bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between COVID-19 morbidity and mortality rates and BCG vaccination policies in OECD countries
Authors: Senoo Yuki , Suzuki Yosuke , Tsuda Kenji , Tanimoto Tetsuya , Takahashi Kenzo
Published: December 2020

We compared whether the national BCG vaccination (BCGV) policy influenced coronavirus disease 2019 (COVID-19) in Organisation for Economic Co-operation and Development (OECD) countries. Those currently implementing BCGV have a reduced number of COVID-19 morbidity and mortality cases, compared to those who have never implemented a BCGV policy, suggesting the potential protective effect of BCGV against COVID-19.
Pooled analysis of 115 patients from updated data of Epitopes-HPV01 and Epitopes-HPV02 studies in first-line advanced anal squamous cell carcinoma
Authors: Kim Stefano , Meurisse Aurélia , Spehner Laurie , Stouvenot Morgane , François Eric , Buecher Bruno , André Thierry , Samalin Emmanuelle , Jary Marine , Nguyen Thierry , El Hajbi Farid , Baba-Hamed Nabil , Pernot Simon , Kaminsky Marie-Christine , Bouché Olivier , Desrame Jerome , Zoubir Mustapha , Ghiringhelli François , Parzy Aurélie , de la Fouchardiere Christelle , Boulbair Fatiha , Lakkis Zaher , Klajer Elodie , Jacquin Marion , Taieb Julien , Vendrely Véronique , Vernerey Dewi , Borg Christophe
Published: December 2020

Aims:

The addition of docetaxel to cisplatin and 5-fluorouracil (DCF) has shown promising efficacy in advanced squamous cell carcinoma of the anus (SCCA). Preliminary results of Epitopes-HPV01 study showed a high rate of long-lasting complete response to DCF. The prospective, multicenter, Epitopes-HPV02 trial then confirmed the high efficacy of the modified DCF (mDCF) regimen in terms of complete response rate and long-term survival in metastatic or non-resectable locally advanced recurrent SCCA. Here, we present updated results of the Epitopes-HPV01 and Epitopes-HPV02 studies.

Patients & methods:

Epitopes-HPV01 is a prospective study performed by the regional cancer network of Franche-Comté, France. Epitopes-HPV02 is a phase II study supported by two French collaborative oncological groups, performed in 25 centers. Both studies included patients with metastatic, or with unresectable local recurrent SCCA, treated with DCF regimen.

Results:

In Epitopes-HPV01, 51 patients were enrolled between September 2012 and January 2019, and 49 patients were included for analysis; while 69 patients were included between September 2014 and December 2016 in Epitopes-HPV02, and 66 patients for analysis. Pooled analysis of 115 patients showed a median progression-free survival of 12.2 months [95% confidence interval (CI) 10.6–16.1] [11.0 months (9.3–16.0) in -HPV02, and 15.6 months (11.2–34.5) in -HPV01, ( p = 0.06)]. The median overall survival was 39.2 months (26.0–109.1) [36.3 in -HPV02 (25.2–NR), and 61.1 months (21.4–120.0) in -HPV01 ( p = 0.62)]. Objective response rate was 87.7% (90.9% in -HPV02 and 83.3% in -HPV01) with 40.3% of complete response (45.5% in -HPV02 and 33.3% in -HPV01). No differences were observed between standard DCF ( n = 54) and mDCF ( n = 58) in terms of OS ( p = 0.57) and PFS ( p = 0.99). 5-years PFS and OS rates were 24.5% and 44.4%, respectively, in the whole population. No treatment-related death was observed.

Conclusion:

Updated results of Epitopes-HPV01 and 02 studies, as well as the pooled analysis, confirm mDCF as a standard treatment in patients with advanced SCCA.
Characterising Independent Candidates in Indonesian Local Politics
Authors: Dinarto Dedi , Ng Jefferson
Published: December 2020

This article examines the phenomenon of independent candidates ( calon perseorangan) in Indonesia’s regional executive elections (Pilkada) to better understand why candidates run as independents and whether independent candidacy has reduced political inequality in the electoral system. In this study, we compiled candidate information using Indonesia’s General Election Commission’s (Komisi Pemilihan Umum, KPU) database as well as structured open-source searches to develop a data set and profiles of independents over three election cycles. Using this data set, we distinguished three categories of independents – partisan, non-partisan, and underdog independents – by analysing differences in power resources and motivations among the candidates. We found that contrary to public perceptions in Indonesia, independent candidacy has not helped to alleviate unequal access to political office. Successful independents are predominantly political insiders and local notables. This finding has important implications for democracy in Indonesia – we show how the inability for political outsiders to win political office harms democratic representation.
Preliminary Analysis of the Therapeutic Mechanism of Feiluoning in Convalescent Patients With COVID-19
Authors: Hong Zongchao , Hong Maolin , Liu Bo , Zhang Ying , Yang Yanfang , Wu Hezhen
Published: December 2020

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), is often accompanied by injury to pulmonary function and pulmonary fibrosis. Feiluoning (FLN) is a new Chinese medicine prescription which is available for the treatment of severe and critical convalescence of COVID-19 patients. FLN also has a positive effect on pulmonary function injury and pulmonary fibrosis. We explored the potential mechanism of FLN’s effect on the convalescent treatment of COVID-19. According to the pharmacodynamic activity parameters, we screened the active chemical constituents of FLN by comparing the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform. The Uniprot database was used to querying the corresponding target genes, and Cytoscape 3.6.1 was used to construct a herb-compound-target network. Protein interaction analysis, target gene function enrichment analysis, and signal pathway analysis were performed using the STRING, DAVID, and Kyoto Encyclopedia of Genes and Genomes pathway databases. Molecular docking was used to predict the binding capacity of the core compound with COVID-19 hydrolase 3 Cl and angiotensin-converting enzyme 2 (ACE2). The herb-compound-target network was successfully constructed and key targets identified, including prostaglandin G/H synthase 2, estrogen receptor 1, heat shock protein HSP 90, and androgen receptor. The major affected metabolic pathways were pathways in cancer, pancreatic cancer, nonsmall cell lung cancer, and toll-like receptor signaling. The core compounds of FLN, including quercetin, luteolin, kaempferol, and stigmasterol, could strongly bind to COVID-19 3 Cl hydrolase, and other compounds, including 7-O-methylisomucronulatol and medicocarpin, could strongly bind to ACE2. Thus, it is predicted that FLN has the characteristics of a multicomponent, multitarget, and multichannel overall control compound. FLN’s mechanism of action in the treatment of COVID-19 may be associated with the regulation of inflammation and immune-related signaling pathways, and the influence of COVID-19 3 Cl hydrolase binding ability.
Tubeimoside-1 Protects Against Renal Ischemia Reperfusion Injury In Vivo and In Vitro
Authors: Yuan Xiaoli , Wang Jing , Zhang Yun
Published: December 2020

Renal ischemia reperfusion injury (RIRI) is one of the main causes of acute kidney injury. This study aimed to explore whether tubeimoside-1 (TBMS1) could protect against RIRI. RIRI mice model and hypoxia/reoxygenation (H/R)-induced NRK-52E cells were used in this study. The renal pathology was observed by hematoxylin and eosin staining to calculate the tubular injury score. The levels of serum creatinine and blood urine nitrogen were analyzed by a Hitachi model 7180 automatic analyzer. The expressions of tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), interleukin 6 (IL-6), Bax, cleaved caspase-3, cleaved caspase-9, total caspase-3, and total caspase-9 in renal tissues and NRK-52E cells were detected by western blot analysis. The levels of TNF-α, IL-1β, and IL-6 in serum and NRK-52E cells were measured by a commercial enzyme-linked immunosorbent assay kit. The renal cell apoptosis in renal tissues was analyzed by TUNEL assay, and NRK-52E cell apoptosis was detected by flow cytometry analysis. CCK-8 assay was used to analyze the viability of NRK-52E cells after the indicated treatment. As a result, the renal tissues that were seriously damaged in mice with RIRI could be alleviated by TBMS1. Therefore, 50 mg/kg TBMS1 was chosen for the animal experiment. Renal cell apoptosis was increased in renal tissues of mice with RIRI. These changes could be partially reversed by TBMS1 treatment. TBMS1 improved the viability, and reduced the inflammation and apoptosis of H/R-induced NRK-52E cells. In conclusion, TBMS1 ameliorates RIRI by promoting viability and suppressing apoptosis and inflammation of renal cells.
Can Physical Design Help Reduce Loneliness in the Elderly? A Theoretical Exploration
Authors: Nasrallah Eman , Pati Debajyoti
Published: December 2020

Background:

Over the past several years, a new problem affecting the elderly population has been increasingly reported in popular press—the elderly population is dying as a result of loneliness and related factors at a rate greater than that of lack of medical care. The problem is so pervasive that loneliness is being described as an epidemic.

Objective:

The objective of this inquiry was to examine whether the physical design of the lived environments could contribute to reducing loneliness in the elderly population.

Method:

A combination of scoping and conceptual review of published literature was adopted for the study. The process involved multiple phases of searching, and a review was conducted at each stage. Databases targeted include PsycINFO, Academic Search Complete, PsycArticles, Psychology and Behavioral Sciences Collection, and SocINDEX. In all, 44 articles and books were subjected to in-depth analyses of underlying concepts, constructs, relationships, and empirical findings.

Results:

Several theories including meaning in life theory, lifespan ego-development theory, symbolic interaction theory, proxemics, and affordance theory suggest that the design of the physical environment may have a role in addressing loneliness in the elderly. A potential explanatory model articulating the causal pathway is presented in this article.

Conclusions:

Between theoretical propositions and empirical literature, there exist grounds to assert that a plausible causal pathway exists between the physical environment and loneliness in the elderly population. The explanatory pathway suggests that the physical design could play both a direct and moderating role in influencing loneliness.
Epidemiology and survival outcome of adult kidney, bladder, and prostate rhabdomyosarcoma: A SEER database analysis
Authors: Patel Sagar R , Hensel Caitlin P , He Jiaxian , Alcalá Nicolas E , Kearns James T , Gaston Kris E , Clark Peter E , Riggs Stephen B
Published: December 2020

Rhabdomyosarcoma (RMS) is rare in adulthood, accounting for 2%–5% of adult soft tissue tumors, and less than 20% occur in genitourinary organs. Given its rarity, survival data on adult kidney, bladder, and prostate RMSs is limited. In this population-based analysis, we performed an analysis of all adult RMS cases reported in Surveillance, Epidemiology, and End Results (SEER) database to understand prognostic factors among kidney, bladder, and prostate RMS. A query of the SEER database was performed from 1973 to 2016 for patients >18 of age with RMS. The final cohort consisted of 14 kidney, 35 bladder, and 21 prostate RMS cases in the adult population. Demographic, treatment, and survival data were obtained. Analysis was performed using Fisher’s exact test, survival analysis, and model. The median (range) age of diagnosis for adult bladder RMS was 65 years old (19–84) compared to 52.5 (28–68) and 42 (19–87) for kidney and prostate ( p = 0.007). About 78.6% of patients underwent surgical intervention. Five-year overall survival (OS) for adult kidney, bladder, and prostate RMS are 17.1% (2.9–41.6%), 22.2% (9.4–38.4%), and 33.0 (12.8–55.0%), respectively. OS was not statistically associated with primary site ( p = 0.209). On multivariable analysis, compared to adult bladder RMS, kidney RMS had a higher incidence of mortality (HR: 2.16, 95% CI 1.03–4.53, p = 0.041). Incidence of mortality from prostate RMS was not significantly different from bladder RMS (HR: 0.70, 95% CI 0.30–1.65, p = 0.411). Extent of disease (HR: 5.17, 95% CI 2.09–12.79, p < 0.001) and older age (HR 1.03, 95% CI 1.01–1.04, p = 0.002) were adverse prognostic factors for OS. Overall survival at 5 years for adult kidney, bladder, and prostate RMS is poor. Localized disease and younger age are prognostic factors for improved outcomes in adult RMS. Hence, early diagnosis and intervention appear paramount to improved survival for this rare malignancy in adulthood.
A case series report of hospitalized children with severe acute respiratory syndrome coronavirus-2 infection in Jinan, China
Authors: Li Jian , Geng Jin , Su Liang , Yang Bo , Gai Zhongtao
Published: December 2020

In December 2019, the outbreak of novel severe acute respiratory syndrome coronavirus-2 infection was reported in Wuhan, China. The disease has spread rapidly throughout China and the rest of the world. It not only occurred in adults but also in some children. So, in this report, we aimed to clarify the epidemiological, clinical, laboratory, and radiological characteristics; treatment; and outcomes of children infected with severe acute respiratory syndrome coronavirus-2 in Jinan, China, and found that children with severe acute respiratory syndrome coronavirus-2 infection are non-specific and are milder than adults. Asymptomatic infections were common. Chest computed tomographic scanning is helpful for diagnosis. While myocardial creatine kinase–myocardial band was prone to increase in these cases. The prognosis of most cases was better.
Upper limb robotic assessment: Pilot study comparing velocity dependent resistance in individuals with acquired brain injury to healthy controls
Authors: Seth Nitin , Johnson Denise , Allen Brian , Abdullah Hussein A
Published: December 2020

Introduction

Assessment of velocity dependent resistance (VDR) can provide insights into spasticity in individuals with upper motor neuron syndrome. This study investigates the relationship between Modified Ashworth scores and a biomechanical based representation of VDR using a rehabilitation robot. Comparisons in VDR are made for the upper limb (UL) between individuals with acquired brain injury and healthy controls for the para-sagittal plane.

Methods

The system manipulates the individual’s limb through five flexion and extension motions at increasing speeds to obtain force profiles at different velocities. An approximation of VDR is calculated and analyzed statistically against clinical scales and tested for interactions.

Results

All individuals (aged 18–65), including healthy controls exhibited VDR greater than 0 (P < 0.05). MAS scores were found to be related to VDR (P < 0.05) with an interaction found between MAS Bicep and Tricep scores (P < 0.01). Considering this interaction, evidence of differences in VDR were found between several neighboring assessment score combinations.

Conclusion

The robot can detect and quantify VDR that captures information relevant to UL spasticity. Results suggests a better categorization of VDR is possible and supports further development of rehabilitation robotics for assisting spasticity assessment.
Automated fall risk assessment of elderly using wearable devices
Authors: Haescher Marian , Chodan Wencke , Höpfner Florian , Bieber Gerald , Aehnelt Mario , Srinivasan Karthik , Murphy Margit Alt
Published: December 2020

Introduction

Falls cause major expenses in the healthcare sector. We investigate the ability of supporting a fall risk assessment by introducing algorithms for automated assessments of standardized fall risk-related tests via wearable devices.

Methods

In a study, 13 participants conducted the standardized 6-Minutes Walk Test, the Timed-Up-and-Go Test, the 30-Second Sit-to-Stand Test, and the 4-Stage Balance Test repeatedly, producing 226 tests in total. Automated algorithms computed by wearable devices, as well as a visual analysis of the recorded data streams, were compared to the observational results conducted by physiotherapists.

Results

There was a high congruence between automated assessments and the ground truth for all four test types (ranging from 78.15% to 96.55%), with deviations ranging all well within one standard deviation of the ground truth. Fall risk (assessed by questionnaire) correlated with the individual tests.

Conclusions

The automated fall risk assessment using wearable devices and algorithms matches the validity of the ground truth, thus providing a resourceful alternative to the effortful observational assessment, while minimizing the risk of human error. No single test can predict overall fall risk; instead, a much more complex model with additional input parameters (e.g., fall history, medication etc.) is needed.
Variation of the Inpatient Cost of Care in the Treatment of Isolated Geriatric Intertrochanteric Hip Fractures
Authors: Wise Kelsey , Blaschke Breanna L. , Parikh Harsh R. , Gorman Tiffany , Casnovsky Lauren , McMilan Logan J. , Flagstad Ilexa , Okelana A. Bandele , Horst Patrick , Cunningham Brian P.
Published: December 2020

Introduction:

Geriatric hip fractures are a major, costly public health issue, expected to increase in incidence and expense with the aging population. As healthcare transitions towards value-based care, understanding cost drivers of hip fracture treatment will be necessary to perform adequate risk adjustment. Historically, cost has been variable and difficult to determine. This study was purposed to identify variables that can predict the overall cost of care for geriatric intertrochanteric (IT) hip fractures and provide a better cost prediction to ensure the success of future bundled payment models.

Methods:

A retrospective review of operatively-managed geriatric hip fractures was performed at single urban level I academic trauma center between 2013 and 2017. Patient variables were collected via the electronic medical record (EMR) including CCI, ACCI, ASA, overall length of stay (LOS), AO/OTA fracture classification and demographics. Direct and indirect costs were calculated by activity-based costing by the hospital’s accounting software. Multivariable linear regression models evaluated which parameters predicted total inpatient cost of care.

Results:

The mean cost of care was $19,822, ranging from $9,128 to $64,211. Critical care comprised 16.9% of total costs, followed by implant costs (13.6%), and nursing costs (12.6%). Regression analysis identified both ASA ( p < 0.01) and ACCI ( p = 0.01) as statistically significant associative parameters, but only LOS ( r 2 = 0.77) as a strong correlative measure for inpatient care cost.

Conclusion:

This study found no correlation between ACCI or ASA and the total inpatient cost of care in isolated intertrochanteric geriatric hip fractures, suggesting that the inpatient episode-of-care costs cannot be accurately predicted by the patient demographics/comorbidities alone. Future bundled care payment models would have to be adjusted to account for variables beyond just patient characteristics.

Level of Evidence:

Diagnostic Level IV.
Efficacy of Povidone Iodine Solution in the Prevention of Surgical Site Infections in Minimally Invasive Instrumented Spinal Fusion Surgery
Authors: Lin Hsi-Hsien , Chou Po-Hsin , Ma Hsuan-Hsiao , Chang Yu-Wei , Wang Shih-Tien , Chang Ming-Chau
Published: December 2020

Study Design:

A retrospective case-controlled study.

Objectives:

To evaluate overall infection rate and adverse event after harvesting bone graft soaking and surgical wound irrigation by povidone iodine solution (PVI) in the minimally invasive instrumented spinal fusion surgery. In order to reduce the rate of surgical site infection in spinal surgery, surgical wound irrigation by povidone iodine solution has been well-established. However, the efficacy of autologous bone graft soaking by PVI has not been evaluated before.

Methods:

This is a retrospective cohort study. 120 patients were enrolled in the PVI group and compared with 124 patients in the historical cohort. In the PVI group, the harvesting autologous bone graft was soaking and the surgical wound was also irrigated by diluted PVI solution. The outcome measures were overall infection rate, superficial wound infection and deep infection. In addition, the delayed union of the fusion mass was also evaluated through the radiograph evaluation.

Results:

Both groups shared similar patient demographics instead of body mass index. The use of PVI solution had decreased the overall infection rate (0% versus 4.03%, p = 0.026) and deep infection rate (0% versus 3.23%, p = 0.047). In addition, there was no delayed bone healing in the PVI group after autologous bone graft soaking.

Conclusions:

In this study, we conclude that harvested autologous bone graft after PVI soaking in spinal fusion surgery can decrease the incidence of deep infection.
Synergistic effects of hip/knee osteoarthritis and comorbidities on mobility and self-care limitations among older adults: Cross-sectional analysis of the Oxford pain, Activity and Lifestyle study
Authors: Nicolson Philippa JA , Williamson Esther , Lee Hopin , Morris Alana , Garrett Angela , Sanchez-Santos Maria T , Lamb Sarah E
Published: December 2020

Objective:

To estimate synergistic effects of hip/knee osteoarthritis (OA) and comorbidities on mobility or self-care limitations among older adults.

Methods:

We used baseline, cross-sectional data from the Oxford Pain, Activity and Lifestyle (OPAL) study. Participants were community-dwelling adults aged 65 years or older who completed a postal questionnaire. Participants reported demographic information, hip/knee OA, comorbidities and mobility and self-care limitations. We used modified Poisson regression models to estimate the independent and combined relative risks (RR) of mobility or self-care limitations, the relative excess risk due to interaction (RERI) between hip/knee OA and comorbidities, attributable proportion of the risk due to the interaction and the ratio of the combined effect and the sum of the individual effects, known as the synergy index.

Results:

Of the 4,972 participants included, 1,532 (30.8%) had hip/knee OA, and of them 42.9% reported mobility limitations and 8.4% reported self-care limitations. Synergistic effects impacting self-care limitations were observed between hip/knee OA and anxiety (RR: 3.09, 95% Confidence Interval (CI): 2.00 to 4.78; RERI: 0.93, 95% CI: 0.01 to 1.90), and between hip/knee OA and depressive symptoms (RR: 2.71, 95% CI: 1.75 to 4.20; RERI: 0.58, 95% CI: 0.03 to 1.48). The portion of the total RR attributable to this synergism was 30% and 22% respectively.

Conclusions:

This study demonstrates that synergism between hip/knee OA and anxiety or depressive symptoms contribute to self-care limitations. These findings highlight the importance of assessing and addressing anxiety or depressive symptoms when managing older adults with hip/knee OA to minimize self-care limitations.
The posterior tibial slope is mainly created by the posterior rotation of the tibial condyles
Authors: Nagamine Ryuji , Kawasaki Makoto , Kim Kang-Il , Sakai Akinori , Suguro Toru
Published: December 2020

Purpose:

Constitutional varus in the coronal plane is formed based on the Hueter-Volkmann’s law. The varus deformity occurs at the proximal metaphysis of the tibia and the tibial condyle rotates medially. In the sagittal plane, we hypothesized that the posterior slope angle of the tibial articular surface may also occur at the proximal metaphysis and the tibial condyle rotates posteriorly. The purpose of this study was to verify the hypothesis.

Methods:

A total of 208 patients who underwent TKA had lateral view proximal tibia digital radiograph on which seven parameters were analyzed. The posterior slope angle of the tibial articular surface relative to the anterior wall of the tibial condyle and that relative to the anterior cortex of the tibial shaft were assessed. Correlation between the position of the tibial condyle and the posterior slope angle of the articular surface were assessed.

Results:

The proximal tibial condyle itself did not have a posterior slope in the 86.5% of the participants. Posterior rotation of the tibial condyle created posterior slope of the tibial articular surface relative to the anterior cortex of the tibial shaft. The more tibial condyle was posteriorly rotated, the more the tibial articular surface shifted posteriorly.

Conclusion:

Study findings showed that the posterior tibial slope occurs at the proximal metaphysis of the tibia, and the tibial condyle rotates posteriorly. The posterior tibial slope involves the posterior shift of the tibial articular surface. The posterior tibial slope is mainly created by the posterior rotation of the tibial condyle.
Commentary: The Role of Internal Communication in Fostering Employee Advocacy: An Exploratory Study
Authors: Thelen Patrick D. , Men Linjuan Rita
Published: December 2020

Employee advocacy has become a buzzword that has captured the interest of organizations. Despite the increased attention, employee advocacy is an understudied topic in the public relations literature. Hence, the purpose of this study was to fill a gap in public relations research on employee advocacy by examining internal communicators’ thoughts on how they can influence this type of behavior. Through interviews with 25 practitioners, the results indicated that the drivers of employee advocacy could be divided into three factors: individual (i.e., emotions, job attitudes, person-organization, fit, personality, and instrumental value), group (i.e., leader-member relationship and group cohesion), and organizational (i.e., organizational culture, top management, communication management, and socialization). Additionally, internal communication can influence employee advocacy through corporate communication strategies (i.e., openness and transparency, positivity, legitimacy and empowerment, and recognition) and employee advocacy management factors (i.e., understand business objectives, policies and guidelines, facilitation, interesting and meaningful content, and collaboration).
Speech Audiometry at Home: Automated Listening Tests via Smart Speakers With Normal-Hearing and Hearing-Impaired Listeners
Authors: Ooster Jasper , Krueger Melanie , Bach Jörg-Hendrik , Wagener Kirsten C. , Kollmeier Birger , Meyer Bernd T.
Published: December 2020

Speech audiometry in noise based on sentence tests is an important diagnostic tool to assess listeners’ speech recognition threshold (SRT), i.e., the signal-to-noise ratio corresponding to 50% intelligibility. The clinical standard measurement procedure requires a professional experimenter to record and evaluate the response (expert-conducted speech audiometry). The use of automatic speech recognition enables self-conducted measurements with an easy-to-use speech-based interface. This article compares self-conducted SRT measurements using smart speakers with expert-conducted laboratory measurements. With smart speakers, there is no control over the absolute presentation level, potential errors from the automated response logging, and room acoustics. We investigate the differences between highly controlled measurements in the laboratory and smart speaker-based tests for young normal-hearing (NH) listeners as well as for elderly NH, mildly and moderately hearing-impaired listeners in low, medium, and highly reverberant room acoustics. For the smart speaker setup, we observe an overall bias in the SRT result that depends on the hearing loss. The bias ranges from +0.7 dB for elderly moderately hearing-impaired listeners to +2.2 dB for young NH listeners. The intrasubject standard deviation is close to the clinical standard deviation (0.57/0.69 dB for the young/elderly NH compared with 0.5 dB observed for clinical tests and 0.93/1.09 dB for the mild/moderate hearing-impaired listeners compared with 0.9 dB). For detecting a clinically elevated SRT, the speech-based test achieves an area under the curve value of 0.95 and therefore seems promising for complementing clinical measurements.
Robust Data-Driven Auditory Profiling Towards Precision Audiology
Authors: Sanchez-Lopez Raul , Fereczkowski Michal , Neher Tobias , Santurette Sébastien , Dau Torsten
Published: December 2020

The sources and consequences of a sensorineural hearing loss are diverse. While several approaches have aimed at disentangling the physiological and perceptual consequences of different etiologies, hearing deficit characterization and rehabilitation have been dominated by the results from pure-tone audiometry. Here, we present a novel approach based on data-driven profiling of perceptual auditory deficits that attempts to represent auditory phenomena that are usually hidden by, or entangled with, audibility loss. We hypothesize that the hearing deficits of a given listener, both at hearing threshold and at suprathreshold sound levels, result from two independent types of “auditory distortions.” In this two-dimensional space, four distinct “auditory profiles” can be identified. To test this hypothesis, we gathered a data set consisting of a heterogeneous group of listeners that were evaluated using measures of speech intelligibility, loudness perception, binaural processing abilities, and spectrotemporal resolution. The subsequent analysis revealed that distortion type-I was associated with elevated hearing thresholds at high frequencies and reduced temporal masking release and was significantly correlated with elevated speech reception thresholds in noise. Distortion type-II was associated with low-frequency hearing loss and abnormally steep loudness functions. The auditory profiles represent four robust subpopulations of hearing-impaired listeners that exhibit different degrees of perceptual distortions. The four auditory profiles may provide a valuable basis for improved hearing rehabilitation, for example, through profile-based hearing-aid fitting.
Finding Rigor Within a Large-Scale Expansion of Preschool to Test Impacts of a Professional Development Program
Authors: Rojas Natalia M. , Morris Pamela , Balaraman Amudha
Published: December 2020

Achieving high-quality preschool at scale is challenging; to do so likely entails a combination of program standards, teacher qualifications and compensation, on-site quality monitoring, and professional development (PD). This study aims to examine the impact of investments in PD within the context of an expansion of universal preschool in one of the nation’s largest school districts. We leverage the opportunity provided by a “natural experiment” to estimate PD’s effects that embeds an evidence-based math curriculum in interdisciplinary units of study with coaching support on teacher math practices. A total of 95 schools participated in this study (51 treatment and 44 comparison schools). Treatment sites implemented more teacher-led math activities for a longer period compared to control sites. The size and magnitude of the impacts of a curriculum and PD program implemented at scale were comparable to results from studies of small-scale efficacy trials.
Child Vulnerabilities And Family-Based Childcare Systems: COVID-19 Challenges Of Foster Care And Adoption In India
Authors: Verma Ratna , Verma Rinku
Published: December 2020

This article has been developed based on a systematic review of research studies conducted in the last 10 years on family-based childcare systems and a rapid review of research and assessments conducted in 2020 to explore the implications of the COVID-19 pandemic on adoption and foster care in India. The study explains child vulnerabilities with a focus on challenges to adoption and foster care before and after the COVID-19 pandemic. The findings depict that India is home to a large number of vulnerable children who have been living with hardships, and the COVID-19 pandemic has put them at a higher risk of adversity. There has been a significant focus on family-based childcare systems, such as adoption and foster care, instead of institutionalisation to provide a safe environment to children in need of care and protection. However, the study shows that the adoption rate has been sharply decreasing in the country due to low social acceptance, unawareness and delays in the adoption process. The study also identifies challenges facing foster care, in terms of lack of financial support to foster parents, lack of an appropriate monitoring system and lack of a social integration plan for children who age out of the system. The COVID-19 pandemic and related measures have further interrupted the process of adoption and foster care and placed several roadblocks in providing a safety net to a large number of children in the country. The article provides viable recommendations that may help make adoption and foster care effective in the country amid the COVID-19 crisis.
Has COVID-19 Hurt Resident Education? A Network-Wide Resident Survey on Education and Experience During the Pandemic
Authors: Ostapenko Alexander , McPeck Samantha , Liechty Shawn , Kleiner Daniel
Published: December 2020

Purpose:

As the COVID-19 pandemic continues to evolve, the healthcare system has been forced to adapt in myriad ways. Residents have faced significant changes in work schedules, deployment to COVID-19 units, and alterations to didactics. This study aims to identify the effects of the COVID-19 pandemic on resident perception of their own education within the Nuvance Health Network.

Methods:

We conducted an observational study assessing resident perception of changes in education and lifestyle during the COVID-19 pandemic. A survey was developed to assess the quality and quantity of resident education during this time and administered anonymously to all residents within the healthcare network.

Results:

Eighty-four (68%) residents responded to the survey from 5 different specialties, including general surgery, internal medicine, obstetrics and gynecology, pathology, and radiology. The average change in hours per week performing clinical work was −6 hours (SD = 17; P = .003), in time studying was +0 hours (SD = 5; P = .96), in weekly didactics was −2 hours (SD = 3; P < .001), and in attending involvement was −1 hours (SD = 2; P < .001). Additionally, 32% of residents expressed concern that the pandemic has diminished their preparedness to become an attending, 13% expressed concern about completing graduation requirements, and 3% felt they would need an additional year of training.

Conclusion:

During the COVID-19 pandemic thus far, residents perceived that time spent on organized didactics/conferences decreased and that attending physicians are less involved in education. Furthermore, the majority of residents felt that the quality of didactic education diminished as a result of the pandemic. Surprisingly, while many residents expressed concerns about being prepared to become an attending, few were concerned about completing graduation requirements or needing an extra year of education. In light of these findings, it is critical to devote attention to the effects of the pandemic on residents’ professional trajectories and create innovative opportunities for improving education during this challenging time.
Sounds of survival, weaponization of sounds: Exploring sonic lieux de mémoire
Authors: Velasco-Pufleau Luis , Atlani-Duault Laëtitia
Published: December 2020

In this article, we argue that sonic experiences in contexts of organized violence can be understood as sonic lieux de mémoire (sonic sites of memory). Exploring how these sonic sites are indissociable from the individual and collective experience of places, we show how they form networks of relationships within which the memory of silences and sounds is constructed and actualized. We also argue that these sonic lieux de mémoire can be seen from two perspectives, representing the dark and bright sides of the same phenomenon. On one hand, sound, music, and silence are used as weapons in organized violence, for example, in detention facilities or during wars or political conflicts. On the other hand, they constitute symbolic resources, positive tools that contribute to the (re)construction of subjectivities and thus can serve as tools for survival and resistance. In both cases, sound and musical practices are essential facets of what makes us human.
Educational potential of teaching evolution as an interdisciplinary science
Authors: Hanisch Susan , Eirdosh Dustin
Published: December 2020

Evolution education continues to struggle with a range of persistent challenges spanning aspects of conceptual understanding, acceptance, and perceived relevance of evolutionary theory by students in general education. This article argues that a gene-centered conceptualization of evolution may inherently limit the degree to which these challenges can be effectively addressed, and may even precisely contribute to and exacerbate these challenges. Against that background, we also argue that a trait-centered, generalized, and interdisciplinary conceptualization of evolution may hold significant learning potential for advancing progress in addressing some of these persistent challenges facing evolution education. We outline a number of testable hypotheses about the educational value of teaching evolutionary theory from this more generalized and interdisciplinary conception.
High-throughput profiling of diapause regulated genes from Trichogramma dendrolimi (Hymenoptera: Trichogrammatidae)
Authors: Zhang Xue , Du Wenmei , Zhang Junjie , Zou Zhen , Ruan Changchun
Published: December 2020

Background

The parasitoid wasp, Trichogramma dendrolimi, can enter diapause at the prepupal stage. Thus, diapause is an efficient preservation method during the mass production of T. dendrolimi. Previous studies on diapause have mainly focused on ecological characteristics, so the molecular basis of diapause in T. dendrolimi is unknown. We compared transcriptomes of diapause and non-diapause T. dendrolimi to identify key genes and pathways involved in diapause development.

Results

Transcriptome sequencing was performed on diapause prepupae, pupae after diapause, non-diapause prepupae, and pupae. Analysis yielded a total of 87,022 transcripts with an average length of 1604 bp. By removing redundant sequences and those without significant BLAST hits, a non-redundant dataset was generated, containing 7593 sequences with an average length of 3351 bp. Among them, 5702 genes were differentially expressed. The result of Gene Ontology (GO) enrichment analysis revealed that regulation of transcription, DNA-templated, oxidation-reduction process, and signal transduction were significantly affected. Ten genes were selected for validation using quantitative real-time PCR (qPCR). The changes showed the same trend as between the qPCR and RNA-Seq results. Several genes were identified as involved in diapause, including ribosomal proteins, zinc finger proteins, homeobox proteins, forkhead box proteins, UDP-glucuronosyltransferase, Glutathione-S-transferase, p53, and DNA damage-regulated gene 1 (pdrg1). Genes related to lipid metabolism were also included.

Conclusions

We generated a large amount of transcriptome data from T. dendrolimi, providing a resource for future gene function research. The diapause-related genes identified help reveal the molecular mechanisms of diapause, in T. dendrolimi, and other insect species.
Altitude influences microbial diversity and herbage fermentation in the rumen of yaks
Authors: Fan Qingshan , Wanapat Metha , Yan Tianhai , Hou Fujiang
Published: December 2020

Background

Rumen microbiota in ruminants are vital for sustaining good rumen ecology, health, and productivity. Currently, limited information is available regarding the response of yaks (Bos grunniens) to fluctuating environments, especially the rumen microbiome. To address this, we investigated the diet, rumen bacterial community, and volatile fatty acids (VFA) of rumen fluid of yaks raised in the great Qinghai-Tibet plateau (QTP) at 2800 (low altitude, L), 3700 (middle altitude, M), and 4700 m (high altitude, H) above sea level.

Results

The results showed that despite a partial diet overlap, H yaks harbored higher fibrous fractious contents than the M and L grazing yaks. Bacteria including Christensenellaceae_R-7_group, Ruminococcus_1, Romboutsia, Alloprevotella, Eubacterium coprostanoligenes, Clostridium, Streptococcus, and Treponema were found to be enriched in the rumen of yaks grazing at H. They also showed higher rumen microbial diversity and total VFA concentrations than those shown by yaks at M and L. Principal coordinates analysis (PCoA) on weighted UniFrac distances revealed that the bacterial community structure of rumen differed between the three altitudes. Moreover, Tax4fun metagenome estimation revealed that microbial genes associated with energy requirement and carbohydrate metabolic fate were overexpressed in the rumen microbiota of H yaks.

Conclusions

Collectively, our results revealed that H yaks had a stronger herbage fermenting ability via rumen microbial fermentation. Their enhanced ability of utilizing herbage may be partly owing to a microbiota adaptation for more energy requirements in the harsh H environment, such as lower temperature and the risk of hypoxia.
Leadership, governance and management for improving district capacity and performance: the case of USAID transform: primary health care
Authors: Desta Binyam Fekadu , Abitew Azeb , Beshir Ismael Ali , Argaw Mesele Damte , Abdlkader Sualiha
Published: December 2020

Background

Primary health care (PHC) in Ethiopia serves as the main entry point for preventive, promotive and curative health services. The district health office is responsible for the planning, implementation and evaluation of all district health activities. In addition, district health offices manage service delivery facilities working on provision of PHC – primary hospitals, health centers and health posts. As the leader of the health care system tier, district health management must ensure direction, alignment and commitment within teams and organizations and make sure that achievements are consistent with the vision, values and strategy of the organization. USAID Transform: Primary Health Care provides diverse support to improve district health manager competencies including in-service trainings followed by planning and implementation of performance improvement projects and on-the-job mentoring and support.

Methods

This study was conducted to compare district level capacity and performances between leadership, management and governance (LMG) and non-LMG districts. Project outcome monitoring data that shows the performance of districts was collected from 284 districts from January to December 2019. The study was carried out using a comparative-cross sectional study design, which assessed and compared district health office level indicators. Districts were classified into two categories: LMG and non-LMG districts. The study compared data from 94 LMG and 190 non-LMG districts. Propensity score matching was used to control the effect of differences between LMG and non-LMG districts.

Results

Results of the independent samples t-test revealed that LMG districts scored better average performances of 61.8 ± 121.45 standard deviation (SD) compared to non-LMG districts 56.89 ± 110.39 SD, with t (282243) = − 3.407317 and p < 0.001, two-tailed. The difference of 4.9 percentage unit in the average performance indicated a statistically significant difference between the LMG and non-LMG districts.

Conclusion

District level leadership development program contributes to improving district capacity, structure and management practices, and quality of care.
Peripheral blood correlates of virologic relapse after Sofosbuvir and Ribavirin treatment of Genotype-1 HCV infection
Authors: Orr Cody , Xu Wenjie , Masur Henry , Kottilil Shyam , Meissner Eric G.
Published: December 2020

Background

Treatment of chronic hepatitis C virus infection with direct acting antiviral therapy results in viral elimination in over 90% of cases. The duration of treatment required to achieve cure differs between individuals and relapse can occur. We asked whether cellular and transcriptional profiling of peripheral blood collected during treatment could identify biomarkers predictive of treatment outcome.

Methods

We analyzed peripheral blood collected during treatment of genotype 1 HCV with 24 weeks of sofosbuvir and weight-based or low dose ribavirin in a trial in which 29% of patients relapsed. Changes in host immunity during treatment were assessed by flow cytometry and whole blood gene expression profiling. Differences in expression of immune-relevant transcripts based on treatment outcome were analyzed using the Nanostring Human Immunology V2 panel.

Results

Multiple cellular populations changed during treatment, but pre-treatment neutrophil counts were lower and natural post-treatment killer cell counts were higher in patients who relapsed. Pre-treatment expression of genes associated with interferon-signaling, T-cell dysfunction, and T-cell co-stimulation differed by treatment outcome. We identified a pre- and post-treatment gene expression signature with high predictive capacity for distinguishing treatment outcome, but neither signature was sufficiently robust to suggest viability for clinical use.

Conclusions

Patients who relapse after hepatitis C virus therapy differ immunologically from non-relapsers based on expression of transcripts related to interferon signaling and T-cell dysfunction, as well as by peripheral neutrophil and NK-cell concentrations. These data provide insight into the host immunologic basis of relapse after DAA therapy for HCV and suggests mechanisms which may be relevant for understanding outcomes with currently approved regimens.