considered; 96 (35%) patients have diagnosed with bone Al accumulation and were younger [50 (41–56) vs. 55 (43–61) years; p = 0.026], had lower body mass index [23.5 (21.6–25.5) vs. 24.3 (22.1–27.8) kg/m2; p = 0.017], higher dialysis vintage [108 (48–183) vs. 71 (28–132) months; p = 0.002], presented pruritus [23 (24%) vs. 20 (11%); p = 0.005], tendon rupture [7 (7%) vs. 3 (2%); p = 0.03) and bone pain [2 (0–3) vs. 0 (0–3) units; p = 0.02]. Logistic regression reveals that prior bone Al accumulation [OR: 4.517 (CI: 1.176–17.353); p = 0.03] and dialysis vintage [OR: 1.003 (CI: 1.000–1.007); p = 0.046] as independent determinants of bone Al accumulation; minor perturbations in dynamic bone parameters and no differences in bone fractures rate were noted; MACE was more prevalent in patients with bone Al accumulation [21 (34%) vs. 23 (18%) events; p = 0.016]. Cox regression shows the actual/prior diagnosis of bone Al accumulation and diabetes mellitus as independent predictors for MACE: [HR = 3.129 (CI: 1.439–6.804; p = 0.004) and HR = 2.785 (CI: 1.120–6.928; p = 0.028].

Conclusions
An elevated proportion of patients have bone Al accumulation, associated with a greater prevalence of bone pain, tendon rupture, and pruritus; bone Al accumulation was associated with minor perturbations in renal osteodystrophy; actual/prior diagnosis of bone Al accumulation and diabetes mellitus were independent predictors for MACE.
Hydroxycamptothecin regulates scar formation of the filtration channel under scleral flap by inhibiting the proliferation of scleral fibroblasts
Authors: Gu Hongwei , Liang Ya , Shen Yao , Shuai Jie , Yu Qiuli , Guan Huaijin , Yuan Zhilan 
Published: April 2023

Background
To investigate the inhibitory effect of a hyaluronic acid hydrogel loaded with hydroxycamptothecin (HCPT) on scar formation after filtration surgery in a rabbit model.

Methods
Scleral fibroblasts were isolated and extracted from rabbits’ eyes. After treatment with different concentrations of HCPT, cytotoxicity was detected using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and proliferation and extent of apoptosis were analysed using flow cytometry. Hydrogels loaded with different dosages of HCPT were prepared and placed under the scleral flap after the filtration surgery. One day, one week, and two weeks after surgery, follicular, conjunctival, corneal, and anterior chamber inflammation and iris and lens changes were observed.

Results
In vitro, compared with cells not treated with HCPT, cells treated with HCPT had decreased survival rate and proliferation, and the apoptosis level increased with increasing HCPT concentrations (p < 0.05). In vivo, the flattening time of filtering blebs in the three groups treated with different dosages of HCPT hydrogel was delayed. The degrees of oedema, inflammation, and bleeding were similar to those observed in the control group. The HCPT hydrogel effectively downregulated the expression of collagen 1 and 3 and tissue inhibitor of metalloproteinase 2 and upregulated the expression of matrix metalloproteinase 2 in a dose-dependent manner.

Conclusions
HCPT significantly inhibited the growth of rabbits’ scleral fibroblasts and effectively inhibited scar formation after filtering surgery by accelerating the degradation of extracellular matrix deposition.
The impact of tinnitus on adult cochlear implant recipients: A mixed-method approach
Authors: Assouly Kelly K. S. , Shabbir Maryam , van Dijk Bas , Hoare Derek J. , Akeroyd Michael A. , Stokroos Robert J. , Stegeman Inge , Smit Adriana L. 
Published: April 2023

Background
Tinnitus is a common problem in patients with a cochlear implant (CI). Between 4% and 25% of CI recipients experience a moderate to severe tinnitus handicap. However, apart from handicap scores, little is known about the real-life impact tinnitus has on those with CIs. We aimed to explore the impact of tinnitus on adult CI recipients, situations impacting tinnitus, tinnitus-related difficulties and their management strategies, using an exploratory sequential mixed-method approach.

Methods
A 2-week web-based forum was conducted using Cochlear Ltd.’s online platform, Cochlear Conversation. A thematic analysis was conducted on the data from the forum discussion to develop key themes and sub-themes. To quantify themes and sub-themes identified, a survey was developed in English with face validity using cognitive interviews, then translated into French, German and Dutch and disseminated on the Cochlear Conversation platform, in six countries (Australia, France, Germany, New Zealand, the Netherlands and United Kingdom). Participants were adult CI recipients experiencing tinnitus who received a Cochlear Ltd. CI after 18 years of age.

Results
Four key themes were identified using thematic analysis of the discussion forum: tinnitus experience, situations impacting tinnitus, difficulties associated with tinnitus and tinnitus management. Among the 414 participants of the survey, tinnitus burden on average was a moderate problem without their sound processor and not a problem with the sound processor on. Fatigue, stress, concentration, group conversation and hearing difficulties were the most frequently reported difficulties and was reported to intensify when not wearing the sound processor. For most CI recipients, tinnitus seemed to increase when performing a hearing test, during a CI programming session, or when tired, stressed, or sick. To manage their tinnitus, participants reported turning on their sound processor and avoiding noisy environments.

Conclusion
The qualitative analysis showed that tinnitus can affect everyday life of CI recipients in various ways and highlighted the heterogeneity in their tinnitus experiences. The survey findings extended this to show that tinnitus impact, related difficulties, and management strategies often depend on sound processor use. This exploratory sequential mixed-method study provided a better understanding of the potential benefits of sound processor use, and thus of intracochlear electrical stimulation, on the impact of tinnitus.
Toward a pan-SARS-CoV-2 vaccine targeting conserved epitopes on spike and non-spike proteins for potent, broad and durable immune responses
Authors: Wang Chang Yi , Peng Wen-Jiun , Kuo Be-Sheng , Ho Yu-Hsin , Wang Min-Sheng , Yang Ya-Ting , Chang Po-Yen , Shen Yea-Huei , Hwang Kao-Pin 
Published: April 2023

BackgroundThe SARS-CoV-2 non-Spike (S) structural protein targets on nucleocapsid (N), membrane (M) and envelope (E), critical in the host cell interferon response and memory T-cell immunity, are grossly overlooked in COVID vaccine development. The current Spike-only vaccines bear an intrinsic shortfall for promotion of a fuller T cell immunity. Vaccines designed to target conserved epitopes could elicit strong cellular immune responses that would synergize with B cell responses and lead to long-term vaccine success. We pursue a universal (pan-SARS-CoV-2) vaccine against Delta, Omicrons and ever-emergent new mutants.Methods and findingsWe explored booster immunogenicity of UB-612, a multitope-vaccine that contains S1-RBD-sFc protein and sequence-conserved promiscuous Th and CTL epitope peptides on the Sarbecovirus N, M and S2 proteins. To a subpopulation (N = 1,478) of infection-free participants (aged 18–85 years) involved in a two-dose Phase-2 trial, a UB-612 booster (third dose) was administered 6–8 months after the second dose. The immunogenicity was evaluated at 14 days post-booster with overall safety monitored until the end of study. The booster induced high viral-neutralizing antibodies against live Wuhan WT (VNT50, 1,711) and Delta (VNT50, 1,282); and against pseudovirus WT (pVNT50,11,167) vs. Omicron BA.1/BA.2/BA.5 variants (pVNT50, 2,314/1,890/854), respectively. The lower primary neutralizing antibodies in the elderly were uplifted upon boosting to approximately the same high level in young adults. UB-612 also induced potent, durable Th1-oriented (IFN-γ+-) responses (peak/pre-boost/post-boost SFU/106PBMCs, 374/261/444) along with robust presence of cytotoxic CD8+T cells (peak/pre-boost/post-boost CD107a+-Granzyme B+, 3.6%/1.8%/1.8%). This UB-612 booster vaccination is safe and well tolerated without SAEs.ConclusionsBy targeting conserved epitopes on viral S2, M and N proteins, UB-612 could provide potent, broad and long-lasting B-cell and T-cell memory immunity and offers the potential as a universal vaccine to fend off Omicrons and new VoCs without resorting to Omicron-specific immunogens.Trial registrationClinicalTrials.gov ID:NCT04773067; ClinicalTrials.gov ID:NCT05293665; ClinicalTrials.gov ID:NCT05541861.