bluuebunny/crossref_metadata_2025 huggingface dataset:
Fénelon and the political summum malum of self-love
Authors: Englert Gianna
Published: March 2021

In The Political Philosophy of Fénelon, Ryan Hanley argues that Fénelon was a realist who aimed to elevate and educate self-love—rather than resist it—in order to avoid tyranny. This roundtable article examines two of Fenelon’s arguments for how self-love, well-directed, could circumvent a king’s absolutist and tyrannical inclinations: 1) the king’s need to be loved and to love in turn, and 2) the relationship between faith and politics / church and state. Contrasting Fénelon with Machiavelli, I question whether the ruler’s “need-love” for his people leaves him susceptible to forms of domination or at least, as Machiavelli warned, renders them politically weak. Given Hanley’s interest to recover Fénelon for the present day, I conclude by arguing that the thinker’s insights about the limiting role of well-directed self-love are inescapably tied to his critiques of absolutism. The same need-love of the people, I argue, cannot similarly check executive power under democracy. Nonetheless, Fénelon’s perspective remains valuable, as does Hanley’s project of recovery, since democracies continue to reckon with particular problems raised by self-love.
“He's under oath”: Privacy and Confidentiality Views Among People Who Inject Drugs Enrolled in a Study of Social Networks and Human Immunodeficiency Virus/Hepatitis C Virus Risk
Authors: Abadie Roberto , Fisher Celia , Dombrowski Kirk
Published: March 2021

Despite the promise of social network research, this method raises important ethical questions regarding privacy and confidentiality. Although researchers and bioethicists have considered research obligations in relation to marginal or vulnerable populations, the views of people who inject drugs (PWIDs) have not been sufficiently considered. To elicit participants’ views of research obligations, we conducted in-depth interviews with a subset ( n = 40) of active PWIDs enrolled in a large social network study. Findings suggest participants have an expectation of confidentiality but believe this obligation need not be absolute and can be waived if a participant violates community norms or place others at risk. Ethics boards should recognize that marginalized populations are able to articulate complex moral views about privacy and confidentiality. Engaging participants in dialogue about the responsible conduct of research presents an opportunity to correct under- or overestimations of research vulnerabilities when such decisions are restricted to the perspectives of investigators or Institutional Review Board members.
Immediate and Delayed Reactions to Trauma-related Laboratory Research Among Rape Survivors and Controls
Authors: Lawyer Steven R. , Holcomb Brittney M. , Příhodová Kateřina
Published: March 2021

Ethical implications of laboratory-based experimental trauma research are not well studied. Female rape survivors ( N = 62) and controls ( N = 79) listened to an audio recording of a sexual assault and completed mental health measures and the Reactions to Research Participation Questionnaire-Revised in the first session and again several weeks later. In the first session, mental health symptoms were associated with stronger emotional reactions and personal benefits from participation. Rape survivors also reported stronger emotional reactions than controls, but also more personal benefits, more satisfaction, and fewer perceived drawbacks from participation. Several weeks later, both groups reported diminished posttraumatic stress disorder symptoms and rape survivors’ reports of stronger emotional reactions and greater satisfaction with their participation remained significant. Benefit–cost ratios indicate positive responses to participation across groups and time. Findings suggest significant benefits to laboratory trauma research for participants.
Percutaneous endoscopic gastrostomy feeding effects in patients with neurogenic dysphagia and recurrent pneumonia
Authors: Lee Jung Hwan , Kwon Hea Yoon , Kwon Kye Sook , Park Soo-Hyun , Suh Young Ju , Kim Jung-Soo , Kim Hyungkil , Shin Yong Woon
Published: March 2021

Background:

Percutaneous endoscopic gastrostomy (PEG) feeding provides enteral nutrition to patients with neurological dysphagia. However, the conditions in which PEG should be applied to prevent pneumonia remain unclear. We aimed to evaluate the effect of PEG for patients with neurological dysphagia in preventing pneumonia.

Methods:

We undertook a retrospective data review of 232 patients with neurological dysphagia who had undergone PEG from January 2008 to December 2018 at Inha University Hospital, in Incheon, Korea. We excluded patients who had not been followed up 6 months pre- and post-PEG feeding. In total, our study comprised 42 patients. We compared pneumonia episodes and incidence pre- and post-PEG.

Results:

During the median post-PEG follow-up period, the 6-month pneumonia incidence among patients who had undergone PEG had decreased [median 0.3 (interquartile range (IQR) 0.0–0.7) versus 0.1 (IQR 0.1–0.3) episodes, p = 0.04]. In a multiple mixed model, PEG did not decrease the incidence of pneumonia ( p = 0.76). However, the association between PEG and the incidence of pneumonia differed significantly depending on the presence or absence of recurrent pneumonia ( p < 0.001).

Conclusions:

PEG could effectively reduce the incidence of pneumonia in patients with neurogenic dysphagia, especially in those who had experienced recurrent pneumonia. The reviews of this paper are available via the supplemental material section.
Why Do Generation Y Consumers Adopt Online Luxury Technologies: A Values Approach
Authors: Erdogmus Irem Eren , Eskiyenentürk Gülsu , Karakaya Arslan Melisa
Published: March 2021

This paper investigates how luxury values act as antecedents of Generation Y consumer’s adoption of online luxury purchasing technologies. Research findings based on 509 Generation Y luxury consumers in Turkey reveal that well-accepted luxury consumer values-namely functional, hedonic, social values -as well as product availability play a significant role on Generation Y consumers’ acceptance of online luxury purchasing technologies. Price consciousness value, which is an essential consumer value of online marketing, is not a significant antecedent in the model. Furthermore, the results of the study also demonstrate that perceived ease of use does not directly impact attitude toward purchasing luxury online. In that way, this research extends the technology acceptance model for online luxury purchasing. Based on the findings, key theoretical and practical implications are explored and discussed.
Extension of the Scope of Anionic Phospholipid-Based Nanoformulation to Kaempferol and Indometacin
Authors: Uchida Noriyuki , Yanagi Masayoshi , Shimoda Kei , Hamada Hiroki
Published: March 2021

In this work, resveratrol was dispersed with anionic phospholipids of 1,2-dipalmitoyl-sn-glycero-3-phosphorylglycerol (DPPG), 1,2-dipalmitoyl-sn-glycero-3-phosphatidic acid, and 1,2-distearoyl-sn-glycero-3-phosphoglycerol. Moreover, small-sized nanoparticles of kaempferol and indometacin were successfully prepared by using DPPG as a dispersion agent.
The use of an automated electronic registry for bladder cancer surveillance during the SARS-CoV-2 pandemic
Authors: O’Meara S , Byrnes KG , Nic An Ríogh AU , Little DM , Davis NF
Published: March 2021

Introduction:

We aimed to develop and compare the utility of an automated registry of all patients undergoing surveillance for non-muscle invasive bladder cancer (NMIBC) during the severe acute respiratory virus coronavirus 2 (SARS-CoV-2) pandemic.

Methods:

We populated an electronic register of all patients undergoing bladder tumour surveillance (July–September 2019). The computerised ‘traffic-light’ system was implemented in September 2019 marking the beginning of phase 2. The register was audited at two- and six-months intervals during phase 2 (November 2019 and April 2020). Audit of the system In April 2020 allowed review of care given during the peak of the SARS-CoV-2 pandemic in Ireland. The primary outcome variable was the number of patients who had delayed surveillance cystoscopy in each group.

Results:

A total of 278 cases were reviewed, 96 in the first cohort and 91 at both intervals of second phase. During the first phase of the audit 17 patients (17.7%) had a missed cystoscopy. Phase 2 showed a sustained decrease in the number of patients with missed surveillance, with eight (8.8%) missing their procedure in both the November and April (SARS-CoV-2) cohorts (17 v. 8, X2 = 10.76, p = 0.0004). Overall, most patients had their procedure done within the recommended time interval (245, 88%).

Conclusion:

A centralised accessible computerised registry of patients with NMIBC undergoing surveillance is superior to traditional manual surveillance methods, especially during the period of SARS-CoV-2. Going forward we aim to have all patients undergo surveillance within schedule with a long-term goal of a centralised national registry.

Level of evidence:

Level 2c: “Outcomes Research”.
US media’s coverage of China’s handling of COVID-19: Playing the role of the fourth branch of government or the fourth estate?
Authors: Jia Wenshan , Lu Fangzhu
Published: March 2021

The present study is an analysis of a sample of reports on China’s handling of COVID-19 by several major US media with a focus on a controversial op-ed by the Wall Street Journal. It is found that instead of covering it objectively as a public health crisis, these media reports tend to adopt the strategy of naming, shaming, blaming, and taming against China. In other words, they seize the outbreak of COVID-19 in Wuhan as an opportunity to serve Trump’s “America First” doctrine by a coordinated attempt to destroy the Chinese dream and arresting China’s ascendency. First, the naming/shaming technique is used to tarnish China’s image as a virus. The op-ed on the Wall Street Journal describes China as “the real sick man of Asia.” In addition, a cluster of ferociously negative names are slung onto China to describe the coronavirus as “the Wuhan virus,” “the Belt & Road Initiative pandemic,” “the China virus,” and so on. Second, the blaming technique is applied. On top of such negative name-calling, these media tend to blame the Chinese leadership, the political system, and finally Chinese food culture for eating pangolins. Finally, the taming technique is used to constrain, isolate, or quarantine China. One goal behind such a China threat strategy is to fan American or foreign businesses to move (back) to the United States out of China. Another goal is to create the public opinion environment that would be conducive to some American groups’ litigations against China. It is concluded that American mainstream media while quarreling with the Trump administration for domestic affairs seem to be colluding with the conservative intellectual base in the United States in supporting Trump’s strategy to knock down and divide China.
The end of China’s romance with Central and Eastern Europe
Authors: Kavalski Emilian
Published: March 2021

The 2016 Mandopop hit ‘Prague square’ ushered in a new romance for Central and Eastern Europe (CEE) in China. Such infatuation has resonated not only in popular culture, but was mirrored in China’s newfound boldness on the international stage. Drawing on CEE media accounts, the article demonstrates that China’s romance with the CEE countries was never reciprocated. In fact, the CEE region might present a significant outlier in that media accounts of China have been consistently negative in the decade preceding the Covid-19 pandemic. In other words, the pandemic merely accelerated trends that were already set in motion prior to 2020. In this respect, CEE media accounts of both China and the Covid-19 pandemic reveal an interesting ‘localization of the other’. As such, China has been used to validate specific domestic positions of different political formations. Perceptions of China (what it is assumed to stands for) have been deployed domestically in the CEE region to justify particular visions of the state and its international identity.
Implementing an Electronic Medical Record Osteoporosis Self-Assessment Tool Score Which Identifies Patients at Risk for Osteoporosis Promotes Osteoporosis Evaluation
Authors: Johnson Taylor , Fox Edward , Hassanbein Sue
Published: March 2021

Introduction:

Osteoporosis affects nearly half of the U.S. population. Screening methods are improving but remain inadequate, leaving the disease underdiagnosed and undertreated. The purpose of this study is to determine the effectiveness of an EMR implemented system that identifies patients at risk for osteoporosis via an OST (osteoporosis screening tool) score in prompting patients toward osteoporosis evaluation.

Methods:

OST scores are generated on every patient 50 years of age and older that is admitted to the Penn State Hershey Medical Center (PSHMC) and recorded in their electronic medical record. An OST score < 2 indicates that a patient has a potential risk for osteoporosis. Information Technology (IT) implemented the EMR OST calculation, which currently generates a daily filtered list of all patients with an OST score <2; patients with an OST score < 2 are then mailed letters approximately 3 months after their admission informing them of their risk for osteoporosis and suggesting that they schedule a follow-up appointment with a physician for further evaluation. To test the effectiveness of this system in prompting patients toward osteoporosis evaluation, approximately 3 months after letters were mailed, the patients were contacted via telephone and asked a series of questions to determine if the patients had sought osteoporosis evaluation.

Results:

In the intervention group, 67 (58.26%) of 115 did not schedule a follow-up, while the remaining 48 (41.74%) did seek a follow-up. Thus, the patient follow-up response rate improved with letter intervention using the OST score as an indicator (P < .0001) compared to historical controls (14.29%).

Conclusion:

Implementing an EMR OST score which identifies patients at risk for osteoporosis, which generates an automatic letter to the patient, significantly promotes patient driven osteoporosis evaluation compared to historical controls.
Implementation of a Multidisciplinary “Code Hip” Protocol is Associated with Decreased Time to Surgery and Improved Patient Outcomes
Authors: VanTienderen Richard J. , Bockelman Kyle , Khalifa Rami , Reich Michael S. , Adler Adam , Nguyen Mai P.
Published: March 2021

Background:

The purpose of this study is to report outcomes data based on the implementation of a “Code Hip” protocol, a multidisciplinary approach to the care of fragility hip fracture patients focussing on medical optimization and early operative intervention. We hypothesized that implementation of this protocol would decrease time from presentation to surgical intervention and improve outcomes based on short term post-operative data.

Methods:

A retrospective chart review was performed on all patients aged greater than 65 years old with a fragility hip fracture from October 2015 through June 2018. In addition to demographic and patient factors, we recorded time to surgery, type of surgical interventions performed, ability to ambulate in the post-operative period, 90-day post-operative complications and overall hospital cost.

Results:

There were 114 patients in the pre-Code Hip cohort and 132 patients in the post-Code Hip cohort. Demographic factors were not different between the 2 cohorts. Time from presentation to surgery in the post-Code Hip cohort was shorter at 23.1 ± 16.4 hours versus 33.2 ± 27.2 hours (p < 0.001). 30.3% of patients in the post-Code Hip cohort had at least one post-operative complication compared to 42.1% in the pre-Code Hip cohort (RR = 0.72, CI = 0.51 -1.01, p = 0.05). The post-Code Hip cohort had a significantly lower rate of hospital readmission (p = 0.04), unplanned reoperation (p = 0.02), surgical site infection (p = 0.03), and sepsis (p = 0.05). Total hospital cost per patient decreased from an average of $14,079 +/- $10,305 pre-Code Hip cohort to $11,744 +/- $4,174 per patient in the post-Code Hip cohort (p = 0.02).

Conclusions:

Implementation of our Code Hip protocol, which invokes a multidisciplinary approach to the elderly patient with a fragility hip fracture, is associated with shorter times from presentation to surgery, increased ability to ambulate post-operatively, decreased short term post-operative complication, and decreased hospital costs.

Level of Evidence:

Therapeutic Level III
Attitudes and Perceptions Toward Voice-Operated Smart Speakers Among Low-Income Senior Housing Residents: Comparison of Pre- and Post-Installation Surveys
Authors: Chung Jane , Bleich Michael , Wheeler David C. , Winship Jodi M. , McDowell Brooke , Baker David , Parsons Pamela
Published: March 2021

Smart speakers have the potential to support independent living and wellness among low-income senior housing (LISH) residents. The aim of this study was to examine and compare LISH residents’ attitudes and perceptions toward smart speakers at two time points: before and after technology use ( N = 47). A descriptive survey was administered to ask questions about hedonic motivation, perceived ease of use, self-efficacy, perceived usefulness of some potential or existing smart speaker features, cost, and privacy. Participants were initially favorable toward using a smart speaker and its digital agent (e.g., Alexa) as a daily assistant and wellness tool. They especially liked the smart speaker’s potential functionality of detecting harmful events and notifying someone to receive immediate help. The comparison of pre- and post-use responses revealed non-significant declines in most items, with the exception of willingness to use Alexa as a reminder system ( p < .01), asking Alexa for help ( p < .01), and asking for help in using Alexa ( p < .01). This finding may reflect confusion or frustration with the device among participants. We conclude with recommendations for the design of smart speakers specifically tailored to the needs of LISH residents.
Post-Translational Modification of Cysteines: A Key Determinant of Endoplasmic Reticulum-Mitochondria Contacts (MERCs)
Authors: Bassot Arthur , Chen Junsheng , Simmen Thomas
Published: March 2021

Cells must adjust their redox state to an ever-changing environment that could otherwise result in compromised homeostasis. An obvious way to adapt to changing redox conditions depends on cysteine post-translational modifications (PTMs) to adapt conformation, localization, interactions and catalytic activation of proteins. Such PTMs should occur preferentially in the proximity of oxidative stress sources. A particular concentration of these sources is found near membranes where the endoplasmic reticulum (ER) and the mitochondria interact on domains called MERCs (Mitochondria-Endoplasmic Reticulum Contacts). Here, fine inter-organelle communication controls metabolic homeostasis. MERCs achieve this goal through fluxes of Ca2+ ions and inter-organellar lipid exchange. Reactive oxygen species (ROS) that cause PTMs of mitochondria-associated membrane (MAM) proteins determine these intertwined MERC functions. Chronic changes of the pattern of these PTMs not only control physiological processes such as the circadian clock but could also lead to or worsen many human disorders such as cancer and neurodegenerative diseases.
Intimate Partner Violence, Anxiety, and Depression in Women with Sexually Transmitted Infections—A Hospital-based Case Control Study
Authors: Bondade Swapna , Hosthota Abhineetha , Karthik K.N.  , Raj Raghul
Published: March 2021

Background:

Sexually transmitted infections (STIs) have complex relationship with mental health and intimate partner violence (IPV) causing community health concern among adolescents and young adults. Women encounter behavioral, psychological, and reproductive health consequences of violence affecting across their lifespan.

Aim:

To determine IPV anxiety and depression in women with STIs.

Methods and materials:

It is a hospital-based cross-sectional study. A total of 115 consecutive females between 18 and 45 years of age who attended STI clinic were enrolled. Sociodemographic details were collected by semi-structured pro forma. IPV was assessed by World Health Organization violence against women instrument; Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale were applied to assess severity of anxiety and depression.

Results:

Mean age of subjects was 31.21 ± 9.08 years. About 55% of the patients had history of IPV. Psychiatric comorbidities noted in 66% of patients. The odds of IPV were more with history of child abuse, suicidal ideation, and substance abuse in husband.

Conclusion:

IPV, anxiety, and depression in STI are in the primitive stage of validation due to associated stigma and lack of awareness. It is high time to divulge dormant triggering factors to protect vulnerable population. Current research should focus on education and women empowerment to prevent STI and mental health issues.
Correction to: Identification of highly conserved, serotype-specific dengue virus sequences: implications for vaccine design
Authors: Chong Li Chuin , Khan Asif M.
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Mutant glucocorticoid receptor binding elements on the interleukin-6 promoter regulate dexamethasone effects
Authors: Chang Wen-Teng , Hong Ming-Yuan , Chen Chien-Liang , Hwang Chi-Yuan , Tsai Cheng-Chieh , Chuang Chia-Chang
Published: March 2021

Background

Glucocorticoids (GCs) have been extensively used as essential modulators in clinical infectious and inflammatory diseases. The GC receptor (GR) is a transcription factor belonging to the nuclear receptor family that regulates anti-inflammatory processes and releases pro-inflammatory cytokines, such as interleukin (IL)-6.

Results

Five putative GR binding sites and other transcriptional factor binding sites were identified on theIL-6 promoter, and dexamethasone (DEX) was noted to reduce the lipopolysaccharide (LPS)-induced IL-6 production. Among mutant transcriptional factor binding sites, nuclear factor-kappa B (NF-κB), activator protein (AP)-1, and specificity protein (Sp)1–2 sites reduced basal and LPS-induced IL-6 promoter activities through various responses. The second GR binding site (GR2) was noted to play a crucial role in both basal and inducible promoter activities in LPS-induced inflammation.

Conclusions

We concluded that selective GR2 modulator might exert agonistic and antagonistic effects and could activate crucial signaling pathways during the LPS-stimulated inflammatory process.
Sex effects on clinical features in LRRK2 G2385R carriers and non-carriers in Parkinson's disease
Authors: Cui Shi-Shuang , Fu Rao , Du Juan-Juan , Lin Yi-Qi , Huang Pei , Gao Chao , Zhou Hai-Yan , Chen Sheng-Di
Published: March 2021

Background

Differences of genotypes between male and female have been studied in Parkinson’s disease (PD), but limited research has focused on the comparison between sexes with LRRK2 G2385 variant.

Objective

The aim of this study was to explore sex effects in the same genetic subtype and role of leucine-rich repeat kinase 2 (LRRK2) G2385R variants in the same sex in PD.

Methods

613 PD patients were recruited from the Movement Disorders Clinic in Ruijin Hospital. We did not include healthy controls in this study. The data collected includes demographic information, disease history, scores of motor and non-motor symptoms scales, midbrain transcranial sonography and DNA. Binary logistic regression analysis was performed to evaluate the association between clinical features and sex in LRRK2 G2385R carriers and non-carriers, as well as the association between the clinical features and LRRK2 G2385R variants in male and female sex.

Results

Sex distribution is similar in LRRK2 G2385R carriers and non-carriers. In male sex, LRRK2 G2385R carriers showed lower risk in cognitive impairment compared with non-carriers (OR = 0.301, p = 0.003, 95%CI 0.135–0.668). In female sex, LRRK2 G2385R carriers showed lower risk in autonomic dysfunction compared with non-carrier (OR = 0.401, p = 0.040, 95%CI 0.167–0.960). In LRRK2 G2385R non-carriers, female sex showed lower risk of impairment in activity of daily living (OR = 0.610, p = 0.021, 95%CI 0.400–0.928), excessive daytime sleepiness (OR = 0.555, p = 0.007, 95%CI 0.361–0.853), substantia nigra hyperechogenicity (OR = 0.448, p = 0.019, 95%CI 0.228–0.878), autonomic dysfunction frequency (OR = 0.626, p = 0.016, 95%CI 0.428–0.917) and higher risk in mood disorders (OR = 1.691, p = 0.022, 95%CI 1.078–2.654) compared with male. In LRRK2 G2385R carriers, female sex showed a lower risk of autonomic dysfunction (OR = 0.294, p = 0.024, 95%CI 0.102–0.849) compared with male.

Conclusion

In contrast to male PD patients, a more benign disease course was observed in female in both LRRK2 G2385R carriers and non-carriers. However, sex differences were less notable in PD with LRRK2 G2385R variants.
Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study
Authors:   EN-BIRTH Study Group, Tahsina Tazeen , Hossain Aniqa Tasnim , Ruysen Harriet , Rahman Ahmed Ehsanur , Day Louise T. , Peven Kimberly , Rahman Qazi Sadeq-ur , Khan Jasmin , Shabani Josephine , KC Ashish , Mazumder Tapas , Zaman Sojib Bin , Ameen Shafiqul , Kong Stefanie , Amouzou Agbessi , Lincetto Ornella , El Arifeen Shams , Lawn Joy E.
Published: March 2021

Background

Immediate newborn care (INC) practices, notably early initiation of breastfeeding (EIBF), are fundamental for newborn health. However, coverage tracking currently relies on household survey data in many settings. “Every Newborn Birth Indicators Research Tracking in Hospitals” (EN-BIRTH) was an observational study validating selected maternal and newborn health indicators. This paper reports results for EIBF.

Methods

The EN-BIRTH study was conducted in five public hospitals in Bangladesh, Nepal, and Tanzania, from July 2017 to July 2018. Clinical observers collected tablet-based, time-stamped data on EIBF and INC practices (skin-to-skin within 1 h of birth, drying, and delayed cord clamping). To assess validity of EIBF measurement, we compared observation as gold standard to register records and women’s exit-interview survey reports. Percent agreement was used to assess agreement between EIBF and INC practices. Kaplan Meier survival curves showed timing. Qualitative interviews were conducted to explore barriers/enablers to register recording.

Results

Coverage of EIBF among 7802 newborns observed for ≥1 h was low (10.9, 95% CI 3.8–21.0). Survey-reported (53.2, 95% CI 39.4–66.8) and register-recorded results (85.9, 95% CI 58.1–99.6) overestimated coverage compared to observed levels across all hospitals. Registers did not capture other INC practices apart from breastfeeding. Agreement of EIBF with other INC practices was high for skin-to-skin (69.5–93.9%) at four sites, but fair/poor for delayed cord-clamping (47.3–73.5%) and drying (7.3–29.0%). EIBF and skin-to-skin were the most delayed and EIBF rarely happened after caesarean section (0.5–3.6%). Qualitative findings suggested that focusing on accuracy, as well as completeness, contributes to higher quality with register reporting.

Conclusions

Our study highlights the importance of tracking EIBF despite measurement challenges and found low coverage levels, particularly after caesarean births. Both survey-reported and register-recorded data over-estimated coverage. EIBF had a strong agreement with skin-to-skin but is not a simple tracer for other INC indicators. Other INC practices are challenging to measure in surveys, not included in registers, and are likely to require special studies or audits. Continued focus on EIBF is crucial to inform efforts to improve provider practices and increase coverage. Investment and innovation are required to improve measurement.
Kangaroo mother care: EN-BIRTH multi-country validation study
Authors:   EN-BIRTH Study Group, Salim Nahya , Shabani Josephine , Peven Kimberly , Rahman Qazi Sadeq-ur , KC Ashish , Shamba Donat , Ruysen Harriet , Rahman Ahmed Ehsanur , KC Naresh , Mkopi Namala , Zaman Sojib Bin , Shirima Kizito , Ameen Shafiqul , Kong Stefanie , Basnet Omkar , Manji Karim , Kabuteni Theopista John , Brotherton Helen , Moxon Sarah G. , Amouzou Agbessi , Hailegebriel Tedbabe Degefie , Day Louise T. , Lawn Joy E.
Published: March 2021

Background

Kangaroo mother care (KMC) reduces mortality among stable neonates ≤2000 g. Lack of data tracking coverage and quality of KMC in both surveys and routine information systems impedes scale-up. This paper evaluates KMC measurement as part of the Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study.

Methods

The EN-BIRTH observational mixed-methods study was conducted in five hospitals in Bangladesh, Nepal and Tanzania from 2017 to 2018. Clinical observers collected time-stamped data as gold standard for mother-baby pairs in KMC wards/corners. To assess accuracy, we compared routine register-recorded and women’s exit survey-reported coverage to observed data, using different recommended denominator options (≤2000 g and ≤ 2499 g). We analysed gaps in quality of provision and experience of KMC. In the Tanzanian hospitals, we assessed daily skin-to-skin duration/dose and feeding frequency. Qualitative data were collected from health workers and data collectors regarding barriers and enablers to routine register design, filling and use.

Results

Among 840 mother-baby pairs, compared to observed 100% coverage, both exit-survey reported (99.9%) and register-recorded coverage (92.9%) were highly valid measures with high sensitivity. KMC specific registers outperformed general registers. Enablers to register recording included perceptions of data usefulness, while barriers included duplication of data elements and overburdened health workers. Gaps in KMC quality were identified for position components including wearing a hat. In Temeke Tanzania, 10.6% of babies received daily KMC skin-to-skin duration/dose of ≥20 h and a further 75.3% received 12–19 h. Regular feeding ≥8 times/day was observed for 36.5% babies in Temeke Tanzania and 14.6% in Muhimbili Tanzania. Cup-feeding was the predominant assisted feeding method. Family support during admission was variable, grandmothers co-provided KMC more often in Bangladesh. No facility arrangements for other family members were reported by 45% of women at exit survey.

Conclusions

Routine hospital KMC register data have potential to track coverage from hospital KMC wards/corners. Women accurately reported KMC at exit survey and evaluation for population-based surveys could be considered. Measurement of content, quality and experience of KMC need consensus on definitions. Prioritising further KMC measurement research is important so that high quality data can be used to accelerate scale-up of high impact care for the most vulnerable.
Psycho-social factors associated with high depressive symptomatology in female adolescents and gender difference in adolescent depression: an epidemiological survey in China’s Hubei Province
Authors: Sun Wenzhe , Mei Junhua , Wang Yanyan , Zhao Xin , Zhu Zhou , Zhang Chenyan , Pan Chensheng , Li Guo , Chen Yuxi , Miao Jinfeng , Lan Yan , Qiu Xiuli , Xu Yi
Published: March 2021

Background

Exploring etiological clues to adolescent depression, especially in female adolescents, might be helpful to improve the social environment of female adolescents. The aim at this study is to explore psycho-social factors of female adolescents with high depressive symptomatology and gender differences in depressive symptoms among Chinese adolescents.

Method

We examined 4100 adolescents from Wuhan city and Jianli county via a cross-sectional study. Depressive symptomatology was screened through the Chinese version of Center for Epidemiology Studies Depression Scale. Multivariate logistic regression was performed to explore the factors related to high depressive symptomatology in female and male adolescents, respectively.

Results

The prevalence of high depressive symptomatology in female and male were 38.9 and 30.2% respectively. The psycho-social factors of high depressive symptomatology in female adolescents were age (Adjusted odds ratio [aOR] = 1.201, 95% confidence interval [CI], 1.076 ~ 1.341), single parent family (aOR = 2.004, 95%CI, 1.448 ~ 2.772) and fathers’ education level (compared to primary school and below, [Junior middle school, aOR = 0.641, 95%CI, 0.439 ~ 0.934; Senior middle school, aOR = 0.603, 95%CI, 0.410 ~ 0.888; College degree and above, aOR = 0.639, 95%CI, 0.437 ~ 0.936]).

Conclusion

Fathers’ education level was associated with high depressive symptomatology in female adolescents. Female adolescents whose father with primary school education or below deserves more attention. Further epidemiologic researches need to be conducted to explore the different risk factors between female and male adolescents in China.
Psychometric properties of the social interaction anxiety scale and the social phobia scale in Hungarian adults and adolescents
Authors: Zsido Andras N. , Varadi-Borbas Brigitta , Arato Nikolett
Published: March 2021

Background

Although social anxiety disorder is one of the most frequent disorders, it often remained unrecognized. Utilizing brief, yet reliable screening tools, such as the Social Interaction Anxiety Scale (SIAS-6) and the Social Phobia Scale (SPS-6) are helping to solve this problem in parts of Western Europe and the US. Still some countries, like Hungary, lag behind. For this purpose, previous studies call for further evidence on the applicability of the scales in various populations and cultures, as well as the elaborative validity of the short forms. Here, we aimed to provide a thorough analysis of the scales in five studies. We employed item response theory (IRT) to explore the psychometric properties of the SIAS-6 and the SPS-6 in Hungarian adults (n = 3213, age range:19–80) and adolescents (n = 292, age range:14–18).

Results

In both samples, IRT analyses demonstrated that the items of SIAS-6 and SPS-6 had high discriminative power and cover a wide range of the latent trait. Using various subsamples, we showed that (1) the scales had excellent convergent and divergent validity in relation to domains of anxiety, depression, and cognitive emotion regulation in both samples. Further, that (2) the scales discriminated those with a history of fainting or avoidance from those without such history. Lastly, (3) the questionnaires can discriminate people diagnosed with social anxiety disorder (n = 30, age range:13–71) and controls.

Conclusions

These findings suggest that the questionnaires are suitable for screening for SAD in adults and adolescents. Although the confirmation of the two-factor structure may be indicative of the validity of the “performance only” specifier of SAD in DSM-V, the high correlation between the factors and the similar patter of convergent validity might indicate that it is not a discrete entity but rather a part of SAD; and that SAD is latently continuous.
The evaluation of degeneration of posterior cruciate ligament using CT Hounsfield unit in knee osteoarthritis
Authors: Sumida Yoshikazu , Nakasa Tomoyuki , Ishikawa Masakazu , Nakamae Atsuo , Adachi Nobuo
Published: March 2021

Background

Posterior cruciate ligament (PCL) degeneration is often seen in knee osteoarthritis (OA); however, there is no established method for its evaluation. The purpose of this study is to investigate whether the Hounsfield unit (HU) using computed tomography (CT) could be a useful scale to evaluate the degeneration of PCL in knee OA.

Methods

Knee OA treated with total knee arthroplasty (21 patients, 21 knees) and non-osteoarthritic knees (21 patients, 21 knees) were retrospectively observed and studied. All PCLs in the knees were analyzed using CT. The PCL in the sagittal section was divided into three regions: proximal, middle, and distal sections. The HU value of the PCL at each area was measured. In osteoarthritic knees, tissues from the PCL were collected and histologically graded. The correlation between the radiological classification by Kellgren and Lawrence and the histological grade was analyzed. The average CT HU values for each degenerative grade were also calculated and compared.

Results

The HU values in OA and non-OA were 70.7 and 88.4 HU (p < 0.05) at the proximal region, 75.7 and 85.3 HU (p < 0.05) in the central region, and 82.3 and 86.5 HU (p > 0.05) in the distal region, respectively. The degeneration of PCL was graded as follows: one, three, and 17 mild, moderate, and severe cases at the proximal portion, and 16, 4, and one mild, moderate, and severe cases at the distal portion, respectively. The radiological classification and the grade of degeneration were not correlated in either the proximal (r = 0.047, p = 0.84) or the distal (r = − 0.21, p = 0.35) portions. The HU value was 84.5, 72.1, and 70.6 HU for mild, moderate, and severe grades, respectively (mild versus moderate: p < 0.05, mild versus severe: p < 0.05, moderate versus severe: p > 0.05).

Conclusions

In knee OA, a lower HU value in the PCL indicates the progression of degeneration. The CT HU value could be a useful measurement to predict the grade of PCL degeneration.
Risk factors of deep vein thrombosis of lower extremity in patients undergone gynecological laparoscopic surgery: what should we care
Authors: Tian Qing , Li Meng
Published: March 2021

Background

Deep vein thrombosis (DVT) significantly influences the prognosis of patients. It’s necessary to analyze the risk factors for postoperative DVT in patients undergone gynecological laparoscopic surgery.

Methods

Patients who underwent gynecological laparoscopic surgery from January 1, 2018 to May 31, 2020 were included. The characteristics and clinical data of DVT and non DVT patients were collected and analyzed. Logistic regression analysis was performed to identify the risk factors of DVT in patients undergone gynecological laparoscopic surgery.

Results

A total of 355 patients undergone gynecological laparoscopic surgery were included, the incidence of postoperative DVT was 11.55%. There were significant differences in the age, hypertension, D-dimer, duration of surgery, intraoperative pneumoperitoneum pressure, duration of days in bed between DVT and non-DVT groups (all p < 0.05), and there were no significant difference in the BMI, diabetes, hyperlipidemia, ASA classification and intraoperative blood transfusion between DVT and non-DVT groups (all p > 0.05). Age > 50 years (OR 4.246, 95% CI 1.234–7.114), hypertension (OR 2.219, 95% CI 1.153–4.591), D-dimer > 0.5 mg/L (OR 3.914, 95% CI 1.083–5.229), duration of surgery ≥ 60 min (OR 2.542, 95% CI 1.101–4.723), intraoperative pneumoperitoneum pressure ≥ 15 mmHg (OR 3.845, 95% CI 1.119–5.218), duration of days in bed > 3 days (OR 1.566, 95% CI 1.182–1.994) was the independent risk factors for DVT in patients undergone gynecological laparoscopic surgery (all p < 0.05).

Conclusions

The incidence of postoperative DVT in patients undergone gynecological laparoscopic surgery is high, and those high-risk factors should be targeted to intervene in order to reduce the postoperative DVT.
Family, social and cultural determinants of long-lasting insecticidal net (LLIN) use in Madagascar: secondary analysis of three qualitative studies focused on children aged 5–15 years
Authors: Njatosoa Ammy Fiadanana , Mattern Chiarella , Pourette Dolorès , Kesteman Thomas , Rakotomanana Elliot , Rahaivondrafahitra Bakoly , Andriamananjara Mauricette , Harimanana Aina , Razafindrakoto Jocelyn , Raboanary Emma , Andrianasolo Andry , Rogier Christophe
Published: March 2021

Background

Although it is accepted that long-lasting insecticidal net (LLIN) use is an effective means to prevent malaria, children aged 5 to 15 years do not appear to be sufficiently protected in Madagascar; the malaria prevalence is highest in this age group. The purpose of this research is to summarize recent qualitative studies describing LLIN use among the Malagasy people with a focus on children aged 5–15 years.

Methods

Qualitative data from three studies on malaria conducted between 2012 and 2016 in 10 districts of Madagascar were analysed. These studies cover all malaria epidemiological profiles and 10 of the 18 existing ethnic groups in Madagascar. A thematic analysis was conducted on the collected data from semi-structured interviews, direct observation data, and informal interviews.

Results

A total of 192 semi-structured interviews were conducted. LLINs are generally perceived positively because they protect the health and well-being of users. However, regional representations of mosquito nets may contribute to LLIN lower use by children over 5 years of age including the association between married status and LLIN use, which leads to the refusal of unmarried young men to sleep under LLINs; the custom of covering the dead with a mosquito net, which leads to fear of LLIN use; and taboos governing sleeping spaces for siblings of opposite sexes, which leads to LLIN shortages in households. Children under 5 years of age are known to be the most vulnerable age group for acquiring malaria and, therefore, are prioritized for LLIN use when there are limited supplies in households. In contrast, children over 5 years of age, who are perceived to be at less risk for malaria, often sleep without LLINs.

Conclusions

Perceptions, social practices and regional beliefs regarding LLINs and vulnerability to malaria contribute to the nonuse of LLINs among children over 5 years of age in Madagascar. Modifying LLIN policies to account for these factors may increase LLIN use in this age group and reduce disease burden.
Hypoxia modulation by dual-drug nanoparticles for enhanced synergistic sonodynamic and starvation therapy
Authors: Wang Jingxue , Huang Ju , Zhou Weichen , Zhao Jiawen , Peng Qi , Zhang Liang , Wang Zhigang , Li Pan , Li Rui
Published: March 2021

Background

Sonodynamic therapy (SDT) is an emerging non-invasive therapeutic technique. SDT-based cancer therapy strategies are presently underway, and it may be perceived as a promising approach to improve the efficiency of anti-cancer treatment. In this work, multifunctional theranostic nanoparticles (NPs) were synthesized for synergistic starvation therapy and SDT by loading glucose oxidase (GOx, termed G) and 5,10,15,20-tetrakis (4-chlorophenyl) porphyrin) Cl (T (p-Cl) PPMnCl, termed PMnC) in Poly (lactic-co-glycolic) acid (PLGA) NPs (designated as MG@P NPs).

Results

On account of the peroxidase-like activity of PMnC, MG@P NPs can catalyze hydrogen peroxide (H2O2) in tumor regions to produce oxygen (O2), thus enhancing synergistic therapeutic effects by accelerating the decomposition of glucose and promoting the production of cytotoxic singlet oxygen (1O2) induced by ultrasound (US) irradiation. Furthermore, the NPs can also serve as excellent photoacoustic (PA)/magnetic resonance (MR) imaging contrast agents, effectuating imaging-guided cancer treatment.

Conclusion

Multifunctional MG@P NPs can effectuate the synergistic amplification effect of cancer starvation therapy and SDT by hypoxia modulation, and act as contrast agents to enhance MR/PA dual-modal imaging. Consequently, MG@P NPs might be a promising nano-platform for highly efficient cancer theranostics.

Graphical Abstract
Therapeutic strategies in RET gene rearranged non-small cell lung cancer
Authors: Drusbosky Leylah M. , Rodriguez Estelamari , Dawar Richa , Ikpeazu Chukwuemeka V.
Published: March 2021

The recent approvals by the Food and Drug Administration several tumor-agnostic drugs have resulted in a paradigm shift in cancer treatment from an organ/histology-specific strategy to biomarker-guided approaches. RET gene fusions are oncogenic drivers in multiple tumor types and are known to occur in 1–2% of non-squamous NSCLC patients. RET gene fusions give rise to chimeric, cytosolic proteins with constitutively active RET kinase domain. Standard therapeutic regimens provide limited benefit for NSCLC patients with RET fusion-positive tumors, and the outcomes with immunotherapy in the these patients are generally poor. Selpercatinib (LOXO-292) and pralsetinib (BLU-667) are potent and selective inhibitors that target RET alterations, including fusions and mutations, irrespective of the tissue of origin. Recently, the results from the LIBRETTO-001 and ARROW clinical trials demonstrated significant clinical benefits with selpercatinib and pralsetinib respectively, in NSCLC patients with RET gene fusions, with tolerable toxicity profiles. These studies also demonstrated that these RET-TKIs crossed the blood brain barrier with significant activity. As has been observed with other TKIs, the emergence of acquired resistance may limit long-term efficacy of these agents. Therefore, understanding the mechanisms of resistance is necessary for the development of strategies to overcome them.
Characterization of 29 polymorphic microsatellite markers developed by genomic screening of Sumatran rhinoceros (Dicerorhinus sumatrensis)
Authors: Brandt Jessica R. , Saidah Sinta H. , Zhao Kai , Ishida Yasuko , Apriyana Isabella , Ryder Oliver A. , Ramono Widodo , Sudoyo Herawati , Suryadi Helena , Van Coeverden de Groot Peter J. , Roca Alfred L.
Published: March 2021

Objective

The Sumatran rhinoceros is critically endangered, with fewer than 100 individuals surviving across its current range. Accurate census estimates of the remaining populations are essential for development and implementation of conservation plans. In order to enable molecular censusing, we here develop microsatellite markers with amplicon sizes of short length, appropriate for non-invasive fecal sampling.

Results

Due to limited sample quantity and potential lack of genome-wide diversity, Illumina sequence reads were generated from two Sumatran rhinoceros samples. Genomic screening identified reads with short tandem repeats and loci that were polymorphic within the dataset. Twenty-nine novel polymorphic microsatellite markers were characterized (A = 2.4;HO = 0.30). These were sufficient to distinguish among individuals (PID < 0.0001), and to distinguish among siblings (PID(sib) < 0.0001). Among rhinos in Indonesia, almost all markers were established as polymorphic and effective for genotyping DNA from fecal samples. Notably, the markers amplified and displayed microsatellite polymorphisms using DNA extracted from 11 fecal samples collected non-invasively from wild Sumatran rhinoceros. These microsatellite markers provide an important resource for a census and genetic studies of wild Sumatran rhinos.