bluuebunny/crossref_metadata_2025 huggingface dataset:
Socioeconomic Inequality in Health Domains in Oman: Evidence from Oman World Health Survey
Authors: Islam M. Mazharul , Al-Hadhrami Ahmed
Published: February 2021

Socioeconomic inequality in health domains is a major challenge in public health in both developed and developing countries. The objective of this study was to assess the socioeconomic inequalities in various health domains in Oman. Data for the study was obtained from the 2008 World Health Survey in Oman, which covered a nationally representative sample of 3,370 Omani adults. Overall self-rated health (SRH) status and the functional difficulties with eight health domains: mobility; self-care, pain and discomfort, cognition, interpersonal activities, vision, sleep and energy, and affect, were used as the outcome variables. Level of education and wealth quintiles were used as the proxy measures of the socioeconomic status (SES). Both descriptive and inferential statistical techniques were used for data analysis. The results revealed significant socioeconomic inequalities in health outcomes for most of the health domains and for overall SRH in Oman. Adults with no education as well as with poorest wealth quintiles had significantly higher rate of poor health. For most of the health domains, a descending gradient in the prevalence of poor health with the level of education and wealth quintiles have been observed. However, education-related inequalities in poor health across the eight domains and the overall health status were found to be more pronounced and consistent than the wealth-related inequalities in poor health. Wealth quintiles showed no significant association with overall SRH and many health domains. The prevailing educational and wealth related inequalities in health underscores the need for policy-making in regard to reduce the inequalities in specific domains of health and overall health. There is a need for research to examine the ways in which socioeconomic factors mediate changes in health domains as well as overall health. The results from this study are of relevance to public health policymakers in developing interventions for specific health domains and overall health status.
Influence of team composition on turnover and efficiency of total hip and knee arthroplasty
Authors: Cahan Eli M. , Cousins Henry C. , Steere Joshua T. , Segovia Nicole A. , Miller Matthew D. , Amanatullah Derek F.
Published: February 2021

Aims

Surgical costs are a major component of healthcare expenditures in the USA. Intraoperative communication is a key factor contributing to patient outcomes. However, the effectiveness of communication is only partially determined by the surgeon, and understanding how non-surgeon personnel affect intraoperative communication is critical for the development of safe and cost-effective staffing guidelines. Operative efficiency is also dependent on high-functioning teams and can offer a proxy for effective communication in highly standardized procedures like primary total hip and knee arthroplasty. We aimed to evaluate how the composition and dynamics of surgical teams impact operative efficiency during arthroplasty.

Methods

We performed a retrospective review of staff characteristics and operating times for 112 surgeries (70 primary total hip arthroplasties (THAs) and 42 primary total knee arthroplasties (TKAs)) conducted by a single surgeon over a one-year period. Each surgery was evaluated in terms of operative duration, presence of surgeon-preferred staff, and turnover of trainees, nurses, and other non-surgical personnel, controlling cases for body mass index, presence of osteoarthritis, and American Society of Anesthesiologists (ASA) score.

Results

Turnover among specific types of operating room staff, including the anaesthesiologist (p = 0.011), circulating nurse (p = 0.027), and scrub nurse (p = 0.006), was significantly associated with increased operative duration. Furthermore, the presence of medical students and nursing students were associated with improved intraoperative efficiency in TKA (p = 0.048) and THA (p = 0.015), respectively. The presence of surgical fellows (p > 0.05), vendor representatives (p > 0.05), and physician assistants (p > 0.05) had no effect on intraoperative efficiency. Finally, the presence of the surgeon’s 'preferred' staff did not significantly shorten operative duration, except in the case of residents (p = 0.043).

Conclusion

Our findings suggest that active management of surgical team turnover and composition may provide a means of improving intraoperative efficiency during THA and TKA. Cite this article: Bone Joint J 2021;103-B(2):347–352.
Capsular resection versus capsular repair in direct anterior approach for total hip arthroplasty: a randomized controlled trial
Authors: Vandeputte Frans-Jozef , Vanbiervliet Jens , Sarac Cigdem , Driesen Ronald , Corten Kristoff
Published: February 2021

Aims

Optimal exposure through the direct anterior approach (DAA) for total hip arthroplasty (THA) conducted on a regular operating theatre table is achieved with a standardized capsular releasing sequence in which the anterior capsule can be preserved or resected. We hypothesized that clinical outcomes and implant positioning would not be different in case a capsular sparing (CS) technique would be compared to capsular resection (CR).

Methods

In this prospective trial, 219 hips in 190 patients were randomized to either the CS (n = 104) or CR (n = 115) cohort. In the CS cohort, a medial based anterior flap was created and sutured back in place at the end of the procedure. The anterior capsule was resected in the CR cohort. Primary outcome was defined as the difference in patient-reported outcome measures (PROMs) after one year. PROMs (Harris Hip Score (HHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and Short Form 36 Item Health Survey (SF-36)) were collected preoperatively and one year postoperatively. Radiological parameters were analyzed to assess implant positioning and implant ingrowth. Adverse events were monitored.

Results

At one year, there was no difference in HSS (p = 0.728), HOOS (Activity Daily Life, p = 0.347; Pain, p = 0.982; Quality of Life, p = 0.653; Sport, p = 0.994; Symptom, p = 0.459), or SF-36 (p = 0.338). Acetabular component inclination (p = 0.276) and anteversion (p = 0.392) as well as femoral component alignment (p = 0.351) were similar in both groups. There were no dislocations, readmissions, or reoperations in either group. The incidence of psoas tendinitis was six cases in the CS cohort (6%) and six cases in the CR cohort (5%) (p = 0.631).

Conclusion

No clinical differences were found between resection or preservation of the anterior capsule when performing a primary THA through the DAA on a regular theatre table. In case of limited visibility during the learning curve, it might be advisable to resect a part of the anterior capsule. Cite this article: Bone Joint J 2021;103-B(2):321–328.
Vancouver B periprosthetic fractures involving the Exeter cemented stem
Authors: Powell-Bowns Matilda F. R. , Oag Erlend , Ng Nathan , Pandit Hemant , Moran Matthew , Patton James T. , Clement Nick D. , Scott Chloe E. H.
Published: February 2021

Aims

The aim of this study was to determine whether fixation, as opposed to revision arthroplasty, can be safely used to treat reducible Vancouver B type fractures in association with a cemented collarless polished tapered femoral stem (the Exeter).

Methods

This retrospective cohort study assessed 152 operatively managed consecutive unilateral Vancouver B fractures involving Exeter stems; 130 were managed with open reduction and internal fixation (ORIF) and 22 with revision arthroplasty. Mean follow-up was 6.5 years (SD 2.6; 3.2 to 12.1). The primary outcome measure was revision of at least one component. Kaplan–Meier survival analysis was performed. Regression analysis was used to identify risk factors for revision following ORIF. Secondary outcomes included any reoperation, complications, blood transfusion, length of hospital stay, and mortality.

Results

Fractures (B1 n = 74 (49%); B2 n = 50 (33%); and B3 n = 28 (18%)) occurred at median of 4.2 years (interquartile range (IQR) 1.2 to 9.2) after primary total hip arthroplasty (THA) (n = 138) or hemiarthroplasty (n = 14). Rates of revision and reoperation were significantly higher following revision arthroplasty compared to ORIF for B2 (p = 0.001) and B3 fractures (p = 0.050). Five-year survival was significantly better following ORIF: 92% (95% confidence interval (CI) 86.4% to 97.4%) versus 63% (95% CI 41.7% to 83.3%), p < 0.001. ORIF was associated with reduced blood transfusion requirement and reoperations, but there were no differences in medical complications, hospital stay, or mortality between surgical groups. No independent predictors of revision following ORIF were identified: where the bone-cement interface was intact, fixation of B2 or B3 fractures was not associated with an increased risk of revision.

Conclusion

When the bone-cement interface was intact and the fracture was anatomically reducible, all Vancouver B fractures around Exeter stems could be managed with fixation as opposed to revision arthroplasty. Fixation was associated with reduced need for blood transfusion and lower risk of revision surgery compared with revision arthroplasty. Cite this article: Bone Joint J 2021;103-B(2):309–320.
Reassessing glenoid inclination in reverse total shoulder arthroplasty with glenosphere lateralization
Authors: Mahendraraj Kuhan A. , Shields Maggie V. , Grubhofer Florian , Golenbock Samuel W. , Jawa Andrew
Published: February 2021

Aims

Existing literature indicates that inferiorly inclined glenoid baseplates following reverse total shoulder arthroplasty (RSA) produce better outcomes compared to superiorly inclined baseplates. We aim to compare clinical outcomes for RSAs with superiorly and neutrally/inferiorly inclined lateralized glenospheres.

Methods

We retrospectively reviewed 154 consecutive patients undergoing RSA between July 2015 and July 2017 by one single-fellowship trained surgeon (AJ). Two raters (KAM and MVS) independently measured glenoid inclination in preoperative and minimum two year follow-up radiographs (anteroposterior/Grashey) using the RSA angle. Inclination was then compared to patient-reported outcomes, range of motion (ROM), and independently assessed degree of scapular notching and staging of heterotopic ossification at two year follow-up.

Results

Median postoperative inclination for each group was found to be -3.6° (interquartile range (IQR) -2.1 to -6.9) and 6.0° (3.2° to 10.1°) for the neutrally/inferiorly and superiorly inclined cohorts, respectively. Preoperative inclination was highly associated with postoperative inclination (p = 0.004). When comparing superiorly and neutrally/inferiorly inclined glenospheres, there were no differences in heterotopic ossification (p = 0.606), scapular notching (p = 0.367), American Shoulder and Elbow Surgeons score (p = 0.419), Single Assessment Numeric Evaluation (p = 0.417), Visual Analogue Scale (VAS) pain score (p = 0.290), forward elevation (p = 0.161), external rotation (p = 0.537), or internal rotation (p = 0.656).

Conclusion

Compared to neutral and inferior inclination, up to 6° ± 3° of superior glenoid baseplate inclination on a lateralized RSA design produces no differences in postoperative ROM or patient-reported outcomes, and produces similar levels of scapular notching and heterotopic ossification. Additionally, the degree of preoperative inclination represents an important factor in surgical decision-making as it is strongly associated with postoperative inclination. It is important to note that the findings of this study are only reflective of lateralized RSA prostheses. Cite this article: Bone Joint J 2021;103-B(2):360–365.
The effect of tibial and femoral component coronal alignment on clinical outcomes and survivorship in unicompartmental knee arthroplasty
Authors: Khow Yong Zhi , Liow Ming Han Lincoln , Lee Merrill , Chen Jerry Yongqiang , Lo Ngai Nung , Yeo Seng Jin
Published: February 2021

Aims

This study aimed to identify the tibial component and femoral component coronal angles (TCCAs and FCCAs), which concomitantly are associated with the best outcomes and survivorship in a cohort of fixed-bearing, cemented, medial unicompartmental knee arthroplasties (UKAs). We also investigated the potential two-way interactions between the TCCA and FCCA.

Methods

Prospectively collected registry data involving 264 UKAs from a single institution were analyzed. The TCCAs and FCCAs were measured on postoperative radiographs and absolute angles were analyzed. Clinical assessment at six months, two years, and ten years was undertaken using the Knee Society Knee score (KSKS) and Knee Society Function score (KSFS), the Oxford Knee Score (OKS), the 36-Item Short-Form Health Survey questionnaire (SF-36), and range of motion (ROM). Fulfilment of expectations and satisfaction was also recorded. Implant survivorship was reviewed at a mean follow-up of 14 years (12 to 16). Multivariate regression models included covariates, TCCA, FCCA, and two-way interactions between them. Partial residual graphs were generated to identify angles associated with the best outcomes. Kaplan-Meier analysis was used to compare implant survivorship between groups.

Results

Significant two-way interaction effects between TCCA and FCCA were identified. Adjusted for each other and their interaction, a TCCA of between 2° and 4° and a FCCA of between 0° and 2° were found to be associated with the greatest improvements in knee scores and the probability of fulfilling expectations and satisfaction at ten years. Patients in the optimal group whose TCCA and FCCA were between 2° and 4°, and 0° and 2°, respectively, had a significant survival benefit at 15 years compared with the non-optimal group (optimal: survival = 100% vs non-optimal: survival = 92%, 95% confidence interval (CI) 88% to 96%).

Conclusion

Significant two-way interactions between the TCCA and FCCA demonstrate the importance of evaluating the alignment of the components concomitantly in future studies. By doing so, we found that patients who concomitantly had both a TCCA of between 2° and 4° and a FCCA of between 0° and 2° had the best patient-reported outcome measures at ten years and better survivorship at 15 years. Cite this article: Bone Joint J 2021;103-B(2):338–346.
The influence of duration of infection on outcome of debridement and implant retention in fracture-related infection
Authors: Morgenstern Mario , Kuehl Richard , Zalavras Charalampos G. , McNally Martin , Zimmerli Werner , Burch Marc Antoine , Vandendriessche Thomas , Obremskey William T. , Verhofstad Michael H. J. , Metsemakers Willem Jan
Published: February 2021

Aims

The principle strategies of fracture-related infection (FRI) treatment are debridement, antimicrobial therapy, and implant retention (DAIR) or debridement, antimicrobial therapy, and implant removal/exchange. Increasing the period between fracture fixation and FRI revision surgery is believed to be associated with higher failure rates after DAIR. However, a clear time-related cut-off has never been scientifically defined. This systematic review analyzed the influence of the interval between fracture fixation and FRI revision surgery on success rates after DAIR.

Methods

A systematic literature search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in PubMed (including MEDLINE), Embase, and Web of Science Core Collection, investigating the outcome after DAIR procedures of long bone FRIs in clinical studies published until January 2020.

Results

Six studies, comprising 276 patients, met the inclusion criteria. Data from this review showed that with a short duration of infection (up to three weeks) and under strict preconditions, retention of the implant is associated with high success rates of 86% to 100%. In delayed infections with a fracture fixation-FRI revision surgery interval of three to ten weeks, absence of recurrent infection was reported in 82% to 89%. Data on late FRIs, with a fracture fixation-FRI revision surgery interval of more than ten weeks, are scarce and a success rate of 67% was reported.

Conclusion

Acute/early FRI, with a short duration of infection, can successfully be treated with DAIR up to ten weeks after osteosynthesis. The limited available data suggest that chronic/late onset FRI treated with DAIR may be associated with a higher rate of recurrence. Successful outcome is dependent on managing all aspects of the infection. Thus, time from fracture fixation is not the only factor that should be considered in treatment planning of FRI. Due to the heterogeneity of the available data, these conclusions have to be interpreted with caution. Cite this article: Bone Joint J 2021;103-B(2):213–221.
Subtrochanteric femur fractures: current review of management
Authors: Garrison Ian , Domingue Grayson , Honeycutt M. Wesley
Published: February 2021

Subtrochanteric (ST) femur fractures are proximal femur fractures, which are often difficult to manage effectively because of their deforming anatomical forces. Operative management of ST fractures is the mainstay of treatment, with the two primary surgical implant options being intramedullary (IM) nails and extramedullary plates. Of these, IM nails have a biologic and biomechanical superiority, and have become the gold standard for ST femur fractures. The orthopaedic surgeon should become familiar and facile with several reduction techniques to create anatomical alignment in all unique ST fracture patterns. This article presents a comprehensive and current review of the epidemiology, anatomy, biomechanics, clinical presentation, diagnosis, and management of subtrochanteric femur fractures.

Cite this article: EFORT Open Rev 2021;6:145-151. DOI: 10.1302/2058-5241.6.200048
The Culture against Patriarchy: Djan Seriy Anaplian, Pariah and Defector in Iain M. Banks’s Matter
Authors: Martín Alegre Sara
Published: February 2021

Djan Seriy Anaplian es, posiblemente, el personaje femenino más completo creado por Iain M. Banks para su serie sobre la Cultura (1987-2013). En Matter (2008) [Materia, 2010] Anaplian comparte protagonismo con sus hermanastros Ferbin y Oramen pero ella es la verdadera heroína. Como mujer, Djan Seriy es una paria en su patriarcal país natal, y eventualmente se convierte en tránsfuga en la utopía de Banks, la Cultura. Nacida princesa en el anticuado reino de su padre, el Rey Hausk, Djan es criada para ser usada en una alianza matrimonial según decida el rey. La Cultura rescata a Anaplian para transformarla en ciudadana libre posthumana y, más tarde, en agente secreto de Circunstancias Especiales (convirtiéndose así en paria interna). No obstante, la singular trayectoria de Anaplian, su empoderamiento personal y su ambigua actitud hacia la Cultura no han sido abordados por los estudiosos de Banks pese a demostrar su posicionamiento anti-patriarcal. Este es el tema que se examina en este artículo.
Integrating adaptive optics-SLO and OCT for multimodal visualization of the human retinal pigment epithelial mosaic
Authors: Bower Andrew J. , Liu Tao , Aguilera Nancy , Li Joanne , Liu Jianfei , Lu Rongwen , Giannini John P. , Huryn Laryssa A. , Dubra Alfredo , Liu Zhuolin , Hammer Daniel X. , Tam Johnny
Published: February 2021

In vivo imaging of human retinal pigment epithelial (RPE) cells has been demonstrated through multiple adaptive optics (AO)-based modalities. However, whether consistent and complete information regarding the cellular structure of the RPE mosaic is obtained across these modalities remains uncertain due to limited comparisons performed in the same eye. Here, an imaging platform combining multimodal AO-scanning light ophthalmoscopy (AO-SLO) with AO-optical coherence tomography (AO-OCT) is developed to make a side-by-side comparison of the same RPE cells imaged across four modalities: AO-darkfield, AO-enhanced indocyanine green (AO-ICG), AO-infrared autofluorescence (AO-IRAF), and AO-OCT. Co-registered images were acquired in five subjects, including one patient with choroideremia. Multimodal imaging provided multiple perspectives of the RPE mosaic that were used to explore variations in RPE cell contrast in a subject-, location-, and even cell-dependent manner. Estimated cell-to-cell spacing and density were found to be consistent both across modalities and with normative data. Multimodal images from a patient with choroideremia illustrate the benefit of using multiple modalities to infer the cellular structure of the RPE mosaic in an affected eye, in which disruptions to the RPE mosaic may locally alter the signal strength, visibility of individual RPE cells, or even source of contrast in unpredictable ways.
Topologically protected plasmon mode with ultrastrong field localization in a graphene-based metasurface
Authors: Lu Yanxin , Chen Yihang
Published: February 2021

Graphene plasmons, the electromagnetic waves coupled to charge excitations in a graphene sheet, have attracted great interest because of their intriguing properties, such as electrical tunability, long plasmon lifetime, and high degree of spatial confinement. They may enable the manufacture of novel optical devices with extremely high speed, low driving voltage, low power consumption and compact sizes. In this paper, we propose a graphene-based metasurface which can support a topologically protected graphene plasmon mode with the ability of ultrastrong field localization. We show that such a plasmonic metasurface, constructed by depositing a graphene sheet on a periodic silicon substrate, would exhibit different bandgap topological characteristics as the filling factor of the periodic substrate changes. By setting suitable Fermi levels of graphene at two different areas of the metasurface, topological interface plasmon modes can be excited, resulting in over 8 orders of magnitude enhancement of the plasmon intensity. The topologically protected plasmon mode is robust against the perturbation of the structural parameters, and its frequency can be tuned by adjusting the gate-voltage on the graphene sheet. This highly integrated platform could provide a pathway for low-power and actively controllable nonlinear optics.
Genomic analyses of glycine decarboxylase neurogenic mutations yield a large-scale prediction model for prenatal disease
Authors: Farris Joseph , Alam Md Suhail , Rajashekara Arpitha Mysore , Haldar Kasturi
Published: February 2021

Hundreds of mutations in a single gene result in rare diseases, but why mutations induce severe or attenuated states remains poorly understood. Defect in glycine decarboxylase (GLDC) causes Non-ketotic Hyperglycinemia (NKH), a neurological disease associated with elevation of plasma glycine. We unified a human multiparametric NKH mutation scale that separates severe from attenuated neurological disease with new in silico tools for murine and human genome level-analyses, gathered in vivo evidence from mice engineered with top-ranking attenuated and a highly pathogenic mutation, and integrated the data in a model of pre- and post-natal disease outcomes, relevant for over a hundred major and minor neurogenic mutations. Our findings suggest that highly severe neurogenic mutations predict fatal, prenatal disease that can be remedied by metabolic supplementation of dams, without amelioration of persistent plasma glycine. The work also provides a systems approach to identify functional consequences of mutations across hundreds of genetic diseases. Our studies provide a new framework for a large scale understanding of mutation functions and the prediction that severity of a neurogenic mutation is a direct measure of pre-natal disease in neurometabolic NKH mouse models. This framework can be extended to analyses of hundreds of monogenetic rare disorders where the underlying genes are known but understanding of the vast majority of mutations and why and how they cause disease, has yet to be realized.
Increased dopaminergic neurotransmission results in ethanol dependent sedative behaviors in Caenorhabditis elegans
Authors: Pandey Pratima , Singh Anuradha , Kaur Harjot , Ghosh-Roy Anindya , Babu Kavita
Published: February 2021

Ethanol is a widely used drug, excessive consumption of which could lead to medical conditions with diverse symptoms. Ethanol abuse causes dysfunction of memory, attention, speech and locomotion across species. Dopamine signaling plays an essential role in ethanol dependent behaviors in animals ranging from C. elegans to humans. We devised an ethanol dependent assay in which mutants in the dopamine autoreceptor, dop-2, displayed a unique sedative locomotory behavior causing the animals to move in circles while dragging the posterior half of their body. Here, we identify the posterior dopaminergic sensory neuron as being essential to modulate this behavior. We further demonstrate that in dop-2 mutants, ethanol exposure increases dopamine secretion and functions in a DVA interneuron dependent manner. DVA releases the neuropeptide NLP-12 that is known to function through cholinergic motor neurons and affect movement. Thus, DOP-2 modulates dopamine levels at the synapse and regulates alcohol induced movement through NLP-12.
Machine learning model for predicting severity prognosis in patients infected with COVID-19: Study protocol from COVID-AI Brasil
Authors: Paiva Proença Lobo Lopes Flávia , Kitamura Felipe Campos , Prado Gustavo Faibischew , Kuriki Paulo Eduardo de Aguiar , Garcia Marcio Ricardo Taveira ,   COVID-AI-Brasil
Published: February 2021

The new coronavirus, which began to be called SARS-CoV-2, is a single-stranded RNA beta coronavirus, initially identified in Wuhan (Hubei province, China) and currently spreading across six continents causing a considerable harm to patients, with no specific tools until now to provide prognostic outcomes. Thus, the aim of this study is to evaluate possible findings on chest CT of patients with signs and symptoms of respiratory syndromes and positive epidemiological factors for COVID-19 infection and to correlate them with the course of the disease. In this sense, it is also expected to develop specific machine learning algorithm for this purpose, through pulmonary segmentation, which can predict possible prognostic factors, through more accurate results. Our alternative hypothesis is that the machine learning model based on clinical, radiological and epidemiological data will be able to predict the severity prognosis of patients infected with COVID-19. We will perform a multicenter retrospective longitudinal study to obtain a large number of cases in a short period of time, for better study validation. Our convenience sample (at least 20 cases for each outcome) will be collected in each center considering the inclusion and exclusion criteria. We will evaluate patients who enter the hospital with clinical signs and symptoms of acute respiratory syndrome, from March to May 2020. We will include individuals with signs and symptoms of acute respiratory syndrome, with positive epidemiological history for COVID-19, who have performed a chest computed tomography. We will assess chest CT of these patients and to correlate them with the course of the disease. Primary outcomes:1) Time to hospital discharge; 2) Length of stay in the ICU; 3) orotracheal intubation;4) Development of Acute Respiratory Discomfort Syndrome. Secondary outcomes:1) Sepsis; 2) Hypotension or cardiocirculatory dysfunction requiring the prescription of vasopressors or inotropes; 3) Coagulopathy; 4) Acute Myocardial Infarction; 5) Acute Renal Insufficiency; 6) Death. We will use the AUC and F1-score of these algorithms as the main metrics, and we hope to identify algorithms capable of generalizing their results for each specified primary and secondary outcome.
Prevalence of unintended pregnancy and its associated factors: Evidence from six south Asian countries
Authors: Sarder Alamgir , Islam Sheikh Mohammed Shariful , Maniruzzaman  , Talukder Ashis , Ahammed Benojir
Published: February 2021

Aim

Unintended pregnancy is a significant public health concern in South Asian countries because of its negative association with the socioeconomic and health outcomes for both children and mothers. The present study aimed to explore the prevalence of unintended pregnancy and explore its determinants among women of reproductive age in six South Asian countries.

Methods

Nationwide latest demography and health survey data from six South Asian countries, including Bangladesh (2014), Pakistan (2017–2018), Nepal (2016), Afghanistan (2015), Maldives (2016–2017) and India (2015–2016) were pooled for the present study. Multivariate analysis was performed to explore the association between unintended pregnancy and its associated factors.

Results

Amongst the total women (n = 41,689), overall, 19.1% pregnancies were reported as unintended (ranging from 11.9% in India to 28.4% in Bangladesh). The logistic regression model showed that younger women (15–19 years) had 1.42 times higher chance of unintended pregnancies. The odds of unintended pregnancies was 1.24 times higher for poorest women and 1.19 times higher for poorer women. Further, urban women (aOR = 0.70, 95% CI = 0.50–0.80), women having no children (aOR = 0.10, 95% CI = 0.09–0.12), smaller (≤4) family (aOR = 0.72, 95% CI = 0.67–0.78), those who intent to use contraceptive (aOR = 0.72, 95% CI = 0.60–0.86), currently living with partner (aOR = 0.90, 95% CI = 0.81–0.99), first cohabitation in teenage (≤19 years) (aOR = 0.85, 95% CI = 0.78–0.92) were less likely to report unintended pregnancies.

Conclusions

This study has showed that women’s age, wealth index, place of residence, number of children, family size, the intention of contraceptive use, living with a partner, and first cohabitation age are essential determinants of unintended pregnancy. These factors should be considered when trying to reduce unintended pregnancy in six South Asian countries. However, there is a need to improve health education, counselling, skills-building, sex education, modern contraceptive use and its access in this region. Intervention programs regarding reproductive health and policies are warranted to reduce rates of unintended pregnancy in South Asian countries.
Pseudomonas aeruginosa induces p38MAP kinase-dependent IL-6 and CXCL8 release from bronchial epithelial cells via a Syk kinase pathway
Authors: Coates Matthew S. , Alton Eric W. F. W. , Rapeport Garth W. , Davies Jane C. , Ito Kazuhiro
Published: February 2021

Pseudomonas aeruginosa (Pa) infection is a major cause of airway inflammation in immunocompromised and cystic fibrosis (CF) patients. Mitogen-activated protein (MAP) and tyrosine kinases are integral to inflammatory responses and are therefore potential targets for novel anti-inflammatory therapies. We have determined the involvement of specific kinases in Pa-induced inflammation. The effects of kinase inhibitors against p38MAPK, MEK 1/2, JNK 1/2, Syk or c-Src, a combination of a p38MAPK with Syk inhibitor, or a novel narrow spectrum kinase inhibitor (NSKI), were evaluated against the release of the proinflammatory cytokine/chemokine, IL-6 and CXCL8 from BEAS-2B and CFBE41o- epithelial cells by Pa. Effects of a Syk inhibitor against phosphorylation of the MAPKs were also evaluated. IL-6 and CXCL8 release by Pa were significantly inhibited by p38MAPK and Syk inhibitors (p<0.05). Phosphorylation of HSP27, but not ERK or JNK, was significantly inhibited by Syk kinase inhibition. A combination of p38MAPK and Syk inhibitors showed synergy against IL-6 and CXCL8 induction and an NSKI completely inhibited IL-6 and CXCL8 at low concentrations. Pa-induced inflammation is dependent on p38MAPK primarily, and Syk partially, which is upstream of p38MAPK. The NSKI suggests that inhibiting specific combinations of kinases is a potent potential therapy for Pa-induced inflammation.
Time-varying properties of asymmetric volatility and multifractality in Bitcoin
Authors: Takaishi Tetsuya
Published: February 2021

This study investigates the volatility of daily Bitcoin returns and multifractal properties of the Bitcoin market by employing the rolling window method and examines relationships between the volatility asymmetry and market efficiency. Whilst we find an inverted asymmetry in the volatility of Bitcoin, its magnitude changes over time, and recently, it has become small. This asymmetric pattern of volatility also exists in higher frequency returns. Other measurements, such as kurtosis, skewness, average, serial correlation, and multifractal degree, also change over time. Thus, we argue that properties of the Bitcoin market are mostly time dependent. We examine efficiency-related measures: the Hurst exponent, multifractal degree, and kurtosis. We find that when these measures represent that the market is more efficient, the volatility asymmetry weakens. For the recent Bitcoin market, both efficiency-related measures and the volatility asymmetry prove that the market becomes more efficient.
A breeding pool of ideas: Analyzing interdisciplinary collaborations at the Complex Systems Summer School
Authors: Brown Jacqueline , Murray Dakota , Furlong Kyle , Coco Emily , Dablander Fabian
Published: February 2021

Interdisciplinary research is essential for the study of complex systems, and so there is a growing need to understand the factors that facilitate collaboration across diverse fields of inquiry. In this exploratory study, we examine the composition of self-organized project groups and the structure of collaboration networks at the Santa Fe Institute’s Complex Systems Summer School. Using data from all iterations of the summer school from 2005 to 2019, comprising 823 participants and 322 projects, we investigate the factors that contribute to group composition. We first test for homophily with respect to individual-level attributes, finding that group composition is largely consistent with random mixing based on gender, career position, institutional prestige, and country of study. However, we find some evidence of homophilic preference in group composition based on disciplinary background. We then conduct analyses at the level of group projects, finding that project topics from the Social and Behavioral Sciences are over-represented. This could be due to a higher level of baseline interest in, or knowledge of, social and behavioral sciences, or the common application of methods from the natural sciences to problems in the social sciences. Consequently, future research should explore this discrepancy further and examine whether it can be mitigated through policies aimed at making topics in other disciplines more accessible or appealing for collaboration.
Excitable actin dynamics and amoeboid cell migration
Authors: Ecker Nicolas , Kruse Karsten
Published: February 2021

Amoeboid cell migration is characterized by frequent changes of the direction of motion and resembles a persistent random walk on long time scales. Although it is well known that cell migration is typically driven by the actin cytoskeleton, the cause of this migratory behavior remains poorly understood. We analyze the spontaneous dynamics of actin assembly due to nucleation promoting factors, where actin filaments lead to an inactivation of these factors. We show that this system exhibits excitable dynamics and can spontaneously generate waves, which we analyze in detail. By using a phase-field approach, we show that these waves can generate cellular random walks. We explore how the characteristics of these persistent random walks depend on the parameters governing the actin-nucleator dynamics. In particular, we find that the effective diffusion constant and the persistence time depend strongly on the speed of filament assembly and the rate of nucleator inactivation. Our findings point to a deterministic origin of the random walk behavior and suggest that cells could adapt their migration pattern by modifying the pool of available actin.
Capture and visualization of live Mycobacterium tuberculosis bacilli from tuberculosis patient bioaerosols
Authors: Dinkele Ryan , Gessner Sophia , McKerry Andrea , Leonard Bryan , Seldon Ronnett , Koch Anastasia S. , Morrow Carl , Gqada Melitta , Kamariza Mireille , Bertozzi Carolyn R. , Smith Brian , McLoud Courtney , Kamholz Andrew , Bryden Wayne , Call Charles , Kaplan Gilla , Mizrahi Valerie , Wood Robin , Warner Digby F.
Published: February 2021

Interrupting transmission is an attractive anti-tuberculosis (TB) strategy but it remains underexplored owing to our poor understanding of the events surrounding transfer of Mycobacterium tuberculosis (Mtb) between hosts. Determining when live, infectious Mtb bacilli are released and by whom has proven especially challenging. Consequently, transmission chains are inferred only retrospectively, when new cases are diagnosed. This process, which relies on molecular analyses of Mtb isolates for epidemiological fingerprinting, is confounded by the prolonged infectious period of TB and the potential for transmission from transient exposures. We developed a Respiratory Aerosol Sampling Chamber (RASC) equipped with high-efficiency filtration and sampling technologies for liquid-capture of all particulate matter (including Mtb) released during respiration and non-induced cough. Combining the mycobacterial cell wall probe, DMN-trehalose, with fluorescence microscopy of RASC-captured bioaerosols, we detected and quantified putative live Mtb bacilli in bioaerosol samples arrayed in nanowell devices. The RASC enabled non-invasive capture and isolation of viable Mtb from bioaerosol within 24 hours of collection. A median 14 live Mtb bacilli (range 0–36) were isolated in single-cell format from 90% of confirmed TB patients following 60 minutes bioaerosol sampling. This represented a significant increase over previous estimates of transmission potential, implying that many more organisms might be released daily than commonly assumed. Moreover, variations in DMN-trehalose incorporation profiles suggested metabolic heterogeneity in aerosolized Mtb. Finally, preliminary analyses indicated the capacity for serial image capture and analysis of nanowell-arrayed bacilli for periods extending into weeks. These observations support the application of this technology to longstanding questions in TB transmission including the propensity for asymptomatic transmission, the impact of TB treatment on Mtb bioaerosol release, and the physiological state of aerosolized bacilli.
In vivo dynamics and adaptation of HTLV-1-infected clones under different clinical conditions
Authors: Izaki Mikiko , Yasunaga Jun-ichirou , Nosaka Kisato , Sugata Kenji , Utsunomiya Hayato , Suehiro Youko , Shichijo Takafumi , Yamada Asami , Sugawara Yasuhiko , Hibi Taizo , Inomata Yukihiro , Akari Hirofumi , Melamed Anat , Bangham Charles , Matsuoka Masao
Published: February 2021

Human T-cell leukemia virus type 1 (HTLV-1) spreads through cell contact. Therefore, this virus persists and propagates within the host by two routes: clonal proliferation of infected cells and de novo infection. The proliferation is influenced by the host immune responses and expression of viral genes. However, the detailed mechanisms that control clonal expansion of infected cells remain to be elucidated. In this study, we show that newly infected clones were strongly suppressed, and then stable clones were selected, in a patient who was infected by live liver transplantation from a seropositive donor. Conversely, most HTLV-1+ clones persisted in patients who received hematopoietic stem cell transplantation from seropositive donors. To clarify the role of cell-mediated immunity in this clonal selection, we suppressed CD8+ or CD16+ cells in simian T-cell leukemia virus type 1 (STLV-1)-infected Japanese macaques. Decreasing CD8+ T cells had marginal effects on proviral load (PVL). However, the clonality of infected cells changed after depletion of CD8+ T cells. Consistent with this, PVL at 24 hours in vitro culture increased, suggesting that infected cells with higher proliferative ability increased. Analyses of provirus in a patient who received Tax-peptide pulsed dendritic cells indicate that enhanced anti-Tax immunity did not result in a decreased PVL although it inhibited recurrence of ATL. We postulate that in vivo selection, due to the immune response, cytopathic effects of HTLV-1 and intrinsic attributes of infected cells, results in the emergence of clones of HTLV-1-infected T cells that proliferate with minimized HTLV-1 antigen expression.
The relationship of texts to dead fish
Authors: Thackara John
Published: February 2021

John Thackara’s theory of change is borrowed from Ilya Prigogene: ‘when a system is far from equilibrium, small islands of coherence have the capacity to shift the entire system’. As a writer, he explains, his work therefore involves a search for small islands of coherence – that he can later describe – in which social and ecological relationships thrive together. His aim as a curator is similar: he strives to enable embodied encounters with situations (or ‘islands’) in which we feel ourselves to be part of nature, rather than separate from it. This work is therefore not symbolic, like ‘systems thinking’. It is more field work than head work. ‘I want people to experience relational ecologies, not just think about them’, Thackara states. He cites the artist Eva Bakkeslett as describing this process – the cultivation of ecological and social connectivity – as social fermentation.
Art school futures
Authors: Wood John
Published: February 2021

The late Sir Ken Robinson attracted great interest for noting the education system’s lack of support for imaginative and creative skills. This omission has important ramifications throughout society as a whole, especially given the challenges of the COVID-19 pandemic, not to mention environmental emergencies that threaten our very survival as a species. Although our predicament calls for a co-creative and transformative response, this amounts to a paradigm change that is beyond the capacity of our current systems of governance. The article therefore calls for a review of education policy that would include some deep reflections on the ecological purpose of learning. It suggests that, in order to augment the scholastic and analytical traditions underpinning the modern university, policy-makers should invest in the modernization and development of the traditional art school. This should cater for a much larger spectrum of human needs and capabilities. These might support ethical, co-creative thinking at all levels, including feeling, acting and experiencing at many simultaneous levels, including head, heart, hand and what the article calls ‘humour’.
Bahía de Palma/Palma Bay (Bosch 1962): An allegory of late Francoism
Authors: Yarza Alejandro
Published: February 2021

Famous for having been the first Spanish film to feature the Franco-banned bikinis, Bahía de Palma/Palma Bay () is generally seen as a frivolous footnote in the history of Spanish cinema, but it is also a pioneering aperturista film, that deserves closer examination as the blue print for late Francoist cultural productions of the 1960s and beyond. This article argues that Bahía de Palma is a veiled allegorical representation of the social and political contradictions that characterized Spain’s reintegration into the international world order after the dark and disastrous period of international isolation during the 1940s and early 1950s.
Revolutionary ruralities: Spaces of surveillance and exclusion in Carlos Lechuga’s Santa y Andrés (2016)
Authors: Peña Lauren
Published: February 2021

The abundance of rural and provincial settings as spaces belonging to or determined by revolutionary time are recurrent elements in Cuban cinema prior to 1989. Many documentaries and films from the late 1960–80s focused on ‘scaping’revolutionary accomplishments and struggles in the construction of a socialist society. At that time, the depiction of provincial and rural towns of Cuba were aligned with and echoed the Revolution’s political and social agenda of collective work, struggle and revolutionary virtue. This article explores rural space, surveillance and exclusions through Carlos Lechuga’s film Santa y Andrés (). The film portrays the punishment and surveillance of a blacklisted homosexual writer in a small town in the eastern part of the island during 1983. This article, first, examines how Santa y Andrés questions the premise that Cuba’s rural and provincial space is a homogeneous revolutionary one, and, second, proposes that the film’s choice of location refashions the rural-provincial space in Cuban cinema as a space of dissidence, exclusionary practices and pervasive surveillance.
Factors That Affect Liquidity of Commercial Banks in Kosovo
Authors: Morina Donjeta , Qarri Albert
Published: February 2021

A very important factor that affects the growth and survival of commercial banks is also the level of liquidity. Banking industry regulators require banks to possess liquid assets in order to fulfill their obligations to depositors and third parties accurately. Lack of liquidity reduces the ability of banks to meet their obligations and otherwise excess liquidity may be the cause of reduced profits for banks. There are many factors that can affect the position of liquidity in commercial banks and which factors cause unbalanced liquidity and as such also affect their performance. As a result, the study of these factors is of particular importance. The main objective of this study is to analyze the liquidity empathy of the banking sector to several specific banking and macroeconomic factors. To achieve this objective, the study uses regression analysis per a data set that includes a time of 8 years respectively the years 2012 - 2019. To build the necessary econometric model and to achieve the purpose of the study, data are taken from the publications of the Central Bank and the World Bank (GDP data), which data are analyzed for each quarter for the study period. After analyzing the available data, the study concludes that between the main factors that can affect the liquidity position of commercial banks, Non-performing loans, Capital adequacy, and Credit interest rate have the grand and most important impact on the liquidity banking position.
Evaluating the Site of Avrocity as a High-Rise Residential Project in Duhok City According to LEED Sustainable Rating Criteria
Authors: Dhuoki Riman , Çağnan Çiğdem
Published: February 2021

Duhok city faced many challenges in the last decades because of urban and population growth especially in the residential sector because there is shortage in providing housing units annually. High-rise residential projects are one of the common solutions to overcome the deficit. Yet, these kinds of residential projects have many issues since it is a new method of development within the city. From here the main aim of this study come to light which is to improve the quality of high-rise residential projects site in accordance to sustainable rating system and establish effective regulations framework with the help of internationally accepted criteria. The reason for upgrading the regulations is that the sites of these projects do not offer healthy built environment to their residents. The lack of nearby social and technical infrastructures caused more distances to be covered by vehicles resulting environmental pollution which could cause global warming. To investigate and evaluate the high-rise residential projects site according to Leadership in Energy and Environmental Design (LEED) sustainable rating tool, a residential project site has been chosen, which is; Avrocity project. The information had been analyzed qualitatively. The obtained results demonstrated that, the lack of updated regulations in Duhok city lead to improper planning and deficiency of services within residential projects site.