bluuebunny/crossref_metadata_2025_split huggingface dataset:
“I felt not prepared to provide care to patients on my own” Challenges experienced by newly qualified nurse-midwives transitioning to practise in selected midwifery settings in northern Malawi
Authors: Mtegha Mathews Brave , Chodzaza Elizabeth , Chirwa Ellen , Kalembo Fatch Welcome , Zgambo Maggie 
Published: March 2022

Abstract
Background: Literature shows that newly qualified nurse-midwives face challenges integrating into the workforce during their transition period from training to practice. However, little is known about the needs and challenges of Malawian nurse-midwives during their transition from training to practice. The aim of the study was to explore the transition experiences of newly qualified nurse-midwives working in selected midwifery units in Northern Malawi.Methodology: A qualitative descriptive approach was used. Data were collected through in-depth interviews using a semi-structured interview guide from a purposive sample of 19 participants (13 newly qualified nurse-midwives and 6 key informants). Participants were from three selected hospitals from the Northern part of Malawi that have maternity units. Data were analysed manually using thematic analysis. Findings: Five themes related to challenges faced by newly qualified nurse-midwives during their transition to practice in midwifery units emerged from the thematic analysis of the data. These included (1) Theory - practice gap, (2) Lack of confidence and skills, (3) Inadequate resources, (4) Transition support system, and (5) Workplace conflict. Conclusion: Newly qualified nurse-midwives in Malawi encounter many challenges while transitioning from training to practice. The study findings underscore the need to develop a national framework support system that could not only help newly qualified midwives adjust positively to their new role but also create more opportunities for learning and developing and strengthening a collaborative partnership between colleges and hospitals.
5-methylcytosine profile of mRNA in breast cancer brain metastasis
Authors: Cai Peiying , Jiang Bo , Zhang Anqi , Wang Yiting , Meng Min , Li Peng , Fu Bo 
Published: March 2022

Abstract
Background: 5-methylcytosine (m5C) modification is involved in various physiological process of diseases. Great amount of research has been conducted to reveal the m5C profile, while the m5C profile of mRNA in breast cancer brain metastasis is unknown. Materials & methods: We performed methylated RNA immunoprecipitation sequencing (MeRIP-seq) to identify the m5C profile of mRNA in breast cancer brain metastasis cells (231-BR cells). Results: mRNA m5C profiles showed difference in peak numbers, length and modification level between 231-BR cells and its parental nonspecific metastatic MDA-MB-231 cells. Compared with the control cells, we gained 1048 higher and 1866 lower methylation peaks in 231-BR cells. The most significant differentially methylated genes in m5C level included NSCN7, YBX3, SHANK1, MMP9, and LCN2. In addition, through GO and KEGG analysis, differently m5C methylated genes were chiefly engaged in the pathways of cancer cell focal adhesion, basal carcinoma, and endocytosis. Finally, the conjoint analysis of mRNA expression and RNA m5C modification was performed and that there are 346 ﻿genes showed coefficient changes. Conclusion: This study may comply a novel vision as a basis for subsequent mechanism research of breast cancer brain metastasis.
Robust locating research of welding fixtures for the aluminum alloy sidewall of a high-speed train body
Authors: Yu Kuigang , Wang Xianjin , Peng Weili 
Published: March 2022

Abstract
The sidewall of a high-speed train body is welded by multiple hollow extruded aluminum alloy sheets. Due to the material characteristics of aluminum alloy, excessive welding deformation is easy to occur in the welding process of the sidewall. The welding quality of the sidewall is mainly guaranteed by fixtures, and the reasonable arrangement of sidewall fixtures can reduce the welding deformation. In this paper, a robust design of sidewall fixtures is carried out based on the Taguchi method and the double response surface method. Firstly, simplified shell element models of the sidewall are established and verified, and a welding deformation evaluation index of the sidewall is put forward. Secondly, based on the inside and outside table experimental design, the Taguchi method is used to design the robust parameters of sidewall fixtures, and robust locating parameters of sidewall fixtures are determined according to the SNR. Thirdly, the mean and standard deviation models of welding deformation are established based on the double response surface method, and the robust design of sidewall fixtures are carried out with the minimization of the square sum of the mean close to the target and the standard deviation. Finally, by comparing the original scheme, the fixture design scheme based on the Taguchi method and the fixture design scheme based on the double response surface method, it shows that the robust scheme of sidewall fixtures based on the double response surface method is best.
Herders’ Perspectives on pastoral systems in the face of changing climate in Karakoram Mountains of Northern Pakistan
Authors: Ali Irfan , Raza Ghulam , Hussain Azhar , Khan Muhammad Zafar , Akram Wasim , Begum Farida 
Published: March 2022

Abstract
Pastoralists in Karakorum Mountains are experiencing rapid climatic change, causing new challenges for the pastoral systems with negative impacts on livestock herding due to shrinking pastures, declining forage productivity, and varying weather patterns. We investigated perceptions of local pastoralists about climate change and its impact on pastoralism, by interviewing 135 households in the study area. We also assessed climatic changes using meteorological data acquired during 1984–2013. The results revealed that pastoralists in the study area perceive climate change and its negative impacts on herding patterns and pastoral livelihoods. The perceived impacts on the local climate were increasing temperature and unpredictable rainfalls with extreme events. The climatic data also showed increasing trends of temperature (mean annual increase of 0.042°C) and precipitation (mean annual increase of 1.42 mm) over 1984–2013. Local people adapt to climate stresses through their traditional and local experiences. The majority of the respondents used some traditional adaptation measures such as raising the different types of livestock, rotational use of pastures, changing traditional grazing patterns, changing herd composition, building new channels to pasture lands, changing feeding strategies to cope with climate change and its consequences. These responses are not enough to cope with such large variability in climate and its adverse impacts. A better adaptation mechanism can be promoted by integrating the traditional practices with science-based improved adaptation measures.
Cellulose-Based Hybrid Composites Enabled by Metal Organic Frameworks for CO2 Capture: The Effect of Cellulosic Substrate
Authors: Jabbar Saysam Qusai , Janani Halimeh , Janani Hamed 
Published: March 2022

Abstract
A comparative study of two cellulosic materials i.e., cotton fabrics and nanobacterial cellulose (NBC), is reported as substrates for metal organic frameworks (MOF-199), to prepare micro and nanocompistes of cellulose@MOF-199 for CO 2 capture. The CO 2 uptake performance was investigated using gravimetric adsorption and desorption kinetics. NBC was an efficient substrate with full coverage and uniform distribution of MOF crystals observed in NBC@MOF-199 nanocomposite. The surface area for NBC@MOF-199 and Cotton@MOF-199 were 553.4 m 2 .g -1 and 168.9 m 2 .g -1 , respectively. NBC@MOF-199 showed a high adsorption capacity (2.9 mmol g 1 ) at ambient temperature and pressure, followed by Cotton@MOF-199 (1.2 mmol g -1 ). The kinetic studies revealed that the adsorption process is controlled by film diffusion at lower temperatures, and by sorption to active sites at higher temperatures. The estimated thermodynamic parameters represent a spontaneous adsorption with low activation energies of adsorption/desorption, promising a fast adsorption and facilitated regeneration adsorbent system with minimum energy costs.
A New Analytical Method for Determination Bisphenol A in Canned meat
Authors: Sarkis Nazira , shaghel Joud Al 
Published: March 2022

Abstract
In recent years, attention has grown to bisphenol A (BPA), as it is an important compound in the manufacture of food packaging materials and many other plastic materials. Therefore, the focus has been recently on studying the characteristics and migration of cans to food, as well as the harmful effect on health. In this research, a reverse phase high liquid chromatography coupled with UV-detector (HPLC-UV) was developed for determining of BPA in canned meat. For quantitative determination of BPA, the following experimental conditions were established: mobile phase (acetonitrile: water, 55:45 v/v), a flow rate of 1mL/min, column temperature of 25oC, injection volume 20µL and UV-detection at 227 nm. To validate the analytical method, it was based on the following parameters: Linearity, precision, recovery, and limit detection. A good linear correlation with R2 = 0.9989 was observed over the range of 1 to 500 mg/Kg. The limit of quantitation (LOQ) was measured to be 0.982 mg/Kg, while the limit of detection (LOD) was measured to be 0.294 mg/Kg. The extraction recoveries for BPA were 90.006% in canned tuna, 98.299% in canned luncheon. The precision of the method, based on relative standard deviations (RSD %), ranged from 1.77–3.44%. The proposed method was found to be suitable and praised for the determination of BPA 1.56 to 1.96 mg/Kg, 0.34 to 0.90 mg/Kg in canned tuna, and canned luncheon meat, respectively.
Iodine Nutrition and Related Factors of Mothers with Children under 2 Years Old from Three Different Areas in China: A Cross-sectional Survey
Authors: Shan Xiaoyun , Zou Yan , Huang Lichun , Jiang Shan , Zhou Weiwen , Qin Qiulan , Liu Changqing , Luo Xiaoyan , Lu Jiaxi , Mao Deqian , Li Min , Yang Zhenyu , Yang Lichen 
Published: March 2022

Abstract
To analyze the iodine nutritional status and related factors of mothers with children under 2 years old, we collected data from the 2016–2017 National Nutrition and Health Surveillance of Children and Lactating Women. A total of 1311 mothers from Hebei, Zhejiang, and Guangxi province were included in the study. Urinary iodine concentration (UIC), thyroid-stimulating hormone (TSH), body mass index (BMI), vitamin A (VA), and vitamin D (VD) were measured. The distributions of UIC and TSH were assessed. Relationships between UIC, TSH and the possible factors were analyzed. The median UIC (MUIC) (P25-P75) of total mothers and mothers in lactation was 142.00 µg/L (99.10-209.40 µg/L) and 139.95 µg/L (96.22-208.03) µg/L, respectively. No differences in UI were found between breastfeeding mothers and non-breastfeeding mothers. The prevalence of mothers with UICs < 50µg/L was 5.03%, and 91.30% of mothers showed TSH normality. UICs and UIC distributions were significantly different among the three provinces, and between rural and urban areas. Obese mothers tended to have higher MUIC and higher prevalence of excessive TSH. Linear correlations between lnUIC and VA/VD were observed with or without adjusting for confounding factors. Higher TSHs were observed in both VD deficiency and insufficiency groups (P < 0.01). However, typical U-shaped relationship between TSH and UIC was not observed in this population. In conclusion, Mothers in our study had no iodine deficiency, but numbers of mothers were still having a UIC of < 100 µg/L or > 300 µg/L. Region, area type, age, BMI, VA, or VD should be taken into consideration in the future iodine evaluation and surveillance.
Technique of enlarged retrosternal tunnel in Nuss procedure
Authors: Li Xiu-qin , Zhang Da , Zhao Ge , Xie Tan , Jia Jia , Yang Lin 
Published: March 2022

Abstract
OBJECTIVE: The Nuss procedure for pectus excavatum involves the risk of cardiopulmonary injury during the creation of retrosternal tunnel. This study describes the enlargement of retrosternal tunnel during Nuss procedure to prevent such problems caused by the inability to directly visualize the left pleural cavity.METHODS: From January 2018 to August 2021, 132 patients with pectus excavatum who underwent the Nuss procedure were divided into the modified group and the conventional group , according to the surgical method performed. The preoperative, intraoperative and postoperative indicators of the two groups were compared. In 70 consecutive patients undergoing the modified Nuss procedure, the separation was expanded by inserting the introducer bluntly and creating a retrosternal tunnel width of 4-5 cm in a coronal horizontal position. Once the pericardium, left parietal pleura and lung had been observed from the right thoracic cavity during the separation, the parietal pleura was punctured to induce a left pneumothorax and left lung collapse. Under thoracoscopic guidance, the introducer was passed through the left intercostal space.RESULTS: All children completed the surgery successfully; there were no cases of death, pericardial or cardiopulmonary injury, or bar displacement. There was no statistical significance in other indicators except age between two groups.CONCLUSION: Coronal plane enlargement of the retrosternal tunnel during the Nuss procedure allows direct visualization of the pericardium, left parietal pleura, and left lung, which has the promise of reducing the incidence of serious complications such as intraoperative cardiopulmonary injury and does not increase the incidence of general complications.
Wearable Adjunct Ozone and Antibiotic Therapy System for Treatment of Gram-negative Dermal Bacterial Infection
Authors: Roth Alexander , Maruthamuthu Murali Kannan , Nejati Sina , Krishnakumar Akshay , Selvamani Vidhya , Sedahat Sotoudeh , Nguyen Juliane , Seleem Mohamed N. , Rahimi Rahim 
Published: April 2022

Abstract
The authors have requested that this preprint be removed from Research Square.
Non-nutritive sweeteners consumption during pregnancy associates with reduced Lactobacillaceae in colostrum and lower gestational age at birth: A pilot study
Authors: Esquivel-Veláz Marcela , Bueno-Hernández Nallely , Cacho-Zayas Ana P , Rosa-Ruiz Leticia de la , Aguayo-Guerrero José A , de-León-Barrera Karen L , Mendoza-Martínez Viridiana M , Briones-Garduño Jesús C , Snowball-del-Pilar Lenin , Escobedo Galileo , Meléndez-Mier Guillermo , Méndez-García Lucía A 
Published: March 2022

Abstract
Background. Human milk is essential for establishing the newborn’s gut microbiota, which can have an impact on future health. Several studies indicate that Non-nutritive Sweeteners (NNS) can modify the intestinal microbiota, promoting metabolic dysfunction in humans and rodents; however, the influence of NNS on human milk microbiota is unknown. This study aimed to assess changes in the relative abundance of several of bacterial groups in colostrum of women who consumed NNS during pregnancy. Methods. This cross-sectional, pilot study included 39 women that gave birth to a live, healthy newborn in the General Hospital of Mexico. We assessed mothers’ diet and NNS consumption by validated questionnaires and the relative abundance of Bifidobacteriaceae, Lactobacillaceae, Lachnospiraceae, Roseburia, Eubacteriales, and Bacteroidales in colostrum samples by real-time PCR.Results. Twenty-six women (66%) showed a low NNS consumption (<350 mg/week), whereas 13 (33%) showed a high NNS consumption (≥350 mg/week). The Lactobacillaceae relative abundance significantly decreased in the high NNS consumption group compared to the low NNS group (12.36±11.29 vs. 4.41±2.84, respectively; P<.001). NNS consumption associated with lower gestational age determined by the Capurro method or Ultrasound/Last Menstrual Period (r=-0.320, P= .025; and r=-0.355, P= .018, respectively).Conclusion. NNS consumption during pregnancy is associated with decreased Lactobacillaceae abundance in colostrum and lower gestational age. The effects of NNS consumption during pregnancy on breast milk microbiota and gestational age should be further investigated.Study registration: This study was registered in ClinicalTrials, number NCT03912038.
Multisystem Inflammatory Syndrome in a Fully Vaccinated 18-Year-Old Without Known SARS-CoV-2 Infection
Authors: Liu Andy , Love Alexa , Katz Sophie , Patrick Anna , Parra David , Halasa Natasha , Miller Michael Raymond 
Published: March 2022

Abstract
Background
Multisystem inflammatory syndrome in children (MIS-C) is a febrile syndrome that is observed in the pediatric population following severe acute respiratory syndrome 2 (SARS-CoV-2) infection. Vaccines have prevented or lessened the severity of the initial acute respiratory infection, while their effectiveness against severe MIS-C is just beginning to be reported.
Case presentation
Here we report a fully vaccinated teenage female with no known history of SARS-CoV-2 infection who presented with shock and heart failure. Her presentation was initially thought secondary to a retropharyngeal abscess but was later identified as MIS-C after confirmed nucleocapsid antibody.
Conclusions
Given the recent Omicron wave, the ongoing international outbreaks with the BA.2 subvariant and the continued evolution of the COVID-19 pandemic, this case emphasizes the need to include MIS-C in the differential diagnosis, even in a fully vaccinated, previously healthy child.
Minimal important difference and patient acceptable symptom state for common outcome instruments in patients with a closed humeral shaft fracture Analysis of the FISH randomised clinical trial data
Authors: Ibounig Thomas , Juurakko Joona , Lähdeoja Tuomas , Sumrein Bakir O. , Järvinen Teppo LN , Paavola Mika , Ardern Clare L. , Karjalainen Teemu , Taimela Simo , Rämö Lasse 
Published: March 2022

Abstract
Background: Two common ways of assessing the clinical relevance of treatment outcomes are the minimal important difference (MID) and the patient acceptable symptom state (PASS). The former represents the smallest change in the given outcome that makes people feel better, while the latter is the symptom level at which patients feel well.Methods: We recruited 124 humeral shaft fracture patients to a randomised controlled trial comparing surgery to nonsurgical care. Outcome instruments included the Disabilities of Arm, Shoulder, and Hand score (DASH), the Constant-Murley score, and two numerical rating scales (NRS) for pain (at rest and on activities). A reduction in DASH and pain score, and increase in the Constant-Murley score represents improvement. We used four methods (receiver operating characteristic [ROC] curve, the mean difference of change, the mean change, and predictive modelling methods) to determine the MID, and two methods (the ROC and 75th percentile) for the PASS. As an anchor for the analyses, we assessed patients’ satisfaction regarding the injured arm using a 7-item Likert-scale. Results: The change in the anchor question was strongly correlated with the change in DASH, moderately correlated with the change of the Constant-Murley score and pain on activities, and poorly correlated with the change in pain at rest (Spearman’s rho 0.51, ‑0.40, 0.36, and 0.15, respectively). Depending on the method, the MID estimates for DASH ranged from -6.7 to -11.2, pain on activities from -0.5 to -1.3, and the Constant-Murley score from 6.3 to 13.5. The ROC method provided reliable estimates for DASH (-6.7 points, Area Under Curve [AUC] 0.77), the Constant-Murley Score (7.6 points, AUC 0.71), and pain on activities (‑0.5 points, AUC 0.68). The PASS estimates were 14 and 10 for DASH, 2.5 and 2 for pain on activities, and 68 and 74 for the Constant-Murley score with the ROC and 75th percentile methods, respectively. Conclusion: Our study provides credible estimates for the MID and PASS values of DASH, pain on activities and the Constant-Murley score, but not for pain at rest. The suggested cut-offs can be used in future studies and for assessing treatment success in humeral shaft fracture patients. Trial registration: ClinicalTrials.gov NCT01719887, first registration 01/11/2012
Effect of Recombinant Human Epidermal Growth Factor on Skin Reaction Induced by Radiation in Rectal and anal Cancer Patients: A Self-Controlled Study
Authors: Liu Shuai , Shi Shu-ting , Zheng Jian , Wan Xiang-bo , Liu Yan-ping 
Published: March 2022

Abstract
Backgtound:
Recombinant human epidermal growth factor (rhEGF) was reported to be beneficial for radiation induced skin injury (RISR), however, whether it is useful in patients with rectal and anal cancers are rarely reported. High-level evidence about this is even more lacking.
Objective
The purpose of this study was to provide high-level evidence for the application of rhEGF for skin protection in rectal and anal cancer patients during radiotherapy and to analyze the factors associated with RISR.
Methods
Patients were prospectively enrolled from January 2019 to December 2020. The pelvic skin area receiving radiotherapy was randomly assigned to the experimental and control side by the midline. Self-controls were formed on both sides.The experimental side was sprayed with rhEGF, while the control side was sprayed with physiological saline. The grading of RISR on two sides were assessed. At the end of radiotherapy, the area of RISR was evaluated. Factors associated with RISR were analyzed.
Results
Totally,193 patients were enrolled. At the end of radiotherapy, between the two groups, there was not a significant difference referring to grading. while there was a difference in dermatitis area. Tumor distance from the anal edge ≤ 4cm, without colostomy, the biological effective dose of radiotherapy > 60Gy are all adverse factors affecting the area of RISR in radiotherapy.
Conclusions
rhEGF can protect the skin receiving radiotherapy in rectal and anal patients.
trial registration number:
This clinical trial has been registered in China’s Clinical trials Network ((registration time: 2019.01.20; registration number: ChiCTR1900020842).
Ultrasound-assisted high voltage cold atmospheric plasma treatment on the inactivation and structure of lysozyme: Effect of treatment voltage
Authors: Nasiru Mustapha Muhammad , Boateng Evan Frimpong , Wang Zhaobin , Yan Wenjing , Zhuang Hong , Zhang Jianhao 
Published: March 2022

Abstract
Emerging non-thermal processing techniques are gaining much attention due to their numerous advantages over traditional methods. Thus, in this study, we employed high voltage cold atmospheric plasma (HV-CAP) separately and synergetically with ultrasound on lysozyme to investigate its activity and structure. The HV-CAP was operated at 120, 140, and 160 kV for 3 min at a frequency of 120 Hz. A significant difference was observed between the untreated and both treatments in lysozyme activity, with a more pronounced result in the ultrasound-assisted HV-CAP treatment. Both treatments influenced the tertiary structure of the lysozyme as lipid oxidation, carbonyl content, UV spectra, intrinsic fluorescence, hydrophobicity, and sulfhydryl groups increased with increased voltage. Particle size distribution of lysozyme shows that noncovalent interactions affected the tertiary structure. The effects of both treatments on the secondary structure of lysozyme were demonstrated by FTIR-ATR, CD, and relative molar ellipticity. The results indicated that plasma-generated reactive species and ultrasound-induced cavitation influenced the unfolding of tertiary and secondary structures of the lysozyme. The CD spectra postulated that lysozyme inactivation was closely linked to the α-helices and β-sheets components of the secondary structure. This study presents an original novel knowledge on the modification of activity and structure of lysozyme subjected to ultrasound-assisted HV-CAP treatment that has been missing from the literature.