bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of dietitians in the multidisciplinary team and the feeding of dysphagic stroke patients-Hungarian study presentation 2022
Authors: Kovacs Andrea , Balint Marta , Beres-Molnar Katalin Anna , Folyovich András 
Published: July 2023

Abstract
In the European Union, it is estimated that the number of people living with stroke will increase by 27% between 2017 and 2047, due to an ageing population and improved survival rates. Variations between countries are expected to continue, showing the potential for improving prevention and case management in Hungary. In acute stroke patients, the most common complication of aspiration due to dysphagia is aspiration pneumonia, which is often fatal. Failure to recognise and screen for dysphagia, in addition to increasing hospitalisation and treatment costs, also increases mortality. Dysphagia is also associated with malnutrition and sarcopenia, which worsen the outcome of stroke patients and the effectiveness of their rehabilitation. The majority of patients are already malnourished on admission to hospital, so the dietitian has a key role to play in assessing their nutritional status and in drawing up a nutrition plan to ensure that they are screened for dysphagia in good time and that a dysphagia diet adapted to the results is prescribed and followed. The present study assesses the knowledge, attitudes and needs of dietitians working in Hungarian health care institutions, mainly with stroke patients, regarding dysphagia, its complications and diet. The dietitians involved in the study, who were caring for stroke patients, identified malnutrition and aspiration pneumonia as the most common complications of dysphagia, but did not have a consistent approach to the diet of stroke patients with dysphagia. In order for dietitians to be able to follow the dysphagia management process and to apply it in practice to their patients with dysphagia, they need a standardized educational material and methodology based on the latest professional recommendations, which builds on and reflects the results of the present research.
Lifestyle habits and obesity indices among male adolescents in Riyadh, Saudi Arabia.
Authors: Alhowikan Abdulrahman , Alsharqawy Nagwa , Alazmaa Nouf , Saeed Abdullah , Alhazzani Yasser , Alhowaish Nasser , Yahya Abdulaziz Bin , Alhozaimi Zeyad , Aleid Naif , Alhussain Maha H. 
Published: July 2023

Abstract
INTRODUCTION:
Obesity among adolescents is a global health apprehension which requires early prevention.
OBJECTIVE:
The aim of the study was to determine the association between lifestyle habits including physical activity, sedentary behaviors and sleep and eating pattern with obesity indices of body mass index (BMI) and waist-to-height ratio (WHtR) among male adolescents in Riyadh, Saudi Arabia.
STUDY DESIGN:
Questionnaire survey
PLACE AND DURATION OF THE STUDY:
College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period Jan 2017 to Oct 2017.
METHODOLOGY:
We randomly selected 471 secondary school male adolescents aged 14-18 years. A pre-validated self-reported questionnaire was used to record the data on eating pattern, sedentary behaviors, physical activity level and sleep duration. The International Obesity Task Force (IOTF) cutoff values for adolescents under 18 years of age were used to define overweight and obesity. Total energy expenditure was calculated using metabolic equivalent-minutes per week. Anthropometry including weight, height, BMI, waist circumference, waist/height ratio (WHtR), were assessed.
RESULTS:
Adolescents with overweigh and obesity and above 50% of WHtR were much less active in terms of METs-min/week from vigorous-intensity sports, sum of all METs-min/week from all vigorous-intensity physical activity, total METs-min/week from all physical activity compared with non-obese adolescents and below 50% of WHtR.
CONCLUSIONS:
The present study showed that more than half of the male adolescents were either overweight or obese. It also showed that physical activity was associated with obesity indices. Physical activity may represent a valid target for the prevention and management of obesity among Saudi adolescents.
How does HIV-related stigma correlate with HIV prevalence in African countries? Distinct perspectives from individuals living with and living without HIV
Authors: Fotso Arlette Simo , Wright Connor G , Low Andrea 
Published: July 2023

Abstract
Background:
Population-level research evaluating HIV-related stigma among countries with varied national HIV prevalence is scarce. To better understand HIV-related stigma and mitigate its potential negative effects, it is necessary to evaluate its relationship with HIV prevalence, as well as the mechanisms that influence it. This study aimed to analyze how HIV-related stigma correlates with subnational HIV prevalence in three African countries with varied HIV epidemics.
Methods:
This paper used data from the nationally representative Population-based HIV Impact Assessment (PHIA) surveys conducted from 2015-2017 in Malawi, Zambia, and Tanzania. Each country's sub-national geographic divisions were used to categorize them as low (0-5.4%), middle (5.5-11.2%), and high (11.3-17.1%) HIV prevalence regions in the main analysis. Questions from the survey stigma module were used to measure HIV-related stigma. Logistic regression and multilevel models were performed to assess the associations between the level of sub-national HIV prevalence and HIV-related stigma measures among persons living with, and without, HIV.
Results:
The results show that the odds of people living without HIV expressing stigmatizing behavior towards PLWH was significantly lower in regions of middle (OR = 0.80, 90%CI= (0.68-0.96)) and high (OR = 0.65, 90%CI= (0.53-0.80)) HIV prevalence when compared to low prevalence regions. The odds of reporting discriminatory attitudes were also lower for those in middle (OR = 0.87, 90%CI= (0.78-0.98)) and high (OR = 0.64, 90%CI= (0.56-0.73)) HIV prevalence regions compared to others. Living in middle and high HIV prevalence regions was associated with lower odds of expressing prejudice toward PLWH (OR=0.84, 90%CI= (0.71-0.99) and OR=0.60, 90%CI= (0.45-0.80), respectively) among people living without HIV. Notably, PLWH living in high prevalence regions had higher odds of reporting internalized stigma (OR=1.48, 90%CI= (1.02-2.14)) compared to those living in middle or low prevalence regions.
Conclusions:
The results indicate that among people not living with HIV, subnational HIV prevalence was negatively associated with discriminatory attitudes and prejudice towards PLWH, but HIV prevalence was positively associated with self-reported internalized stigma among PLWH. These results provide insight on how resources could be invested to reduce HIV related stigma among both PLWH and those not living with HIV.
Evaluation of the safety and efficacy of givosiran in treating patients with acute hepatic porphyria and improving their quality of life: Clinical findings from the Expanded Access Protocol in Japan
Authors: Ozaki Nobuaki , Goto Yoshie , Fujii Norihisa , Oyama Takuro , Frascello Karen , Fanelli Mary Jean , Adachi Tomohide 
Published: July 2023

Abstract
Background
The givosiran Expanded Access Trial is an open-label, multicenter, single-arm study designed to provide access to investigational givosiran for patients with acute hepatic porphyria (AHP) who have limited or no available treatment options and for whom the treating physician believes the benefits outweigh the risks. The effects of givosiran were evaluated in an exploratory manner.
Results
Givosiran was administered to 10 patients: three patients who continued from the Phase III clinical study (the ENVISION study) and seven newly included patients from this study. Low aminolevulinic acid and porphobilinogen levels were maintained. Two porphyria attacks were reported by the patients; however, both were mild and did not require hemin or hospitalization. In the Givosiran Patient Experience Questionnaire, eight of the 10 patients reported symptom improvement. Adverse events occurred in eight cases, five of which were suspected to be causally associated with givosiran. All adverse events were non-serious, and there were no deaths; however, one patient discontinued treatment due to alopecia.
Conclusion
This study demonstrates that AHP patients on once-monthly administration of givosiran experienced clinical benefits, and there was an acceptable safety profile.
Trial registration: jRCT2071200074. Registered Dec. 24, 2020, https://jrct.niph.go.jp/en-latest-detail/jRCT2071200074
Social and Ecological Drivers of Behavior that Prevents Aquatic Invasive Species Transport
Authors: Moore Alison , Ford Danika , Golebie Elizabeth , Joffe-Nelson North , Hitzroth Greg , Huegelmann Amanda , King Sarah , Stein Jeffrey , Riper Carena Joleen van 
Published: July 2023

Abstract

Aquatic invasive species (AIS) have caused widespread damage to environmental and socio-economic systems across the globe. One vector of biological invasions is recreational boaters who are at risk of unintentionally introducing AIS when moving between freshwater ecosystems. The drivers of boater behaviors and belief systems therefore warrant careful research attention, yet surprisingly few studies have empirically tested how the ecological context of biological invasions influences the behavioral decisions of recreational boaters. We asked: what are the relationships among boater proximity to AIS, perceptions of risk and efficacy, familiarity with AIS, and engagement in AIS prevention behavior? Drawing from a survey of boaters administered across the U.S. state of Illinois, we quantified and spatially located where boaters lived and evaluated their behavioral patterns. We then combined these survey data with spatially explicit observations of AIS across four taxa, which were collated using secondary data sources. We observed high levels of perceived risks from biological invasions, strong beliefs that individuals could make a difference in minimizing the spread of AIS, and low AIS-related familiarity. Results from a structural equation path model indicated that proximity to invasive fish species, but not other types of AIS, was associated with higher risk perceptions, which in turn, influenced self-efficacy and the intended behaviors of boaters. This study offers new insights on how decision-makers can optimize their effort and direct attention toward high and low priority locations defined in both social and ecological terms.
Epidemiology And Clinical Characteristics of Breast Cancer in Ethiopia: A Systematic Review
Authors: Dandena Firaol Guyassa , Teklewold Berhanetsehay Teklemariam , Dana Tadele Darebo , Suga Yisihak Debodina 
Published: July 2023

Abstract
Background
Breast cancer is the most common cancer among women worldwide and in Ethiopia. Even though there are scattered studies in Ethiopia, no study has attempted to establish systematic knowledge in the area. Hence, we reviewed studies that examined the epidemiology, clinical and histological characteristics, and management of breast cancer in Ethiopia.
Methods
We searched PubMed, Google Scholar, and Science Direct without other restrictions from November 1, 2021, until June 20, 2022. The search keywords included various aspects of breast cancer, including epidemiology, clinical presentation, histological and molecular subtypes, and management. We followed the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guideline to identify, search, extract articles, and report this systematic review. The protocol was registered in PROSPERO, ID: CRD42023403320.
Results
of the initial 883 studies identified, 20 studies included with 31,831 participants. from 20 included articles, 3 were community-based and 17 were hospital-based. In most reviewed studies, breast cancer is the most common cancer among women of Ethiopia. The most typical presenting symptom was a breast lump affecting the right breast. Most patients presented at a late stage and they are premenopausal age group. The commonest histology type is ductal carcinoma, that the most prevalent receptor was estrogen receptor positive, and the most common molecular subtype was Luminal A in pathology samples.
Conclusion
Breast cancer incidence is rising, and it accounts for the major cancer burden in the country. There is a need for additional awareness-raising and health education because delayed presentation are critical problems throughout Ethiopia. For planning and monitoring cancer patterns, comprehensive demographic and clinical data from a population or facility-based registry are needed in the regions.
Early safety and efficiency outcomes of a novel interdisciplinary laparoscopic resection rectopexy combined with sacrocolpopexy for women with obstructive defecation syndrome and pelvic organ prolapse: a single center study
Authors: Rudroff Claudia , Madukkakuzhy Joshy , Hernandez Alberto Vega , Otten Jakob , Ulrici Christoph , Karapanos Leonidas , Ludwig Sebastian 
Published: July 2023

Abstract

Background
Obstructive defecation syndrome (ODS) defines a disturbed defecation process frequently associated with pelvic organ prolapse (POP) in women. It substantially compromises quality of life and conservative treatment options are limited. In cases surgery is required the interventions are characterized by individual approaches. Laparoscopic resection rectopexy (L-RRP) combined with laparoscopic sacrocolpopexy (L-SCP) was established in an interdisciplinary setting.
Methods
Women with ODS combined with POP underwent surgery using an interdisciplinary laparoscopic approach. The primary endpoint was the postoperative morbidity and mortality measured by the Clavien-Dindo classification (CDC). Further endpoints were changes in bowel evacuation, POP, and urinary incontinence at a median follow-up period of > 12 months after surgery. Additionally, a biological mesh (BM) was offered premenopausal women and those, who asked for an alternative to synthetic mesh material (SM).
Results
Of a total of 44 patients, 36 patients were treated with L-RRP combined with L-SCP; 28 patients with SM and 8 patients with BM. CDC grades and the frequency of postoperative complications were low. Clinical outcomes for ODS, bowel dysfunction, and fecal control improved significantly. Anatomical outcome for POP was better with 28 (78%) patients having POP-Q stage 0 after surgery. 17 patients (47%) had urinary incontinence before surgery, which was restored in 14 patients (82%). No de-novo urinary incontinence appeared.
Conclusions
The interdisciplinary surgical approach with L-RRP and L-SCP is safe, feasible, and effective in treating women with ODS and POP. The use of a BM was established as an alternative to the SM and offers an additional and uterine-preserving option.
Trial registration
trial number NCT05910021, date of registration 10/06/2023.
An Empirical Study on the Relationship Between Organisational Support and Unethical Pro-organisational Behaviour of Medical Staff: The Mediation of Organisational Identification
Authors: Jiahuan Zheng , Xiaohan Jiang , Zhanjie Lu , Xin Yan , Dandan Chen , Zhi Zeng 
Published: July 2023

Abstract
Due to the particularity of the services provided by the medical industry, medical staff need to not only be proficient in their professional skills, but also pay attention to the cultivation of ethical qualities. However, at present, the performance-oriented management system of medical institutions, imbalanced allocation of medical resources, and other problems are likely to cause unethical pro-organisational behaviour (UPB) among medical staff. To explore the causes of UPB and the mechanisms behind the impact of perceived organisational support on UPB, this study conducted a survey with a sample of 322 medical staff from multiple tertiary public hospitals in China, using organisational identification as an intermediary variable. The results showed that all dimensions of perceived organisational support (job support, concerns about employee interests, and value identification) significantly positively predicted organisational identification and UPB (p < 0.05). Organisational identification significantly positively predicted UPB (p < 0.05), and partially mediated the relationship between all three dimensions of perceived organisational support and UPB. The results show that medical institutions in China could positively guide medical staff through professional training to effectively avoid their UPB. Digital technologies, such as internet platforms, can also be used to increase job support for medical staff from outside the organisation. The recognition of the contributions of medical staff could be strengthened to enhance their sense of social identity and social responsibility, which may help effectively reduce their UPB.
Interdecadal Change of the South China Sea Summer Monsoon Onset around 2010
Authors: Wu Cihuang , Qi Li 
Published: July 2023

Abstract

The onset of the South China Sea summer monsoon (SCSSM) implies the transition of East Asian monsoon circulation from winter to summer, which affects not only the local weather and climate near the South China Sea (SCS) but also other regions through remote teleconnection. In this paper, the interdecadal variability characteristics of the SCSSM onset is analyzed by using various datasets as well as its possible causes. The results show that there is a significant interdecadal change in the onset date of the SCSSM around 2010. The onset is early around May 12 during 1994-2009, conversely, the onset is significantly late during 1980-1993 and 2010-2020 with an average of May 29. Besides, the SCS May climate also took significantly decadal shift around 2010 and manifested itself in atmospheric forcing on the ocean, thus the SCSSM onset is mainly influenced remotely by tropical Pacific SST anomaly. However, the close relationship between the SCS precipitation and tropical eastern Pacific SST drops dramatically after 1998, while its correlation with the tropical central Pacific SST rises up to -0.8 after 2010, playing a leading role. The related anomalous anticyclone over the SCS not only prevents the western Pacific subtropical high withdrawing eastward, but also weakens the activity of low-frequency oscillation and, both unfavorable for the convection formation and SCSSM onset. Therefore, besides the tropical eastern Pacific SST, more and special attentions should be paid on the tropical central Pacific SST condition, it will help us to monitor and predict the SCSSM onset effectively and improve the seasonal prediction of East Asia summer monsoon greatly.
A systematic approach to obtain the analytical solution for coupled linear second order ordinary differential equations - Part II
Authors: Fogaça Matheus Janczkowski , Cardoso Eduardo Lenz 
Published: July 2023

Abstract
Coupled systems of second order ODEs are found in many areas, such as vibrations and electric circuits. Thus, accurate and efficient solutions are of great interest. This manuscript extends the concept of generalized integrating factor, recently introduced by the authors for one dimensional problems, to coupled n-dimensional systems of second order ODEs. The general formulation for time-varying coefficients is found and particularized to the constant coefficients. Closed-form integrating factors are obtained for the constant coefficient case under mild assumptions about the damping coefficient matrix. Analytical solutions for different types of continuous and discontinuous excitations are presented for problems with constant coefficients and proportional damping, disregarding the damping level. Examples are provided for each type of excitation studied in this manuscript. Results obtained with the proposed approach are compared to traditional numerical methods. Results show that the proposed procedure is accurate, not suffering with interpolation errors found in traditional numerical methods.
Impact of the “Action Leadership for Adolescents Approach” in Traditional Classroom Settings
Authors: Hamdorf Leslie 
Published: July 2023

Abstract
Action Leadership for Adolescents (ALA) is a cutting-edge inclusive approach to adolescent leadership development. The Self-Reflection Evaluation Inventory evaluated the growth of 21st-century skills taught through the five principles of ALA. The five principles: Brain Balance, Skill Development, Interdisciplinary Collaboration, Innate Wisdom, and Cultural Responsibility; guided the curriculum of a course for seniors in a traditional high school and validated the hypothesis that the curriculum rooted in these principles ensured growth and empowerment for adolescents. ALA was born from a combination of Positive Youth Development and Transformational Leadership models and the efficacy of the approach was confirmed through the mixed-methods action research study presented in this article. Overall, the participants of the study demonstrated significant growth in the maturation of their 21st-century skills. The next steps for ALA include partnering with social researchers to continue analyzing the efficacy of ALA in all activities for adolescents.
Effect of gastric mucosal status on the invasion of undifferentiated early gastric cancer and the role of the glucocholesterol glycoside-a multicenter study
Authors: Jiang Zhang-Xiu , Deng wei , Ning Jia-Juan , Qin yue-qiu , Qi Jing-Jing , Yan yu-dong , Li hong , Liang Yun-Xiao 
Published: July 2023

Abstract
Background
Undifferentiated early gastric cancer in different patients can show a completely different type of biological behavior. The purpose of this study was to clarify the effect of Helicobacter pylori infection in the gastric mucosa on the biological behavior of undifferentiated early gastric cancer and to provide ideas for the selection of treatment and the control of its occurrence and development.
Methods
According to the inclusion and exclusion criteria, patients suspected of undifferentiated early gastric cancer who underwent gastroscopy in several hospitals in Guangxi from 2018 to 2020 were included in succession.
Results
A total of 61 cases of undifferentiated early gastric cancer, 41 cases from the H. pylori related gastric cancer group (including 16 cases of H. pylori infection and 25 cases of previous infection), 20 cases from the H. pylori negative group (control group). The neutrophil lymphocyte ratio, lymph node metastasis rate, and the glucocholesterol glycoside from the H. pylori related gastric cancer group were higher than those from the control group.
Conclusion
H. pylori can inhibit T cell immunity through the glucocholesterol glycoside and promote the development and metastasis of undifferentiated early gastric cancer.