bluuebunny/crossref_metadata_2025 huggingface dataset:
The Future of Somatostatin Receptor Ligands in Acromegaly
Authors: Gadelha Monica R , Wildemberg Luiz Eduardo , Kasuki Leandro
Published: October 2021

Currently, the first-generation somatostatin receptor ligands (fg-SRLs), octreotide LAR and lanreotide autogel, are the mainstays of acromegaly treatment and achieve biochemical control in approximately 40% of patients and tumor shrinkage in over 60% of patients. Pasireotide, a second-generation SRL, shows higher efficacy with respect to both biochemical control and tumor shrinkage but has a worse safety profile. In this review, we discuss the future perspectives of currently available SRLs, focusing on the use of biomarkers of response and precision medicine, new formulations of these SRLs and new drugs, which are under development. Precision medicine, which is based on biomarkers of response to treatment, will help guide the decision-making process by allowing physicians to choose the appropriate drug for each patient and improving response rates. New formulations of available SRLs, such as oral, subcutaneous depot, and nasal octreotide, may improve patients’ adherence to treatment and quality of life since there will be more options available that better suit each patient. Finally, new drugs, such as paltusotine, somatropin, ONO-5788, and ONO-ST-468, may improve treatment adherence and present higher efficacy than currently available drugs.
Urocortin3 in the Posterodorsal Medial Amygdala Mediates Stress-induced Suppression of LH Pulsatility in Female Mice
Authors: Ivanova Deyana , Li Xiao-Feng , McIntyre Caitlin , Liu Yali , Kong Lingsi , O’Byrne Kevin T
Published: October 2021

Psychosocial stress disrupts reproduction and interferes with pulsatile LH secretion. The posterodorsal medial amygdala (MePD) is an upstream modulator of the reproductive axis and stress. Corticotropin-releasing factor type 2 receptors (CRFR2s) are activated in the presence of psychosocial stress together with increased expression of the CRFR2 ligand Urocortin3 (Ucn3) in the MePD of rodents. We investigate whether Ucn3 signalling in the MePD is involved in mediating the suppressive effect of psychosocial stress on LH pulsatility. First, we administered Ucn3 into the MePD and monitored the effect on LH pulses in ovariectomized mice. Next, we delivered Astressin2B, a selective CRFR2 antagonist, intra-MePD in the presence of predator odor, 2,4,5-trimethylthiazole (TMT) and examined the effect on LH pulses. Subsequently, we virally infected Ucn3-cre-tdTomato mice with inhibitory designer receptor exclusively activated by designer drugs (DREADDs) targeting MePD Ucn3 neurons while exposing mice to TMT or restraint stress and examined the effect on LH pulsatility as well as corticosterone release. Administration of Ucn3 into the MePD dose-dependently inhibited LH pulses and administration of Astressin2B blocked the suppressive effect of TMT on LH pulsatility. Additionally, DREADDs inhibition of MePD Ucn3 neurons blocked TMT and restraint stress-induced inhibition of LH pulses and corticosterone release. These results demonstrate for the first time that Ucn3 neurons in the MePD mediate psychosocial stress-induced suppression of the GnRH pulse generator and corticosterone secretion. Ucn3 signalling in the MePD plays a role in modulating the hypothalamic-pituitary-gonadal and hypothalamic-pituitary-adrenal axes, and this brain locus may represent a nodal center in the interaction between the reproductive and stress axes.
Classification of Retail Chain services
Authors: Valeeva Yu.
Published: October 2021

The relevance of the development of theoretical provisions for the classification of services of retail trade networks is predetermined by the modern transformation of the trade industry, where the services provided by the chains are formed on the basis of building communications with all participants in the consumer market. The main purpose of the article is to generalize the approach to the classification of services and the implementation of a value-oriented and process approach to the content and identification of the classification features of services of retail trade networks. The article presents modern foreign and domestic approaches to the classification of retail trade services. Certain features are highlighted and the expediency of taking into account the network forms of organizing trade services in the formation of classification signs is indicated. In the presented article, the service of a retail trade network is considered as a result, an action and a process. On the other hand, the retail chain service is viewed through the prism of value for suppliers, end-users and owners on the network. The implementation of the value approach allows taking into account consumer preferences, as well as the interests of the network owners in the development of retail facilities, ensuring the quality of trade services, developing the infrastructure of the territory, paying attention to the requests and proposals of agricultural producers, processors, service providers. which create services according to the format of goods circulation. The application of the process and value approach made it possible to single out the components of the service and propose their own classification. This classification will allow, in the future, to develop an appropriate methodology for assessing the effectiveness of retail trade network services, as well as to develop management decisions at the enterprise level, to build more effective communications with all participants in the consumer market.
Methodological Approaches to Assessing the Level of Economic Security of Small and Medium-Sized Businesses
Authors: Bykova O. , Garnov Andrey , Shpileva A. , Chuhlebov A.
Published: October 2021

In the constantly changing conditions of the external environment, with the modern development of science and technology, with a high level of competition, the success of an organization's functioning lies in its timely ability to effectively respond to market demands. An enterprise's resistance to external and internal threats is determined by the level of its economic security. In other words, the economic security of an enterprise is the state of its protection from the negative influence of external and internal threats, destabilizing factors, under which the sustainable implementation of the main commercial interests and goals of the statutory activities is achieved.

It is extremely important to conduct a systematic analysis of the management of the economic security of enterprises, develop effective methods for assessing the current level of security in companies and improve mechanisms for increasing economic security to improve the competitiveness of Russian business in modern market realities.

The concept of economic security includes a whole range of functional components. In addition to financial security, the system of economic security includes personnel, technological, market, legal, interface, environmental, information and power components, which equally affect the well-being of the company. And only when comprehensive measures are taken to improve each functional component, a high, competitive level of economic security can be achieved.

It is extremely important to understand the essence of the economic security of an enterprise, to study methodological approaches to assessing the current level of economic security and to learn how to correctly use the mechanisms to improve it.
Presencia de publicaciones de mujeres en dos revistas académicas de Historia en Chile entre 1920 y 1939.
Authors: Román Guajardo Karin
Published: October 2021

El presente artículo se centra en el análisis de publicaciones historiográficas de mujeres chilenas en la Academia de Historia entre 1920 y 1939. Este abarca el contexto histórico que permitió dicha producción académica, ligada al proceso desarrollo de la educación femenina en Chile, el ingreso de las mujeres a la Universidad y la profesionalización del trabajo de éstas, al igual que el estudio de las condiciones materiales e inmateriales de los artículos publicados en las revistas Clío y Revista Chilena de Historia y Geografía. El análisis de los artículos muestra un cambio en los valores atribuidos a las mujeres: Desde un énfasis en temas ligados a la pedagogía, que se desprende del rol tradicional de madre (educadora) en la década del 20, hacia la incorporación de temas propios de la disciplina histórica, que coincidió con la profesionalización femenina durante la década del 30. Asimismo, el impacto de la crisis política de 1925 y económica de 1929 se vio reflejado en la baja del número de publicaciones de mujeres, dejando en evidencia la precaria situación de las mujeres profesionales, abordada por el incipiente movimiento feminista en Chile.
Madeleine Pelletier, ou les rêves et les frustrations d’une miraculée sociale.
Authors: Brouardelle Nadia
Published: October 2021

Selon une étude de Le quotidien du médecin. fr publiée en 2017, des 7978 étudiants qui eurent l’opportunité de choisir leur spécialité médicale, 4545 étaient des femmes. Parmi ces spécialités se trouve la psychiatrie qui est féminisée à 57,8 %. Il semble donc évident que l’accès de la femme à l’internat s’est largement démocratisé depuis le début du XXème siècle. Cependant, nombreuses sont celles qui oublient que la réalité dont elles jouissent aujourd’hui, est le résultat du combat de Madeleine Pelletier, une féministe hors pair pour son époque. Cette dernière entreprit des études de médecine et désirait se spécialiser en psychiatrie. Or, pour accéder à l’internat, il était indispensable de pouvoir exercer certains droits politiques comme le vote qui était interdit aux femmes. Pour arriver à ses fins, Madeleine Pelletier défiera le patriarcat politique et obtiendra gain de cause. Elle sera ainsi la première femme en France à devenir interne des hôpitaux de Paris. Malheureusement, elle n’exercera jamais comme psychiatre car elle échouera à la deuxième partie des épreuves de l’adjuvat. Un rêve avorté mais une porte ouverte pour des milliers de femmes. Cet article prétend rendre hommage à Madeleine Pelletier et analyser le lent cheminement vers la féminisation médicale.
Validade das medidas do tempo sentado do questionário IPAQ-versão curta em universitários brasileiros
Authors: Franco Dayana Chaves , Farias Gildeene Silva , Pelegrini Andreia , Virtuoso Junior Jair Sindra , Sousa Thiago Ferreira de
Published: October 2021

Os objetivos deste estudo foram estimar o nível de reprodutibilidade das medidas do tempo sentado do questionário International Physical Activity Questionnaire (IPAQ-versão curta) e analisar a validade concorrente dessas medidas em relação ao tempo sedentário mensurado pelo acelerômetro em universitários. Realizou-se um estudo correlacional com amostra de 61 universitários de uma instituição do ensino superior de Minas Gerais, Brasil, que autopreencheram as medidas do tempo sentado do IPAQ, intercalados por dois momentos diferentes para fins da análise de reprodutibilidade, e usaram o acelerômetro para estimativa do tempo sedentário e emprego como padrão ouro na análise de validade concorrente. Empregou-se as análises de correlação, via coeficiente de correlação intraclasse (CCI) e gráfico de dispersão de Bland-Altman, para analisar a concordância. O nível de significância adotado foi de 5%. A média de idade foi de 21,54 anos e 62,3% foram do sexo feminino. A reprodutibilidade do tempo sentado durante um dia de semana foi moderada (CCI = 0,51; p < 0,01), enquanto em um dia do final de semana foi baixa (CCI = 0,30; p = 0,01). As diferenças médias entre o tempo sentado pelo IPAQ e o tempo sedentário pelo acelerômetro, em um dia da semana foi de -51 minutos e em um dia do final de semana foi de -64,7 minutos. Conclui-se que houve correlações e concordâncias satisfatórias tanto na reprodutibilidade quanto na comparação com a medida critério (acelerômetro) das medidas do tempo sentado mensurado pelo IPAQ para aplicação em universitários.
Sexuality, student mental health nurse and lecturer experience in education and practice
Authors: Milward Benjamin , Collier Elizabeth
Published: October 2021

This article presents a critical reflection on an experience relating to sexuality from two perspectives, a mental health nursing student and a lecturer. It took place during stage 1 of a graduate entry nursing 2-year Master of Science mental health nursing programme at a UK university. Student mental health nurses in higher education who identify as lesbian, gay, bisexual or transgender can feel less safe than others, which affects performance. Lecturers can make a difference to the educational experience of student nurses who are lesbian, gay, bisexual or transgender and this can have an impact on clinical practice. The emotional impact of ‘coming out’ in the classroom can have far-reaching consequences for their mental health. The response of educational staff can have a huge impact on the ability to learn and the marks achieved. Student–lecturer relationships can have transformative consequences. Student mental health nurses make meaning from their educational experiences in the classroom and clinical practice. If they do not see themselves represented, this can affect engagement and motivation. Safe nursing practice is role modelled from lecturer to student and has implications for service user experience in clinical settings.
Preventing skin tears among older adults in general practice
Authors: Palmer Sarah Jane
Published: October 2021

In this article, Sarah Jane Palmer discusses the importance of the prevention of skin tears and the role practice nurses can play

Skin tears can present a complex and chronic problem for an older patient with fragile skin, and can be very disabling, reducing quality of life dramatically in some cases. The right care is essential from all members of the wider team caring for older patients, in order to identify risk factors for skin tears, as well as formulating a care plan of prevention that relates to these risk factors. Good skin care is essential, as well as patient education, and identifying ongoing issues with the patient's health that present a factor to consider when caring for them, such as mobility issues. Self-care should be encouraged where possible, and the correct use and choice of emollients that are pH balanced is crucial. By preventing skin tears we not only give the patient a far better quality of life, but we also reduce the need for very limited NHS resources.
Ambiente de aprendizagem e Jogos de empresas: a percepção dos discentes
Authors: Schmitt Tatiani , Alberton Anete , Butzke Marco Aurélio , Neves Francine Simas
Published: October 2021

O jogo de empresas é uma estratégia de ensino ativa que oportuniza aos discentes uma experiência vivencial mais próxima da realidade organizacional, o qual é desenvolvido em ambientes de aprendizagem. O objetivo da presente pesquisa é analisar a percepção dos discentes ao utilizar a estratégia de ensino jogos de empresas em um ambiente virtual de aprendizagem em duas universidades de Santa Catarina. A pesquisa é considerada mista, de abordagem quantitativa e qualitativa, com dados oriundos de 2 questionários e de 2 focus group aplicados com discentes de graduação e pós-graduação de duas universidades de Santa Catarina. Na análise dos dados foram utilizadas a estatística descritiva, a análise fatorial e a análise de conteúdo. Os resultados mostram que os discentes tiveram uma percepção positiva sobre o uso da estratégia de ensino Jogos de empresas e no ambiente de aprendizagem apontaram dificuldades ao utilizar a plataforma digital dos jogos. A principal contribuição é o fornecimento de subsídios aos docentes para aperfeiçoar o processo de ensino-aprendizagem, bem como um estímulo para docentes utilização de jogos de empresas e de outras estratégias de ensino em sala de aula, levando em consideração questões importantes para o sucesso na aplicação.
Concealment and Disclosure: The Cholera Crisis of 1969–70 in Korea
Authors: SIHN Kyu-hwan
Published: October 2021

The anti-cholera measures of 1969–70 represent one of the most unsuccessful quarantine cases in modern Korea. The military government, which overthrew the democratic government in 1961, tried to amend the Constitution aiming for a long-term seizure of power, and had to overcome the cholera crisis of 1969–70. Previous scholarship has emphasized the limitation of the state power when it came to controlling the cholera epidemic or the poor sanitation system of 1969–70. However, it is undeniable that the military government did have organizations, facilities, and human capital available. When a cholera epidemic broke out in 1963–64, the military government defended its people against cholera as part of the Revolutionary Tasks. Furthermore, it took counsel from a team of medical professionals knowledgeable in microbiology. In 1969, the possibility of bacteriological warfare by North Korea emerged while the government responded to cholera. To avoid this crisis, Park Chŏng-hŭi’s military government, which had been preparing for longterm rule, had to provide successful model in the cholera defense. For the military government, the concealment and distortion of infectious disease information was inevitable. Many other medical professionals trusted the activities of international organizations more than they did the government bodies, and the media accused the government of fabricating cholera death statistics. As the government failed to prevent the cholera crisis, it tightened its secrecy by concealing facts and controlling information.
Convergent numerical method for the reflector antenna problem via optimal transport on the sphere
Authors: Froese Hamfeldt Brittany , Turnquist Axel G. R.
Published: October 2021

We consider a partial differential equation (PDE) approach to
numerically solve the reflector antenna problem by solving an optimal
transport problem on the unit sphere with cost function

c
(
x
,
y
)
=
−
2
log
⁡

|

|

x
−
y

|

|

. At each point on the sphere, we
replace the surface PDE with a generalized Monge–Ampère type equation
posed on the local tangent plane. We then use a provably convergent
finite difference scheme to approximate the solution and construct the
reflector. The method is easily adapted to take into account highly
nonsmooth data and solutions, which makes it particularly well adapted
to real-world optics problems. Computational examples demonstrate the
success of this method in computing reflectors for a range of
challenging problems including discontinuous intensities and
intensities supported on complicated geometries.
Improved electro-optical and photoelectric performance of GaN-based micro-LEDs with an atomic layer deposited AlN passivation layer
Authors: Chen Dingbo , Wang Zhe , Hu Fang-Chen , Shen Chao , Chi Nan , Liu Wenjun , Zhang David Wei , Lu Hong-Liang
Published: October 2021

The quantum efficiency of GaN-based micro-light-emitting diodes (micro-LEDs) is of great significance for their luminescence and detection applications. Optimized passivation process can alleviate the trapping of carriers by sidewall defects, such as dangling bonds, and is regarded as an effective way to improve the quantum efficiency of micro-LEDs. In this work, an AlN passivation layer was prepared by atomic layer deposition to improve the electro-optical and photoelectric conversion efficiency in GaN-based micro-LEDs. Compared to conventional Al2O3 passivation, the AlN passivation process has a stronger ability to eliminate the sidewall defects of micro-LEDs due to the homogeneous passivation interface. Our experiments show that the AlN-passivated device exhibits two orders of magnitude lower forward leakage and a smaller ideality factor, which leads to significantly enhanced external quantum efficiency (EQE). For 25*25 μm2 micro-LEDs, the EQE of the AlN-passivated device was 18.3% and 57.7% higher than that of the Al2O3-passivated device in luminescence application and detection application, respectively.
Molecular dynamic investigation of ethanol-water mixture by terahertz-induced Kerr effect
Authors: Zhao Hang , Tan Yong , Zhang Rui , Zhao Yuejin , Zhang Cunlin , Zhang Xi-Cheng , Zhang Liangliang
Published: October 2021

The terahertz Kerr effect (TKE) spectroscopy provides time-resolved measurement of low-frequency molecular motions of liquids. Here, the intense broadband terahertz (THz) pulses resonantly excite multiple molecular modes in pure ethanol and ethanol-water mixtures. For pure ethanol, the obtained unipolar TKE response contains the molecular relaxation information extending over tens of picoseconds, which originates from the coupling between the permanent molecular dipole moment of ethanol and the THz electric field. For ethanol-water mixtures with different molar proportions, the results observed on the sub-picosecond time scale can always be divided into the linear superposition of the TKE signals of pure ethanol and water. Under the observation time window over tens of picoseconds (after 1 picosecond), the relative molecular contribution of ethanol in the mixture changes nonlinearly with the increase of water molecules, implying the complex structural perturbation of ethanol hydrogen bond network in the mixture. This work provides a new perspective for further investigation on the hydrogen bond network structure and dynamics in aqueous amphiphilic solutions.
51-W average power, 169-fs pulses from an ultrafast non-collinear optical parametric oscillator
Authors: Lang L. , Bauer C. P. , Phillips C. R. , Keller U.
Published: October 2021

We present a high power optical parametric oscillator (OPO) synchronously pumped by the second-harmonic of a modelocked 1030-nm thin-disk laser (TDL) oscillator. The OPO delivers an average power of 51.1 W around degeneracy (1030 nm) with a 10.2-MHz repetition-rate. After extra-cavity dispersion compensation using dispersive mirrors, we obtain a pulse duration of 169 fs, which is 4.6× shorter than the TDL pulse duration of 770 fs. The TDL has 250 W average power, which is converted to 215 W at the second-harmonic. Hence, the OPO exhibits a high photon conversion efficiency of 47% (ratio of signal photons to 515-nm pump photons). Moreover, the OPO generates a peak power of 26.2 MW, which is very similar to the 28.0-MW peak power of the TDL. To facilitate continuous tuning around degeneracy and convenient extraction of the pump and idler beams, the OPO is operated in a noncollinear configuration. A linear cavity configuration was chosen since it offers easy alignment and straightforward cavity length tuning. To the best of our knowledge, this source has the highest average power generated by any ultrafast OPO, and the shortest pulse duration for any >5-W OPO. This result is an important step to adding wavelength tunability to high power Yb-based laser sources without the complexity of either laser or parametric amplifier systems.
Light absorption enhancement in ultrathin perovskite solar cells using light scattering of high-index dielectric nanospheres
Authors: Kim Hyeonwoo , Kwak Hojae , Jung Incheol , Kim Mi Suk , Kim Jeonghyun , Park Hui Joon , Lee Kyu-Tae
Published: October 2021

Arrays of high-index dielectric nanoparticles supporting both electrical and magnetic resonances have gained increasing attention for their excellent light-trapping (LT) effects, thus greatly improving the performance of ultrathin solar cells. This work explores front-located, high-index dielectric subwavelength nanosphere arrays as an efficient and broadband LT structure patterned on top of an ultrathin perovskite solar cell (PSC) for a greatly enhanced absorption. Combined strong light scattering and anti-reflection properties achieved by optimized geometrical parameters of the LT structure lead to a broadband absorption enhancement in the ultrathin thickness of a photoactive layer (100 nm) yielding the short-circuit current density (Jsc) of 18.7 mA/cm2, which is 31.7% higher than that of a planar counterpart. Moreover, effects of the LT structure on far-field radiation patterns, scattering cross-sections, multipoles’ contributions, and asymmetry parameters along with the incidence angle and polarization dependence are investigated. The present strategy could be applied to diverse applications, such as other ultrathin or semitransparent solar cells, absorbers and photodetectors.
Leishmania infantum xenodiagnosis from vertically infected dogs reveals significant skin tropism
Authors: Scorza Breanna M. , Mahachi Kurayi G. , Cox Arin C. , Toepp Angela J. , Leal-Lima Adam , Kumar Kushwaha Anurag , Kelly Patrick , Meneses Claudio , Wilson Geneva , Gibson-Corley Katherine N. , Bartholomay Lyric , Kamhawi Shaden , Petersen Christine A.
Published: October 2021

Background

Dogs are the primary reservoir for human visceral leishmaniasis due to Leishmania infantum. Phlebotomine sand flies maintain zoonotic transmission of parasites between dogs and humans. A subset of dogs is infected transplacentally during gestation, but at what stage of the clinical spectrum vertically infected dogs contribute to the infected sand fly pool is unknown.

Methodology/Principal findings

We examined infectiousness of dogs vertically infected with L. infantum from multiple clinical states to the vector Lutzomyia longipalpis using xenodiagnosis and found that vertically infected dogs were infectious to sand flies at differing rates. Dogs with mild to moderate disease showed significantly higher transmission to the vector than dogs with subclinical or severe disease. We documented a substantial parasite burden in the skin of vertically infected dogs by RT-qPCR, despite these dogs not having received intradermal parasites via sand flies. There was a highly significant correlation between skin parasite burden at the feeding site and sand fly parasite uptake. This suggests dogs with high skin parasite burden contribute the most to the infected sand fly pool. Although skin parasite load and parasitemia correlated with one another, the average parasite number detected in skin was significantly higher compared to blood in matched subjects. Thus, dermal resident parasites were infectious to sand flies from dogs without detectable parasitemia.

Conclusions/Significance

Together, our data implicate skin parasite burden and earlier clinical status as stronger indicators of outward transmission potential than blood parasite burden. Our studies of a population of dogs without vector transmission highlights the need to consider canine vertical transmission in surveillance and prevention strategies.
Effect of photobiomodulation combined with physical therapy on functional performance in children with myelomeningocele: A protocol randomized clinical blind study
Authors: Silva Tamiris , Queiroz Juliana Roque de , Turcio Karina Helga Leal , Tobelem Daysi da Cruz , Araújo Tamires Ribeiro , Coutinho Kevelin Siqueira Lira , Chavantes Maria Cristina , Horliana Anna Carolina Ratto Tempestini , Deana Alessandro Melo , Silva Daniela de Fátima Teixeira da , Castelo Paula Midori , Fernandes Kristianne Porta Santos , Motta Lara Jansiski , Mesquita-Ferrari Raquel Agnelli , Kalil Bussadori Sandra
Published: October 2021

Introduction

Myelomeningocele is a severe type of spina bifida, resulting from improper closure of the neural tube. This condition drastically affects the structures of the spinal cord resulting in deficiencies. The combination of these deficiencies results in an overall decrease in mobility and functional participation amongst this population. Physiotherapy plays an essential role in rehabilitating people with MMC. The current literature shows that resources such as photobiomodulation (PBM) may support the rehabilitation of neurological conditions. The aim of the proposed study is to evaluate the effects of photobiomodulation (PBM) combined with physical therapy on functional performance in children with low lumbosacral myelomeningocele.

Materials and methods

This is a protocol randomized clinical blind study, that will include 30 individuals of both sexes, aged between 5 to 8 years, diagnosed with low and sacral lumbar myelomeningocele and capable of performing the sit-to-stand task. The participants will be randomly assigned into two treatment groups: PBM + physiotherapeutic exercises and sham PBM + physiotherapeutic exercises. Irradiation will be carried out with light emitting diode (LED) at a wavelength of 850 nm, energy of 25 J per point, 50 seconds per point and a power of 200 mW. The same device will be used in the placebo group but will not emit light. Muscle activity will be assessed using a portable electromyograph (BTS Engineering) and the sit-to-stand task will be performed as a measure of functioning. Electrodes will be positioned on the lateral gastrocnemius, tibialis anterior and rectus femoris muscles. The Pediatric Evaluation of Disability Inventory will be used to assess functional independence. Quality of life will be assessed using the Child Health Questionnaire—Parent Form 50. Changes in participation will be assessed using the Participation and Environment Measure for Children and Youth. The data will be analyzed with the aid of GraphPad PRISM.

Discussion

The results of this study can contribute to a better understanding of the effectiveness of PBM on functioning and quality of life in children with myelomeningocele.

Clinical trial registration

ClinicalTrials.gov Identifier:NCT04425330.
easyFulcrum: An R package to process and analyze ecological sampling data generated using the Fulcrum mobile application
Authors: Di Bernardo Matteo , Crombie Timothy A. , Cook Daniel E. , Andersen Erik C.
Published: October 2021

Large-scale ecological sampling can be difficult and costly, especially for organisms that are too small to be easily identified in a natural environment by eye. Typically, these microscopic floral and fauna are sampled by collecting substrates from nature and then separating organisms from substrates in the laboratory. In many cases, diverse organisms can be identified to the species-level using molecular barcodes. To facilitate large-scale ecological sampling of microscopic organisms, we used a geographic data-collection platform for mobile devices called Fulcrum that streamlines the organization of geospatial sampling data, substrate photographs, and environmental data at natural sampling sites. These sampling data are then linked to organism isolation data from the laboratory. Here, we describe the easyFulcrum R package, which can be used to clean, process, and visualize ecological field sampling and isolation data exported from the Fulcrum mobile application. We developed this package for wild nematode sampling, but it can be used with other organisms. The advantages of using Fulcrum combined with easyFulcrum are (1) the elimination of transcription errors by replacing manual data entry and/or spreadsheets with a mobile application, (2) the ability to clean, process, and visualize sampling data using a standardized set of functions in the R software environment, and (3) the ability to join disparate data to each other, including environmental data from the field and the molecularly defined identities of individual specimens isolated from samples.
Detecting critical nodes in forest landscape networks to reduce wildfire spread
Authors: Yemshanov Denys , Liu Ning , Thompson Daniel K. , Parisien Marc-André , Barber Quinn E. , Koch Frank H. , Reimer Jonathan
Published: October 2021

Although wildfires are an important ecological process in forested regions worldwide, they can cause significant economic damage and frequently create widespread health impacts. We propose a network optimization approach to plan wildfire fuel treatments that minimize the risk of fire spread in forested landscapes under an upper bound for total treated area. We used simulation modeling to estimate the probability of fire spread between pairs of forest sites and formulated a modified Critical Node Detection (CND) model that uses these estimated probabilities to find a pattern of fuel reduction treatments that minimizes the likely spread of fires across a landscape. We also present a problem formulation that includes control of the size and spatial contiguity of fuel treatments. We demonstrate the approach with a case study in Kootenay National Park, British Columbia, Canada, where we investigated prescribed burn options for reducing the risk of wildfire spread in the park area. Our results provide new insights into cost-effective planning to mitigate wildfire risk in forest landscapes. The approach should be applicable to other ecosystems with frequent wildfires.
A descriptive study of healthcare-providers’ experiences with the use and quality of oxytocin for the prevention of post-partum hemorrhage in Nigeria: A nation-wide survey
Authors: Ejekam Chioma S. , Nyangara Florence M. , Anyakora Chimezie , Nwokike Jude
Published: October 2021

Background

Oxytocin is recommended as an affordable and effective drug in the prevention of postpartum hemorrhage—one of the leading causes of maternal morbidity and mortality in low- and middle-income countries, however, there are concerns about its proper use and quality. This study builds on earlier work conducted in a South-Western state in Nigeria.

Objective

The study assessed the knowledge around oxytocin, usage, storage practices and perceived quality of oxytocin used by healthcare providers that directly administer oxytocin for the prevention of postpartum hemorrhage across Nigeria.

Methods

This was a descriptive cross-sectional study that surveyed a representative sample of 6,299 healthcare providers who offer obstetrics and gynecological services and recruited from 1,894 healthcare facilities in Public and Private sectors in 12 states across Nigeria. Data were collected using an electronic questionnaire, analyzed using SPSS, and presented in frequencies and percentages.

Results

Only forty-six percent of respondents (52.8% in private; 40.0% in public sector) had proper knowledge that oxytocin storage is in the refrigerator. Proper knowledge also varied by professional cadre, doctors (71.2%); nurses (46.6%); Community Health Workers (28.4%) and by years of experience, less than 10 years (51.4%); more than 10 years (40.8%). Only 34% of the respondents (41% in private and 27.5% in public sector) reported good practices that oxytocin is stored in the refrigerator in their facilities. Most healthcare providers used oxytocin for prevention of PPH (77.9%). Oxytocin was also used for augmentation (66.7%) and induction of labor (52.6%). Half of respondents used above the WHO-recommended oxytocin dose of 10IU for prevention of PPH. Twenty-three percent of respondents reported experiencing oxytocin failure in PPH prevention of whom, 54.3% changed to another uterotonic and 37.1% doubled the dose of oxytocin for their patients.

Conclusion

Our study findings should be used to establish clinical guidelines and trainings for healthcare providers to improve their knowledge and storage practices and use to safeguard the quality of these lifesaving medicines.
High levels of pathological jaundice in the first 24 hours and neonatal hyperbilirubinaemia in an epidemiological cohort study on the Thailand-Myanmar border
Authors: Thielemans Laurence , Peerawaranun Pimnara , Mukaka Mavuto , Paw Moo Kho , Wiladphaingern Jacher , Landier Jordi , Bancone Germana , Proux Stephane , Elsinga Henrike , Trip-Hoving Margreet , Hanboonkunupakarn Borimas , Htoo Tha Ler , Wah Thaw Shee , Beau Candy , Nosten Francois , McGready Rose , Carrara Verena I.
Published: October 2021

Population risks for neonatal hyperbilirubinaemia (NH) vary. Knowledge of local risks permits interventions that may reduce the proportion becoming severe. Between January 2015 and May 2016, in a resource-limited setting on the Thailand-Myanmar border, neonates from 28 weeks’ gestation were enrolled into a prospective birth cohort. Each neonate had total serum bilirubin measurements: scheduled (24, 48, 72 and 144 hours of life) and clinically indicated; and weekly follow up until 1 month of age. Risk factors for developing NH were evaluated using Cox proportional hazard mixed model. Of 1710 neonates, 22% (376) developed NH (83% preterm, 19% term). All neonates born <35 weeks, four in five born 35–37 weeks, and three in twenty born ≥38 weeks had NH, giving an overall incidence of 249 per 1000 livebirths [95%CI 225, 403]. Mortality from acute bilirubin encephalopathy was 10% (2/20) amongst the 5.3% (20/376) who reached the severe NH threshold. One-quarter (26.3%) of NH occurred within 24 hours. NH onset varied with gestational age: at a median [IQR] 24 hours [24, 30] for neonates born 37 weeks or prematurelyvs59 hours [48, 84] for neonates born ≥38 weeks. Risk factors for NH in the first week of life independent of gestational age were: neonatal G6PD deficiency, birth bruising, Sgaw Karen ethnicity, primigravidae, pre-eclampsia, and prolonged rupture of membranes. The genetic impact of G6PD deficiency on NH was partially interpreted by using the florescent spot test and further genotyping work is in progress. The risk of NH in Sgaw Karen refugees may be overlooked internationally as they are most likely regarded as Burmese in countries of resettlement. Given high levels of pathological jaundice in the first 24 hours and overall high NH burden, guidelines changes were implemented including preventive PT for all neonates <35 weeks and for those 35–37 weeks with risk factors.
Impaired function and delayed regeneration of dendritic cells in COVID-19
Authors: Winheim Elena , Rinke Linus , Lutz Konstantin , Reischer Anna , Leutbecher Alexandra , Wolfram Lina , Rausch Lisa , Kranich Jan , Wratil Paul R. , Huber Johanna E. , Baumjohann Dirk , Rothenfusser Simon , Schubert Benjamin , Hilgendorff Anne , Hellmuth Johannes C. , Scherer Clemens , Muenchhoff Maximilian , von Bergwelt-Baildon Michael , Stark Konstantin , Straub Tobias , Brocker Thomas , Keppler Oliver T. , Subklewe Marion , Krug Anne B.
Published: October 2021

Disease manifestations in COVID-19 range from mild to severe illness associated with a dysregulated innate immune response. Alterations in function and regeneration of dendritic cells (DCs) and monocytes may contribute to immunopathology and influence adaptive immune responses in COVID-19 patients. We analyzed circulating DC and monocyte subsets in 65 hospitalized COVID-19 patients with mild/moderate or severe disease from acute illness to recovery and in healthy controls. Persisting reduction of all DC subpopulations was accompanied by an expansion of proliferating Lineage−HLADR+ cells lacking DC markers. Increased frequency of CD163+ CD14+ cells within the recently discovered DC3 subpopulation in patients with more severe disease was associated with systemic inflammation, activated T follicular helper cells, and antibody-secreting cells. Persistent downregulation of CD86 and upregulation of programmed death-ligand 1 (PD-L1) in conventional DCs (cDC2 and DC3) and classical monocytes associated with a reduced capacity to stimulate naïve CD4+ T cells correlated with disease severity. Long-lasting depletion and functional impairment of DCs and monocytes may have consequences for susceptibility to secondary infections and therapy of COVID-19 patients.
Autism spectrum disorder screening in children aged 16-30 months using the Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R)
Authors: Aditya Clarissa Josephine , Dahliana Jenni Kim , Widodo Ariani Dewi , Sekartini Rini
Published: October 2021

Background Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with a global prevalence of 7.6 in 1,000 children. The Modified Checklist for Autism in Toddlers - Revised (M-CHAT-R) is one of many screening tools for ASD. It is fast, easy to use, and has been translated and validated in the Indonesian language.

Objective To determine the prevalence of ASD in Indonesia and its risk factors.

Methods A cross-sectional study was conducted from March to October 2020. In the first protocol (March to July 2020), 219 children aged 16-30 months from 20 hospital walk-in clinics in five districts of Jakarta were included. Subjects’ parents filled out the M-CHAT-R questionnaire during their visit. A series of questions were asked to provide information about probable risk factors associated with ASD: gender, family history of ASD, preterm birth, low birth weight (LBW), and history of seizures. The second protocol (August to October 2020) was completed by parents via an online form, where 746 children aged 16-30 months were enrolled. Therefore, a total of 965 subjects were eligible for statistical analysis.

Results Of 965 subjects, 56.58% were males. Subjects’ mean of age was 22.59 (SD 4.15) months. M-CHAT-R screening showed that 34 (3.52%) subjects were at high risk of developing ASD. Only male gender was significantly associated with ASD.

Conclusion We screened for ASD in healthy 16-30-month-old Indonesian children. The rate of high-risk M-CHAT-R score was 3.52%. Male gender was a significant risk factor for high-risk M-CHAT-R results.
Epstein-Barr DNA in advanced pediatric nasopharyngeal cancer
Authors: Adham Marlinda , Jelita Namira Kesuma , Gatot Djajadiman , Gondhowiardjo Soehartati Argadikoesoema , Rachmadi Lisnawati , Greijer Astrid E , Tan I Bing , Middeldorp Jaap M
Published: October 2021

Background Studies suggest that the most common type of nasopharyngeal carcinoma (NPC) is WHO-3, which is strongly associated with Epstein-Barr virus (EBV).

Objective To assess NPC patient characteristics in a national general referral hospital in Indonesia, with regards to EBV DNA load and treatment response.

Methods Twenty-three pediatric patients diagnosed with NPC were included in the study. Data collected were history, physical examination, tissue biopsy, CT scan, staging and EBV DNA load from nasopharyngeal (NP) brushing as well as blood specimens. The NP brushing, blood specimens and CT scan evaluations were done two months post-treatment.

Results Pediatric patients with symptoms such as  blood tinged secretion, lymph node enlargement, and nasal congestion were more likely to have higher EBV DNA loads in their NP brushings (P<0.05) (including T3 and higher). Despite significant reduction of EBV DNA load in NP brushing post-treatment, it was not associated with treatment response, as evaluated by CT scan.

Conclusion Higher DNA load from NP brushings is associated with a higher tumor stage. Larger sample size and follow-up data are needed to assess the usefulness of EBV DNA load assessment in pediatric patients.
Clinical profiles of neonates born to mothers with COVID-19
Authors: Jacob Ambili Susan , MTP Mohammed , Gopinath Reetha , Divakaran Binoo , Harris Tariq
Published: October 2021

Background The risk of congenital infections in neonates born to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected mothers and those breastfed by infected mothers remains largely unknown.

Objective To describe the outcomes and clinical features of neonates born to mothers infected with SARS-CoV-2 during pregnancy, to follow up neonates who were positive for SARS-CoV-2 at the time of delivery for a period of 1 month, and to identify potential risk factors associated with disease transmission.

Methods This prospective observational study on neonates born to SARS-CoV-2-infected mothers between June 2020 and January 2021 was carried out after getting written informed consent in a tertiary care government hospital (Government Medical college Kannur, North Kerala, India). The clinical and demographic characteristics of infected mothers were reviewed. Neonates were tested for SARS-CoV-2 infection within 24 hours of birth, with repeat testing on day 5 for those who were negative at birth.  The demographic and clinical characteristics as well as potential risk factors for disease transmission in these neonates were evaluated.

Results A total of 342 neonates (95.3%) were tested for SARS-CoV-2 infection at birth. Rooming-in and breastfeeding was practiced in 75% of at-risk neonates. Fifty neonates tested positive for SARS-CoV-2 infection at birth (14.3%); 293 neonates who tested negative at birth remained so on day 5, except one baby isolated with a caretaker who also tested positive, indicating postnatal infection. There was no statistically significant increased risk of infection in neonates born to SARS-CoV-2-positive mothers compared to those born to mothers who had already become negative at delivery. Mild symptoms were present in 8% of positive neonates. On one-month follow up, all neonates were well and gaining weight.

Conclusion Vertical transmission, in particular transplacental, may be possible in SARS-CoV-2-infected mothers. Maternal infection at the time of delivery is not a predictor for increased vertical transmission compared to mothers whose infections had resolved prior to delivery. Breastfeeding with appropriate hygiene measures is not a risk factor for horizontal transmission.
Valuation of Country Food in Nunavut Based on Energy and Protein Replacement
Authors: Warltier Duncan W. , Landry-Cuerrier Manuelle , Humphries Murray M.
Published: October 2021

Communicating value across the pluralities of Indigenous Peoples’ food systems requires attention to economy and environment, food and wildlife, and the health of the people and that of the land. Valuation of distinct entities is always difficult but often essential to describe collective wealth and well-being, to quantify trade-offs, and to consider compensation when one is compromised for another. Here we estimate the replacement value of Nunavut country food by combining information on the amount and nutritional composition of harvested country food with the nutritional content and local price of store-bought food. Comparing the five-year average of energy and protein available in reported harvest to recommended dietary allowances indicates that 17 of 21 Nunavut communities harvest enough country food to satisfy the protein requirements of all community members. Nunavut’s country food system annually harvests five million kg of protein-rich food from across the territory, which would cost $198 million to purchase as store-bought protein, with a replacement value between $13.19 and $39.67 per kg depending on energy versus protein replacement and the inclusion versus exclusion of store-bought food subsidies. These valuations are higher than most previous estimates of local food value because they are more reflective of the energy and nutrient richness of country food and the high price of store-bought food in northern communities. The country food system is priceless in many, profound ways; better awareness of its energy and protein cost of replacement, together with the breadth of its nutritional and cultural value, may help to ensure local food systems are prioritized in northern food security and economic development initiatives.