bluuebunny/crossref_metadata_2025 huggingface dataset:
Impacts and Burden of Niemann pick Type-C: a patient and caregiver perspective
Authors: Mengel Eugen , Patterson Marc C. , Chladek Michael , Guldberg Christina , í Dali Christine , Symonds Tara , Lloyd-Price Lucy , Mathieson Toni , Crowe Joslyn , Burbridge Claire
Published: November 2021

Background

Niemann-Pick disease type C (NPC) is a debilitating condition that impacts patients’ and caregivers’ quality of life (QOL) and reduces the patient’s life expectancy. Since there is little qualitative research from the perspective of patients and family caregivers, this study explored the impact of NPC on patients’ and caregivers’ daily lives to understand the burden of disease.

Results

A survey of caregivers for patients with NPC and adult patients with NPC (n = 49; patient age: 13 months–65 years) assessed NPC severity, importance of NPC symptoms, and how symptoms impacted patients’ and caregivers’ activities of daily living (ADLs) and health-related QOL (HRQOL). Follow-up interviews with a subset of survey participants (n = 28) explored the ranking of NPC symptom importance and impact on ADLs and HRQOL. Findings indicated that the most important manifestations of NPC were ambulation, swallowing, speech, fine motor skills, and cognition, which were those that had the most significant impact on ADLs and HRQOL. A wide range of ADLs were affected by NPC, mainly eating/drinking and the ability to perform daily tasks, including self-care, communicating, participating in school or work, and moving indoors as well as outside the home. Along with these impacts, there was an increased risk of experiencing dangerous or life-threatening situations leading to loss of patient independence and additional caregiver burden, often requiring changes in lifestyle such as giving up work. All aspects of patients’ and caregivers’ HRQOL were affected. Participants reported feelings of social isolation, loss of enjoyment in activities (patients), and feelings of sadness or worry (caregivers).

Conclusions

Ambulation, swallowing, speech, fine motor skills, and cognition are important manifestations of NPC. ADLs and HRQOL were impaired in the majority of patients as well as their caregivers. The findings were independent of current age, age of onset of symptoms, and level of NPC disease-related disability; however, the impact increased at higher levels of disease disability. Knowing the impact of NPC on patients and caregivers is important for understanding the lived experience of NPC and for identifying potential areas of support.
Retrospective analysis of post-mortem findings in domestic ducks and geese from non-commercial flocks in Sweden, 2011–2020
Authors: Jansson Désirée Seger , Otman Faruk , Bagge Elisabeth , Lindgren Ylva , Etterlin Pernille Engelsen , Eriksson Helena
Published: November 2021

Background

Small poultry flock ownership has become a popular hobby in Europe and North America in recent years but there is a general lack of information regarding bird health and welfare. This retrospective analysis of routine post-mortem cases of non-commercial anseriform poultry aimed at providing information on causes of mortality mostly in relation to mortality events. For this purpose, birds that were submitted for routine post-mortem diagnostics to the National Veterinary Institute (SVA) in Sweden in 2011–2020 were retrospectively reviewed to determine main causes of mortality.

Results

Records from 79 necropsy submissions involving 120 birds (domestic ducks n = 41, Muscovy ducks n = 45, hybrid ducks n = 2 and domestic geese n = 32) were retrieved and analysed. Most submissions (72.2%) represented flock disease events and unexpected mortality was the most common cause of submission (70.9% of submissions). Twenty-two submissions (27.8%) were referred by veterinarians. There was a wide range of diagnoses of infectious and noninfectious aetiologies. Infectious causes of mortality included parasitic (19.2%), bacterial (13.3%), fungal (10.0%) and viral infections (3.3%) (at bird level of all 120 birds). Some of these infections such as duck virus enteritis (DVE), highly pathogenic influenza (HPAI H5N8) in Muscovy ducks and leucocytozoonosis (Leucocytozoon sp.) in all three species were most likely acquired from contact with wild free-living waterfowl. Generalised yeast infection (Muscovy duck disease) was diagnosed in Muscovy ducks and in a Muscovy duck/domestic duck hybrid. Other diseases were related to generalised noninfectious causes (27.5% of all birds) including diseases such as kidney disease, amyloidosis, cardiac dilatation, reproductive diseases and idiopathic inflammatory conditions. Nutritional or management-related diseases were diagnosed in 14.2% of all birds including rickets and gastrointestinal impaction/obstruction. Congenital/developmental, neoplastic, toxic and traumatic causes of mortality were rare.

Conclusions

The information obtained in this study can be used to identify and evaluate risks and help owners and veterinarians to prevent disease and provide adequate veterinary care for non-commercial anseriform poultry.
Surface modification of decellularized bovine carotid arteries with human vascular cells significantly reduces their thrombogenicity
Authors: Keshi Eriselda , Tang Peter , Weinhart Marie , Everwien Hannah , Moosburner Simon , Seiffert Nicolai , Lommel Michael , Kertzscher Ulrich , Globke Brigitta , Reutzel-Selke Anja , Strücker Benjamin , Pratschke Johann , Sauer Igor Maximillian , Haep Nils , Hillebrandt Karl Herbert
Published: November 2021

Background

Since autologous veins are unavailable when needed in more than 20% of cases in vascular surgery, the production of personalized biological vascular grafts for implantation has become crucial. Surface modification of decellularized xenogeneic grafts with vascular cells to achieve physiological luminal coverage and eventually thromboresistance is an important prerequisite for implantation. However, ex vivo thrombogenicity testing remains a neglected area in the field of tissue engineering of vascular grafts due to a multifold of reasons.

Methods

After seeding decellularized bovine carotid arteries with human endothelial progenitor cells and umbilical cord-derived mesenchymal stem cells, luminal endothelial cell coverage (LECC) was correlated with glucose and lactate levels on the cell supernatant. Then a closed loop whole blood perfusion system was designed. Recellularized grafts with a LECC > 50% and decellularized vascular grafts were perfused with human whole blood for 2 h. Hemolysis and complete blood count evaluation was performed on an hourly basis, followed by histological and immunohistochemical analysis.

Results

While whole blood perfusion of decellularized grafts significantly reduced platelet counts, platelet depletion from blood resulting from binding to re-endothelialized grafts was insignificant (p = 0.7284). Moreover, macroscopic evaluation revealed thrombus formation only in the lumen of unseeded grafts and histological characterization revealed lack of CD41 positive platelets in recellularized grafts, thus confirming their thromboresistance.

Conclusion

In the present study we were able to demonstrate the effect of surface modification of vascular grafts in their thromboresistance in an ex vivo whole blood perfusion system. To our knowledge, this is the first study to expose engineered vascular grafts to human whole blood, recirculating at high flow rates, immediately after seeding.
Development of glaucoma predictive model and risk factors assessment based on supervised models
Authors: Sharifi Mahyar , Khatibi Toktam , Emamian Mohammad Hassan , Sadat Somayeh , Hashemi Hassan , Fotouhi Akbar
Published: November 2021

Objectives

To develop and to propose a machine learning model for predicting glaucoma and identifying its risk factors.

Method

Data analysis pipeline is designed for this study based on Cross-Industry Standard Process for Data Mining (CRISP-DM) methodology. The main steps of the pipeline include data sampling, preprocessing, classification and evaluation and validation. Data sampling for providing the training dataset was performed with balanced sampling based on over-sampling and under-sampling methods. Data preprocessing steps were missing value imputation and normalization. For classification step, several machine learning models were designed for predicting glaucoma including Decision Trees (DTs), K-Nearest Neighbors (K-NN), Support Vector Machines (SVM), Random Forests (RFs), Extra Trees (ETs) and Bagging Ensemble methods. Moreover, in the classification step, a novel stacking ensemble model is designed and proposed using the superior classifiers.

Results

The data were from Shahroud Eye Cohort Study including demographic and ophthalmology data for 5190 participants aged 40-64 living in Shahroud, northeast Iran. The main variables considered in this dataset were 67 demographics, ophthalmologic, optometric, perimetry, and biometry features for 4561 people, including 4474 non-glaucoma participants and 87 glaucoma patients. Experimental results show that DTs and RFs trained based on under-sampling of the training dataset have superior performance for predicting glaucoma than the compared single classifiers and bagging ensemble methods with the average accuracy of 87.61 and 88.87, the sensitivity of 73.80 and 72.35, specificity of 87.88 and 89.10 and area under the curve (AUC) of 91.04 and 94.53, respectively. The proposed stacking ensemble has an average accuracy of 83.56, a sensitivity of 82.21, a specificity of 81.32, and an AUC of 88.54.

Conclusions

In this study, a machine learning model is proposed and developed to predict glaucoma disease among persons aged 40-64. Top predictors in this study considered features for discriminating and predicting non-glaucoma persons from glaucoma patients include the number of the visual field detect on perimetry, vertical cup to disk ratio, white to white diameter, systolic blood pressure, pupil barycenter on Y coordinate, age, and axial length.
Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol
Authors: Schmidt Stefan , Dieks Jana-Katharina , Quintel Michael , Moerer Onnen
Published: November 2021

Background

The use of ultrasonography in the intensive care unit (ICU) is steadily increasing but is usually restricted to examinations of single organs or organ systems. In this study, we combine the ultrasound approaches the most relevant to ICU to design a whole-body ultrasound (WBU) protocol. Recommendations and training schemes for WBU are sparse and lack conclusive evidence. Our aim was therefore to define the range and prevalence of abnormalities detectable by WBU to develop a simple and fast bedside examination protocol, and to evaluate the value of routine surveillance WBU in ICU patients.

Methods

A protocol for focused assessments of sonographic abnormalities of the ocular, vascular, pulmonary, cardiac and abdominal systems was developed to evaluate 99 predefined sonographic entities on the day of admission and on days 3, 6, 10 and 15 of the ICU admission. The study was a clinical prospective single-center trial in 111 consecutive patients admitted to the surgical ICUs of a tertiary university hospital.

Results

A total of 3003 abnormalities demonstrable by sonography were detected in 1275 individual scans of organ systems and 4395 individual single-organ examinations. The rate of previously undetected abnormalities ranged from 6.4 ± 4.2 on the day of admission to 2.9 ± 1.8 on day 15. Based on the sonographic findings, intensive care therapy was altered following 45.1% of examinations. Mean examination time was 18.7 ± 3.2 min, or 1.6 invested minutes per detected abnormality.

Conclusions

Performing the WBU protocol led to therapy changes in 45.1% of the time. Detected sonographic abnormalities showed a high rate of change in the course of the serial assessments, underlining the value of routine ultrasound examinations in the ICU.

Trial registration The study was registered in the German Clinical Trials Register (DRKS, 7 April 2017; retrospectively registered) under the identifier DRKS00010428.
Efficacy of manual acupuncture versus placebo acupuncture for generalized anxiety disorder (GAD) in perimenopause women: study protocol for a randomized controlled trial
Authors: Liu Xin , Xie Xiaoyan , Li Yingjia , Li Meichen , Wang Yuting , Wang Nanbu , Zhuang Lixing , Liao Muxi
Published: November 2021

Background

Generalized anxiety disorder (GAD) is common among perimenopausal women. Acupuncture may be an effective treatment for GAD, but evidence is limited. The pathogenesis of GAD is not yet clear, but it is related to the hypothalamic-pituitary-adrenal axis and its excretion, cortisol (CORT), and adrenocorticotropic hormone (ACTH). The object of this study is to evaluate the efficacy of manual acupuncture (MA) versus placebo acupuncture (PA) for perimenopausal women with GAD.

Methods

This study is a single-center, randomized, single-blind clinical trial that will be conducted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine. A total of 112 eligible GAD patients will be randomly assigned (1:1) to receive MA (n=56) or PA (n=56) three times per week for 4 weeks. The primary outcome measure will be the HAMA score. The secondary outcome measures will be the GAD-7 and PSQI scores and the levels of CORT and ACTH. The evaluation will be executed at baseline, 2 weeks, the end of the treatment, and a follow-up 3-month period. All main analyses will be carried out based on the intention-to-treat (ITT) principle.

Discussion

This study intends to compare the efficacy between MA and PA in the treatment of perimenopausal women with GAD and to further study the mechanisms underlying the effect.

Trial registration

Chinese Clinical Trial Registry ChiCTR2100046604. Registered on 22 May 2021.
Lithium and preventing chemotherapy-induced peripheral neuropathy in breast cancer patients: a placebo-controlled randomized clinical trial
Authors: Najafi S. , Heidarali Z. , Rajabi M. , Omidi Z. , Zayeri F. , Salehi M. , Haghighat S.
Published: November 2021

Background

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of some chemotherapy regimens. Lithium has been suggested for CIPN in some animal studies. We aimed to study lithium’s preventive effect on CIPN in breast cancer patients treated with taxanes and platinum-based medications.

Method

A double-blind placebo-controlled randomized clinical trial (RCT) was implemented on 36 breast cancer patients in two equal-size groups by block randomization. Participants in both groups consumed daily tablets, either placebo or lithium (300 mg), for 5 days in each course of chemotherapy. The tablets were prescribed 1 day before the start of chemotherapy. The electromyography (EMG) and nerve-conduction-velocity (NCV) tests were achieved before the first chemotherapy, 3 and 9 months after the treatment. The changes and signs or symptoms of CIPN, such as numbness, tingling, freezing, sensitivity to touch, muscle weakness, fibrillation, and knee and elbow reflex disorders, were recorded by examination. The trend of outcome changes was compared between two groups during the 9 months of study.

Results

In both groups, neurologic signs and symptoms were exacerbated during the first 3 months and improved up to the ninth month of study. Results showed significant changes of all EMG-NCV variables during the 9 months of research in each group (P < 0.001), but the interaction of time and group effect was not significant in none of those indices. All symptoms changed significantly over the study time (P < 0.001) without significant statistical difference between the two groups (P=0.352). No side effect was found during the study.

Conclusion

The study showed that 300 mg lithium prescription once daily for 5 days might not effectively prevent CIPN in breast cancer patients. Evaluation of lithium effect on CIPN on different cancers in future studies is suggested.

Trial registration

Iranian Registry of Clinical Trials IRCT20160813029327N10.  Registration date: May 16, 2018.
Impact of the Covid-19 pandemic on primary care utilization: evidence from Sweden using national register data
Authors: Ekman Björn , Arvidsson Eva , Thulesius Hans , Wilkens Jens , Cronberg Olof
Published: November 2021

Objective

To analyze changes in primary care utilization as a result of the Covid-19 pandemic. Swedish national register data from 2019 to 2020 on utilization of services were used to compare overall utilization levels and across types of contacts and patient groups. A specific objective was to assess the extent to which remote types of patient consultations were able to compensate for any observed fall in on-site visits. Data were stratified by sex and age to investigate any demographic pattern.

Results

Findings show significant reductions in overall utilization of services as the pandemic occurred in the first quarter of 2020. On-site visits fell during the first wave of the pandemic and rebounded thereafter. Patients over 65 years of age appear to have reduced utilization to a larger extent compared with younger groups. Simultaneously, remote contacts increased from around 12% before the pandemic to 17% of the total number of consultations. However, the net effect of changes in service utilization suggests an overall reduction of around 12 percent in the number of primary care consultations as a result of the pandemic. No differences between men and women were observed. Further research will continue to monitor changes in primary care utilization as the pandemic continues.
Saliency-based 3D convolutional neural network for categorising common focal liver lesions on multisequence MRI
Authors: Wang Shu-Hui , Han Xin-Jun , Du Jing , Wang Zhen-Chang , Yuan Chunwang , Chen Yinan , Zhu Yajing , Dou Xin , Xu Xiao-Wei , Xu Hui , Yang Zheng-Han
Published: November 2021

Background

The imaging features of focal liver lesions (FLLs) are diverse and complex. Diagnosing FLLs with imaging alone remains challenging. We developed and validated an interpretable deep learning model for the classification of seven categories of FLLs on multisequence MRI and compared the differential diagnosis between the proposed model and radiologists.

Methods

In all, 557 lesions examined by multisequence MRI were utilised in this retrospective study and divided into training–validation (n = 444) and test (n = 113) datasets. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the performance of the model. The accuracy and confusion matrix of the model and individual radiologists were compared. Saliency maps were generated to highlight the activation region based on the model perspective.

Results

The AUC of the two- and seven-way classifications of the model were 0.969 (95% CI 0.944–0.994) and from 0.919 (95% CI 0.857–0.980) to 0.999 (95% CI 0.996–1.000), respectively. The model accuracy (79.6%) of the seven-way classification was higher than that of the radiology residents (66.4%, p = 0.035) and general radiologists (73.5%, p = 0.346) but lower than that of the academic radiologists (85.4%, p = 0.291). Confusion matrices showed the sources of diagnostic errors for the model and individual radiologists for each disease. Saliency maps detected the activation regions associated with each predicted class.

Conclusion

This interpretable deep learning model showed high diagnostic performance in the differentiation of FLLs on multisequence MRI. The analysis principle contributing to the predictions can be explained via saliency maps.
Detection of lung lesions in breath-hold VIBE and free-breathing Spiral VIBE MRI compared to CT
Authors: Olthof Susann-Cathrin , Reinert Christian , Nikolaou Konstantin , Pfannenberg Christina , Gatidis Sergios , Benkert Thomas , Küstner Thomas , Krumm Patrick
Published: November 2021

Background

Detection of pulmonary nodules in MRI requires fast imaging strategies without respiratory motion impairment, such as single-breath-hold Cartesian VIBE. As patients with pulmonary diseases have limited breath-hold capacities, this study investigates the clinical feasibility of non-Cartesian Spiral VIBE under free-breathing compared to CT as the gold standard.

Methods

Prospective analysis of 27 oncological patients examined in PET/CT and PET/MR. A novel motion-robust 3D ultrashort-echo-time (UTE) MR sequence was evaluated in comparison with CT and conventional breath-hold MR. CT scans were performed under breath-hold in end-expiratory and end-inspiratory position (CT ex, CT in). MR data was acquired with non-contrast-enhanced breath-hold Cartesian VIBE followed by a free-breathing 3D UTE Spiral VIBE. Impact of respiratory motion on pulmonary evaluation was investigated by two readers in Cartesian VIBE, followed by UTE Spiral VIBE and CT ex and the reference standard of CT in. Diagnostic accuracy was calculated, and visual image quality assessed.

Results

Higher detection rate and sensitivity of pulmonary nodules in free-breathing UTE Spiral VIBE in comparison with breath-hold Cartesian VIBE were found for lesions > 10 mm (UTE Spiral VIBE/VIBE/CT ex): 93%/54%/100%; Lesions 5–10 mm: 67%/25%/ 92%; Lesions < 5 mm: 11%/11%/78%. Lobe-based analysis revealed sensitivities and specificities of 64%/96%/41% and 96%/93%/100% for UTE Spiral VIBE/VIBE/CT ex.

Conclusion

Free-breathing UTE Spiral VIBE indicates higher sensitivity for detection of pulmonary nodules than breath-hold Cartesian VIBE and is a promising but time-consuming approach. However, sensitivity and specificity of inspiratory CT remain superior in comparison and should be preferred for detection of pulmonary lesions.
Carboxymethylcellulose excipient allergy: a case report
Authors: Townsend Katherine , Laffan James , Hayman Grant
Published: November 2021

Background

Excipients are widely used in pharmaceuticals, detergents, food, and drink because of their properties of low toxicity and hypoallergenicity. The excipient carboxymethylcellulose is used extensively as a thickener in foods such as baked goods, ice cream, gluten free, and reduced fat products, where it may be labeled as e-number E466. However, excipients can rarely cause type 1 hypersensitivity reactions. Several publications have described systemic allergy following carboxymethylcellulose exposure in pharmaceuticals, particularly systemic corticosteroids. Furthermore, there is one reported case in the literature of anaphylaxis following food containing carboxymethylcellulose.

Case presentation

We identify a case of anaphylaxis in a 45-year-old atopic Caucasian woman on receiving an injectable suspension of the corticosteroid triamcinolone acetonide containing carboxymethylcellulose, and subsequent allergic symptoms on reexposure to carboxymethylcellulose in a commercial drink. Diagnosis of carboxymethylcellulose excipient allergy was confirmed through skin prick testing using Celluvisc carmellose 0.5% eye drops, which contain carboxymethylcellulose as the active ingredient.

Conclusion

This case highlights the importance of identifying excipients such as carboxymethylcellulose as causes of allergy, to reduce burden of further hypersensitivity reactions, not just to drugs but to other consumables.
Molecular differences of adipose-derived mesenchymal stem cells between non-responders and responders in treatment of transphincteric perianal fistulas
Authors: Tencerova Michaela , Lundby Lilli , Buntzen Steen , Norderval Stig , Hougaard Helene Tarri , Pedersen Bodil Ginnerup , Kassem Moustapha
Published: November 2021

Background

Injection of autologous adipose tissue (AT) has recently been demonstrated to be an effective and safe treatment for anal fistulas. AT mesenchymal stem cells (AT-MSCs) mediate the healing process, but the relationship between molecular characteristics of AT-MSCs of the injected AT and fistula healing has not been adequately studied. Thus we aimed to characterize the molecular and functional properties of AT-MSCs isolated from autologous AT injected as a treatment of cryptogenic high transsphincteric perianal fistulas and correlate these findings to the healing process.

Methods

27 patients (age 45 ± 2 years) diagnosed with perianal fistula were enrolled in the study and treated with autologous AT injected around the anal fistula tract. AT-MSCs were isolated for cellular and molecular analyses. The fistula healing was evaluated by MRI scanning after 6 months of treatment. AT-MSC phenotype was compared between responders and non-responders with respect to fistula healing.

Results

52% of all patients exhibited clinical healing of the fistulas as evaluated 6 months after last injection. Cultured AT-MSCs in the responder group had a lower short-term proliferation rate and higher osteoblast differentiation potential compared to non-responder AT-MSCs. On the other hand, adipocyte differentiation potential of AT-MSCs was higher in non-responder group. Interestingly, AT-MSCs of responders exhibited lower expression of inflammatory and senescence associated genes such as IL1B, NFKB, CDKN2A, TPB3,TGFB1.

Conclusion

Our data suggest that cellular quality of the injected AT-MSCs including cell proliferation, differentiation capacity and secretion of proinflammatory molecules may provide a possible mechanism underlying fistula healing. Furthermore, these biomarkers may be useful to predict a positive fistula healing outcome.

Trial registration: NTC04834609, Registered 6 April 2021. https://clinicaltrials.gov/ct2/show/NCT04834609
Applying livestock thresholds to examine poverty in Karamoja
Authors: Catley Andy , Ayele Mesfin
Published: November 2021

In pastoralist and agro-pastoralist areas, wealth and poverty are closely aligned to levels of livestock ownership and social inclusion. Whereas cash income per capita is a useful measure of poverty in non-pastoralist areas, measures of livestock ownership per capita are needed to understand poverty in pastoralist systems. This study estimated a livestock threshold for agro-pastoralist households in Karamoja, being the minimum per capita ownership of livestock needed to sustain a predominantly agro-pastoral livelihood. The study then applied the livestock threshold to pre-existing livestock population data to estimate the proportions of households above and below the threshold. Using an estimated livestock threshold of 3.3 Tropical Livestock Units (TLU)/capita for agro-pastoralism, 56.5% of households in Karamoja’s main livestock-keeping districts were below the threshold and could be categorized as livestock-poor. The ownership of livestock was skewed in two main ways. First, there was a high-end skew with the wealthiest 30% of households owning 69.3% of all livestock in terms of TLU. Second, there was a low-end skew. Among poorer households, below the 3.3 TLU/capita livestock threshold, livestock ownership was skewed away from the threshold. Forty-seven per cent of these households owned only 1.2 TLU/capita or less; 13% of households owned no livestock at all. These findings are discussed, with programming and policy recommendations.
The role of culture in influencing sexual and reproductive health of pastoral adolescent girls in Karamoja sub-region in Uganda
Authors: Achen Stella , Atekyereza Peter , Rwabukwali Charles B.
Published: November 2021

Sexual and reproductive health (SRH) is vital for general health. However, problems of SRH such as unwanted pregnancies, sexually transmitted infections (STIs), and complications during pregnancy and childbirth among adolescents frequently arise due to risky sexual behaviour. Often, this challenge is linked to socio-cultural issues associated with sexuality which result in disparities in the SRH of adolescent girls. Culture provides rules of sexual conduct between sexes which shape knowledge, beliefs, and practices regarding the sexuality of adolescent girls and influence SRH. However, empirical evidence remains scarce on the role of culture in shaping sexuality which affects the SRH of adolescent girls of pastoral communities. This paper explores the role of culture in shaping the SRH of adolescent girls in the pastoral communities of Karamoja sub-region in Uganda. Using the ethnographic method, qualitative data from interviews, key informants, and focus groups was obtained from adolescent girls, key informants, and old women in Moroto District to understand the perceptions of sexuality. The authors made audio recordings and took field notes. Atlas.ti 8.4.15 was used to organize the data which was analysed using thematic analysis. The findings showed that the perception of wealth defines sexuality and influences SRH, social support for sexual assault victims promotes SRH, and beliefs and practices of sexuality shape the SRH of adolescent girls. Promoting a continuous awareness of the harmful cultural practices is vital in attaining SRH among pastoral adolescent girls. Understanding the role of culture in the influence of SRH is important for the effective provision of SRH services.
U2-VC: one-shot voice conversion using two-level nested U-structure
Authors: Liu Fangkun , Wang Hui , Peng Renhua , Zheng Chengshi , Li Xiaodong
Published: November 2021

Voice conversion is to transform a source speaker to the target one, while keeping the linguistic content unchanged. Recently, one-shot voice conversion gradually becomes a hot topic for its potentially wide range of applications, where it has the capability to convert the voice from any source speaker to any other target speaker even when both the source speaker and the target speaker are unseen during training. Although a great progress has been made in one-shot voice conversion, the naturalness of the converted speech remains a challenging problem. To further improve the naturalness of the converted speech, this paper proposes a two-level nested U-structure (U2-Net) voice conversion algorithm called U2-VC. The U2-Net can extract both local feature and multi-scale feature of log-mel spectrogram, which can help to learn the time-frequency structures of the source speech and the target speech. Moreover, we adopt sandwich adaptive instance normalization (SaAdaIN) in decoder for speaker identity transformation to retain more content information of the source speech while maintaining the speaker similarity between the converted speech and the target speech. Experiments on VCTK dataset show that U2-VC outperforms many SOTA approaches including AGAIN-VC and AdaIN-VC in terms of both objective and subjective measurements.
Communication strategies in the prevention of type 2 diabetes and gestational diabetes in vulnerable groups: a scoping review
Authors: Breuing Jessica , Joisten Christine , Neuhaus Annika Lena , Heß Simone , Kusche Lena , Haas Fabiola , Spiller Mark , Pieper Dawid
Published: November 2021

Background

The global prevalence of diabetes is nearly 9%, with an upward trend in type 2 diabetes mellitus (T2DM) and gestational diabetes (GDM). Although evidence shows that vulnerable groups are affected disproportionally, these groups are difficult to reach in terms of preventive measures. Currently, there is no gold standard regarding communication strategies and/or public awareness campaigns.

Methods

We conducted a scoping review in September 2019. Two reviewers independently screened the results of the electronic literature search in several databases, including Medline, EMBASE, and PsycINFO. Extracted data were charted, categorized, and summarized.

Results

All of the included articles (n=24) targeted T2DM; none targeted GDM. We identified the following five different vulnerable groups within the identified studies: migrants (n=9), ethnic groups such as African Americans (n=8), people with low socioeconomic status (n=3), older people (n=1), and people in need of care (n=1). Three categories of communication strategies were identified as follows: adapted diabetes prevention programs (n=21), community health workers (n=5), and technical approaches (n=9).

Conclusion

We found different approaches for preventive interventions for T2DM. Some of these approaches were already adapted to known barriers. Communication strategies should be adapted to barriers and facilitating factors to increase participation and motivation.
The existence of solutions for Sturm–Liouville differential equation with random impulses and boundary value problems
Authors: Li Zihan , Shu Xiao-Bao , Miao Tengyuan
Published: November 2021

In this article, we consider the existence of solutions to the Sturm–Liouville differential equation with random impulses and boundary value problems. We first study the Green function of the Sturm–Liouville differential equation with random impulses. Then, we get the equivalent integral equation of the random impulsive differential equation. Based on this integral equation, we use Dhage’s fixed point theorem to prove the existence of solutions to the equation, and the theorem is extended to the general second order nonlinear random impulsive differential equations. Then we use the upper and lower solution method to give a monotonic iterative sequence of the generalized random impulsive Sturm–Liouville differential equations and prove that it is convergent. Finally, we give two concrete examples to verify the correctness of the results.
Global stability for a new predator–prey model with cross-dispersal among patches based on graph theory
Authors: Gao Yang
Published: November 2021

In this paper, cross-dispersal is considered in a predator–prey model with a patchy environment. A new predator–prey model with cross-dispersal among patches is constructed. A new cross-dispersal matrix is established by the coupling relationship between vertices. First, an existence theorem of the positive equilibrium for the new model is obtained. Secondly, based on the idea of constructing Lyapunov functions and a graph-theoretical approach for coupled systems, sufficient conditions that the positive equilibrium of the new model is globally asymptotically stable in $R^{2n}_{+}$

R
+

2
n

are derived on a network with strongly connected graphs. Thirdly, based on the theory of asymptotically autonomous systems, Lyapunov functions method and graph theory, a stability theorem for the positive equilibrium of the new model is established on a complex network without strongly connected graphs. Finally, two examples are given to illustrate main results.
Prevalence of severe adverse events among health professionals after receiving the first dose of the ChAdOx1 nCoV-19 coronavirus vaccine (Covishield) in Togo, March 2021
Authors: Konu Yao Rodion , Gbeasor-Komlanvi Fifonsi Adjidossi , Yerima Mouhoudine , Sadio Arnold Junior , Tchankoni Martin Kouame , Zida-Compaore Wendpouire Ida Carine , Nayo-Apetsianyi Josée , Afanvi Kossivi Agbélénko , Agoro Sibabe , Salou Mounerou , Landoh Dadja Essoya , Nyansa Atany B. , Boko Essohanam , Mijiyawa Moustafa , Ekouevi Didier Koumavi
Published: November 2021

Background

The coronavirus disease 2019 (COVID-19) vaccines can cause adverse events that can lead to vaccine hesitancy. This study aims at estimating the prevalence of severe adverse events (SAEs) and their associated factors among health professionals vaccinated with ChAdOx1 nCoV-19 vaccine in Togo.

Methods

A cross-sectional study was conducted from March 13th to 19th, 2021 in Togo among health professionals who received the first dose of the vaccine. An online self-administered questionnaire was used to collect sociodemographic and vaccination data. SAEs were defined as one resulting in hospitalization, medical consultation, or inability to work the day following the administration of the vaccine. Data analysis were performed using R© 4.0.1 software, and a 5% significance level was considered.

Results

A total of 1,639 health professionals (70.2% male) with a median age of 32 (interquartile range: 27-40) were enrolled. At least one adverse event was reported among 71.6% of participants (95% CI = [69.3-73.8]). The most commonly reported adverse events were injection site pain (91.0%), asthenia (74.3%), headache (68.7%), soreness (55.0%), and fever (47.5%). An increased libido was also reported in 3.0% of participants. Of the participants who experienced adverse events, 18.2% were unable to go to work the day after vaccination, 10.5% consulted a medical doctor, and 1.0% were hospitalized. The SAEs’ prevalence was 23.8% (95% CI = [21.8-25.9]). Being <30 years (AOR = 5.54; p<0.001), or 30-49 years (AOR = 3.62; p<0.001) and being female (AOR = 1.97; p<0.001) were associated with SAEs.

Conclusions

High prevalence of SAEs have been observed in health professionals in Togo after ChAdOx1 nCoV-19 vaccination especially in young people and females. However, these data are reassuring as they inform on COVID-19 vaccines’ SAE management. Systematic prescription of antalgics or antipyretics could be proposed to young people who get vaccinated.
Cefazolin-induced hemolytic anemia: a case report and systematic review of literature
Authors: Mause Elizabeth , Selim Mohammad , Velagapudi Manasa
Published: November 2021

Background

Cefazolin is a first-generation cephalosporin commonly used for skin and soft tissue infections, abdominal and orthopedic surgery prophylaxis, and methicillin-sensitive staph aureus. Cephalosporins as a whole are known potential inducers of hemolytic anemia; however, mechanism of action is primarily autoimmune, and compared to other drugs, cefazolin is the least common.

Methods

A rare case report of cefazolin-induced hemolytic anemia “CIHA” and a systematic review of CIHA articles in English literature. Two authors performed review of publications and articles were selected based on inclusion and exclusion criteria. A systematic search of the literature yielded 768 entries with five case reports on cefazolin-induced hemolytic anemia.

Case presentation/results

An 80-year-old female with methicillin-sensitive Staphylococcus aureus “MSSA” endocarditis. The patient was started on intravenous “IV” cefazolin that that resulted in hemolytic anemia and eosinophilia. Switching to vancomycin improved hemoglobin level and resolved eosinophilia. Four cefazolin-induced hemolytic anemia case reports and one population-based article with a case reported were analyzed with respect to direct antiglobulin test “DAT” (also known as the direct Coombs test) results, prior penicillin sensitivity, and acute anemia causes exclusion.

Conclusions

CIHA is a rare cause of clinically significant anemia. The diagnosis of drug-induced anemia is one of exclusion. It is important to consider DAT results and prior penicillin sensitivity when evaluating a patient for cefazolin-induced hemolytic anemia. However, the frequency of cefazolin use and resultant anemia necessitates early recognition of hemolytic anemia and prompt discontinuation of cefazolin, especially with long-term use.
Evaluating farmers’ perception toward the effectiveness of agricultural extension services in Ghana and Zambia
Authors: Somanje Albert Novas , Mohan Geetha , Saito Osamu
Published: November 2021

Background

In this study, we present the current situation and the role of agricultural extension services for farmers and indicates the potential solutions for the optimum effectiveness of these services. Thus, we investigate the vital determinants influencing the farmers’ attitudes toward using agricultural extension services in Ghana and Zambia.

Methods

In this study, we used a mixed-method research analysis of data from a household survey of 240 farmers and 8 key informant interviews in the Upper West Region of Ghana and the Southern Province of Zambia.

Results

The significant factors affecting the association of agricultural extension officers with farmers are regular meetings, demand for services and productivity, and the adoption rate of technology. Notably, approaches based on information communication technology indicators include owning cell phones; further, having radio access significantly affects agricultural practices. However, the role of gender, access to credit, and owning a television would influence food safety and nutrition.

Conclusions

Understanding the critical determinants will provide potential solutions to national agricultural research institutes, private research entities, and policymakers to scale-up the effectiveness of agricultural extension services, particularly in Ghana and Zambia.
The relationship between dental anxiety and other kinds of anxiety: a naturalistic, cross-sectional and comparative study
Authors: Valdes-Stauber Juan , Hummel Kevin
Published: November 2021

Background

Dental anxiety is of public health importance because it leads to postponed dental treatment, which comes with health complications. The present study investigated whether there is a correlation between the degree of dental anxiety and other kinds of anxiety and whether there are prognostic factors for the different kinds of anxiety.

Method

In the sample (N = 156) from a dental practice in a large German city, 62% of patients received a check-examination and 38% received dental surgery. The target variables were recorded with validated questionnaires: dental anxiety (IDAF-4c+), subclinical anxiety (SubA), anxiety of negative evaluation (SANB-5), current general anxiety (STAI state), loneliness (LS-S) and self-efficacy (GSW-6). The applied statistics were: t-tests for 31 variables, correlation matrix and multivariate and bivariate regression analyses.

Results

The dental surgery patients displayed more dental anxiety and more dental interventions than the check-examination group. The main result was a positive correlation of all kinds of anxiety with each other, a positive correlation of loneliness and neuroticism with all forms of anxiety and a negative correlation between all forms of anxiety and self-efficacy. Especially dental anxiety is positively associated with other kinds of anxiety. In multivariate regression models only neuroticism is associated with dental anxiety, but feelings of loneliness are positively associated with with the other kinds of anxiety assessed in this study. The higher the self-efficacy, the lower the level of general anxiety.

Conclusions

In dentistry, anxiety from negative experiences with buccal interventions should be distinguished from anxiety caused by personality traits. Self-efficacy tends to protect against anxiety, while loneliness and neuroticism are direct or indirect risk factors for anxiety in this urban dentistry sample. Dental anxiety seems to be independent from biographical strains but not from neuroticism. In practice, more attention must be paid to anxiety control, self-management and efforts to improve the confidence of patients with emotional lability, less self-confidence and propensity to shame.
Preparation of alginate hydrogel microparticles by gelation introducing cross-linkers using droplet-based microfluidics: a review of methods
Authors: Zhang Cheng , Grossier Romain , Candoni Nadine , Veesler Stéphane
Published: November 2021

This review examines the preparation of alginate hydrogel microparticles by using droplet-based microfluidics, a technique widely employed for its ease of use and excellent control of physicochemical properties, with narrow size distribution. The gelation of alginate is realized “on-chip” and/or “off-chip”, depending on where cross-linkers are introduced. Various strategies are described and compared. Microparticle properties such as size, shape, concentration, stability and mechanical properties are discussed. Finally, we consider future perspectives for the preparation of hydrogel microparticles and their potential applications.
Different solutions of the diffusion equation and its applications
Authors: Essa Khaled S. M. , Etman Soad M. , El-Otaify Maha S. , Embaby M. , Mosallem Ahmed M. , Shalaby Ahmed S.
Published: November 2021

In this  report, we solved the advection–diffusion equation under pollutants deposition on the ground surface, taking wind speed and vertical diffusion depend on the vertical height. Also, we estimated a simple diffusion model from point source in an urban atmosphere and the conservative material with downwind was evaluated. Then, we calculated the extreme ground-level concentration as a function of stack height and plume rise in two cases. Comparison between the proposed models and the emission from the Egyptian Atomic Research Reactor at Inshas had been done. Lastly, we discussed the results in this report.
Hyperuricaemia as a predictor of hospital outcome in patients with sepsis: results of a prospective study
Authors: Nadeem Mir , Mir Bilal Ahmad , Waseem Mir , Shah Tabinda Ayub , Raja Rameez
Published: November 2021

Background

Early management of sepsis in the emergency department improves patient outcomes. The identification of at-risk patients for aggressive management by an easily available biomarker could go a long way in the triage of patients in the emergency department. It is postulated that during sepsis, the majority of patients undergo ischaemic reperfusion injury or inflammation, and uric acid with its oxidant and antioxidant properties may be playing some role and, hence, the measurement of uric acid could possibly predict the hospital course in patients with sepsis. We were prompted to undertake this study as serum uric acid estimation is readily available and economical compared to newly evolving biomarkers in sepsis. Estimation of serum uric acid levels on arrival to the emergency department may prove a useful predictor of hospital outcome in patients with sepsis especially in regions with limited resources.

Results

Of 102 patients, 55 (53.9%) were males. The mean age of the study cohort was 63.2 ± 10.48. Patients with higher qSOFA scores had higher uric acid levels on admission. While 12 (11.8%) patients had a septicaemic shock, acute kidney injury was recorded in 48 (47.1%) patients and 11 (10.8%) patients required dialysis. Thirty-four (33.3%) patients had respiratory failure, and of these, 21 (20.6%) patients required mechanical ventilation. The overall median stay in the medical intensive care (MICU) was 3days (range 2–7 days). The patients with higher uric acid levels had higher rates of respiratory failure but did not reach significant levels. In 15 (14.7%) patients, 7 males expired (mortality rate of 14.7%). There was a significant association between SOFA score and mortality. Patients who succumbed to sepsis had higher serum uric acid levels on arrival.

Conclusions

Patients with higher qSOFA scores had higher uric acid levels on admission. Hyperuricaemia predicted acute kidney injury, a requirement of mechanical ventilation and mean hospital stay in patients with sepsis. Further studies may be required to confirm the association.