bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender discrimination as a barrier to high-quality maternal and newborn health care in Nigeria: findings from a cross-sectional quality of care assessment
Authors: Oduenyi Chioma , Banerjee Joya , Adetiloye Oniyire , Rawlins Barbara , Okoli Ugo , Orji Bright , Ugwa Emmanuel , Ishola Gbenga , Betron Myra
Published: March 2021

Background

Poor reproductive, maternal, newborn, child, and adolescent health outcomes in Nigeria can be attributed to several factors, not limited to low health service coverage, a lack of quality care, and gender inequity. Providers’ gender-discriminatory attitudes, and men’s limited positive involvement correlate with poor utilization and quality of services. We conducted a study at the beginning of a large family planning (FP) and maternal, newborn, child, and adolescent health program in Kogi and Ebonyi States of Nigeria to assess whether or not gender plays a role in access to, use of, and delivery of health services.

Methods

We conducted a cross-sectional, observational, baseline quality of care assessment from April–July 2016 to inform a maternal and newborn health project in health facilities in Ebonyi and Kogi States. We observed 435 antenatal care consultations and 47 births, and interviewed 138 providers about their knowledge, training, experiences, working conditions, gender-sensitive and respectful care, and workplace gender dynamics. The United States Agency for International Development’s Gender Analysis Framework was used to analyze findings.

Results

Sixty percent of providers disagreed that a woman could choose a family planning method without a male partner’s involvement, and 23.2% of providers disagreed that unmarried clients should use family planning. Ninety-eight percent believed men should participate in health services, yet only 10% encouraged women to bring their partners. Harmful practices were observed in 59.6% of deliveries and disrespectful or abusive practices were observed in 34.0%. No providers offered clients information, services, or referrals for gender-based violence. Sixty-seven percent reported observing or hearing of an incident of violence against clients, and 7.9% of providers experienced violence in the workplace themselves. Over 78% of providers received no training on gender, gender-based violence, or human rights in the past 3 years.

Conclusion

Addressing gender inequalities that limit women’s access, choice, agency, and autonomy in health services as a quality of care issue is critical to reducing poor health outcomes in Nigeria. Inherent gender discrimination in health service delivery reinforces the critical need for gender analysis, gender responsive approaches, values clarification, and capacity building for service providers.
Low incidence of venous thrombosis but high incidence of arterial thrombotic complications among critically ill COVID-19 patients in Singapore
Authors:   on behalf of the Thrombosis Haemostasis Workgroup of Singapore Society of Haematology, Tan Chuen Wen , Fan Bingwen Eugene , Teo Winnie Z. Y. , Tung Moon Ley , Shafi Humaira , Christopher Dheepa , Zheng Shuwei , Peh Wee Ming , Chan Stephrene Seok Wei , Chong Vanessa Cui Lian , Gallardo Christian Aledia , Chang Cheng Chieh Ray , Ling Li Min , Tan Jing Yuan , Lee Ken Cheah Hooi , Phua Ghee Chee , Cherng Benjamin Pei Zhi , Low Jenny Guek Hong , Ho Vui Kian , Prasad Vishnu , Wong Lester Jung Long , Lim Cheryl Xiu Qi , Chee Yen Lin , Ong Kiat Hoe , Lee Lai Heng , Ng Heng Joo , Yap Eng Soo
Published: March 2021

Background

Arterial and venous thrombosis are reported to be common in critically ill COVID-19 patients.

Method and results

This is a national multicenter retrospective observational study involving all consecutive adult COVID-19 patients who required intensive care units (ICU) admission between 23 January 2020 and 30 April 2020 in Singapore. One hundred eleven patients were included and the venous and arterial thrombotic rates in ICU were 1.8% (n = 2) and 9.9% (n = 11), respectively. Major bleeding rate was 14.8% (n = 16).

Conclusions

Critically ill COVID-19 patients in Singapore have lower venous thromboembolism but higher arterial thrombosis rates and bleeding manifestations than other reported cohorts.
Minimum initial service package (MISP) for sexual and reproductive health for women in a displacement setting: a narrative review on the Syrian refugee crisis in Lebanon
Authors: Nabulsi Dana , Abou Saad Maya , Ismail Hussein , Doumit Myrna A. A. , El-Jamil Fatima , Kobeissi Loulou , Fouad Fouad M.
Published: March 2021

Background

Women and girls are disproportionately affected in times of conflict and forced displacement, with disturbance in access to healthcare services leading to poor sexual and reproductive health outcomes. The minimal initial service package (MISP) was created to mitigate the consequences of conflict and prevent poor sexual and reproductive health (SRH) outcomes, especially among women and girls. The aim of this narrative review was to explore the SRH response for Syrian refugee women and girls in Lebanon, with a focus on MISP implementation.

Methodology

A comprehensive literature search was conducted for peer-reviewed articles in 8 electronic databases and multiple grey literature sites for articles published from March 2011 to May 2019. The target population was Syrian refugee women in Lebanon displaced from Syria as a result of the conflict that erupted in March 2011. The selected articles addressed MISP, SRH needs and services, and barriers to service access. A narrative synthesis was conducted, guided by the six main objectives of the MISP.

Results

A total of 254 documents were retrieved, from which 12 peer-reviewed articles and 12 reports were included in the review. All identified articles were descriptive in nature and no studies evaluating MISP or other interventions or programs were found. The articles described the wide range of SRH services delivered in Lebanon to Syrian refugee women. However, access to and quality of these services remain a challenge. Multiple sources reported a lack of coordination, leading to fragmented service provision and duplication of effort. Studies reported a high level of sexual and gender-based violence, pregnancy complications and poor antenatal care compliance, and limited use of contraceptive methods. Very few studies reported on the prevalence of HIV and other STIs, reporting low levels of infection. Multiple barriers to healthcare access were identified, which included system-level, financial, informational and cultural factors, healthcare workers.

Conclusion

This study highlights the main SRH services provided, their use and access by Syrian refugee women in Lebanon. Despite the multitude of services provided, the humanitarian response remains decentralized with limited coordination and multiple barriers that limit the utilization of these services. A clear gap remains, with limited evaluation of SRH services that are pertinent to achieve the MISP objectives and the ability to transition into comprehensive services. Improving the coordination of services through a lead agency can address many of the identified barriers and allow the transition into comprehensive services.
Age-related differences in monocyte DNA methylation and immune function in healthy Kenyan adults and children
Authors: Dobbs Katherine R. , Embury Paula , Koech Emmily , Ogolla Sidney , Munga Stephen , Kazura James W. , Dent Arlene E.
Published: March 2021

Background

Age-related changes in adaptive and innate immune cells have been associated with a decline in effective immunity and chronic, low-grade inflammation. Epigenetic, transcriptional, and functional changes in monocytes occur with aging, though most studies to date have focused on differences between young adults and the elderly in populations with European ancestry; few data exist regarding changes that occur in circulating monocytes during the first few decades of life or in African populations. We analyzed DNA methylation profiles, cytokine production, and inflammatory gene expression profiles in monocytes from young adults and children from western Kenya.

Results

We identified several hypo- and hyper-methylated CpG sites in monocytes from Kenyan young adults vs. children that replicated findings in the current literature of differential DNA methylation in monocytes from elderly persons vs. young adults across diverse populations. Differentially methylated CpG sites were also noted in gene regions important to inflammation and innate immune responses. Monocytes from Kenyan young adults vs. children displayed increased production of IL-8, IL-10, and IL-12p70 in response to TLR4 and TLR2/1 stimulation as well as distinct inflammatory gene expression profiles.

Conclusions

These findings complement previous reports of age-related methylation changes in isolated monocytes and provide novel insights into the role of age-associated changes in innate immune functions.
Serum ferritin levels in inflammation: a retrospective comparative analysis between COVID-19 and emergency surgical non-COVID-19 patients
Authors: Banchini Filippo , Cattaneo Gaetano Maria , Capelli Patrizio
Published: March 2021

Background

SARS-CoV-2 infection has spread worldwide, and the pathogenic mechanism is still under investigation. The presence of a huge inflammatory response, defined as “cytokine storm,” is being studied in order to understand what might be the prognostic factors implicated in the progression of the infection, with ferritin being one of such markers. The role of ferritin as a marker of inflammation is already known, and whether it changes differently between COVID and non-COVID patients still remains unclear. The aim of this retrospective analysis is to understand whether the inflammatory process in these two types is different.

Methods

In this retrospective analysis, we compared 17 patients affected by SARS-CoV-2, who had been admitted between February and April 2020 (group A) along with 30 patients admitted for acute surgical disease with SARS-CoV-2 negative swab (group B). A further subgroup of Covid negative patients with leukocytosis was compared to group A.

Results

In group A, the median (interquartile range) serum ferritin was 674 (1284) ng/mL, and it was double the cutoff (300 ng/mL) in 9 out of 17 (52%). The median (IQR) value of ferritin level in the total blood samples of group B was 231, and in the subgroup with leucocytosis, 149 (145). Group A showed a significantly higher ferritin median level compared to the entire group B (two-tailed Mann-Whitney test, p < 0.0001) as well as to the subgroup with leucocytosis (p < 0.0014).

Conclusions

The role of iron metabolism appears to be directly involved in COVID infection. On the other hand, in the acute inflammation of patients admitted for surgery, and probably in other common phlogistic processes, iron modifications appear to be self-limited. However, our finding suggests the use of ferritin as a marker for COVID infection.
Intraosseous versus intravenous vascular access during cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of observational studies
Authors: Hsieh Yu-Lin , Wu Meng-Che , Wolfshohl Jon , d’Etienne James , Huang Chien-Hua , Lu Tsung-Chien , Huang Edward Pei-Chuan , Chou Eric H. , Wang Chih-Hung , Chen Wen-Jone
Published: March 2021

Introduction

This study is aimed to investigate the association of intraosseous (IO) versus intravenous (IV) route during cardiopulmonary resuscitation (CPR) with outcomes after out-of-hospital cardiac arrest (OHCA).

Methods

We systematically searched PubMed, Embase, Cochrane Library and Web of Science from the database inception through April 2020. Our search strings included designed keywords for two concepts, i.e. vascular access and cardiac arrest. There were no limitations implemented in the search strategy. We selected studies comparing IO versus IV access in neurological or survival outcomes after OHCA. Favourable neurological outcome at hospital discharge was pre-specified as the primary outcome. We pooled the effect estimates in random-effects models and quantified the heterogeneity by the I2 statistics. Time to intervention, defined as time interval from call for emergency medical services to establishing vascular access or administering medications, was hypothesized to be a potential outcome moderator and examined in subgroup analysis with meta-regression.

Results

Nine retrospective observational studies involving 111,746 adult OHCA patients were included. Most studies were rated as high quality according to Newcastle-Ottawa Scale. The pooled results demonstrated no significant association between types of vascular access and the primary outcome (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.27–1.33; I2, 95%). In subgroup analysis, time to intervention was noted to be positively associated with the pooled OR of achieving the primary outcome (OR: 3.95, 95% CI, 1.42–11.02, p: 0.02). That is, when the studies not accounting for the variable of “time to intervention” in the statistical analysis were pooled together, the meta-analytic results between IO access and favourable outcomes would be biased toward inverse association. No obvious publication bias was detected by the funnel plot.

Conclusions

The meta-analysis revealed no significant association between types of vascular access and neurological outcomes at hospital discharge among OHCA patients. Time to intervention was identified to be an important outcome moderator in this meta-analysis of observation studies. These results call for the need for future clinical trials to investigate the unbiased effect of IO use on OHCA CPR.
Retraction Note: Esoteric Connective Tissue Therapy for chronic low back pain to reduce pain, and improve functionality and general well-being compared with physiotherapy: study protocol for a randomised controlled trial
Authors: Schnelle Christoph , Messerschmidt Steffen , Minford Eunice J. , Greenaway-Twist Kate , Szramka Maxine , Masiorski Marianna , Sheldrake Michelle , Jones Mark
Published: March 2021

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s13063-021-05154-3.
Serum chitinase-3-like 1 protein is a useful biomarker to assess disease activity in ANCA-associated vasculitis: an observational study
Authors: Ahn Sung Soo , Yoon Taejun , Park Yong-Beom , Prendecki Maria , Bhangal Gurjeet , McAdoo Stephen P. , Lee Sang-Won
Published: March 2021

Background

To investigate whether serum chitinase-3-like 1 protein (YKL-40) is associated with disease activity in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).

Methods

ELISA was performed in serum samples from AAV patients who were enrolled in our prospective observational cohort to estimate levels of YKL-40. Birmingham vasculitis activity score (BVAS) (version 3), five factor score (FFS), and short form-36 (SF-36), as well as clinical and laboratory data were collected. Kidney expression of YKL-40 was assessed by immunohistochemical staining using renal biopsy tissues from ANCA-associated glomerulonephritis patients (AAGN). Severe AAV and FFS were defined as BVAS ≥ 12 and FFS ≥ 2, and the correlations between laboratory variables, BVAS, FFS, and SF-36 score were assessed using linear regression analysis. The optimal cut-off of serum YKL-40 for severe AAV and high FFS was calculated using the receiver operator characteristic curve analysis.

Results

Of the included 60 patients, 32 (53.3%), 17 (28.3%), and 11 (18.3%) were classified as microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatosis with polyangiitis. The median BVAS and FFS were 7.0 and 1.0, whereas the mean SF-36 physical and mental component scores were 50.5 and 58.3. Serum YKL-40 level was higher in patients with severe AAV and high FFS compared to those without (p = 0.007 and p < 0.001); multivariable linear regression analysis revealed that serum YKL-40 was independently associated with BVAS, FFS, and SF-36 scores. On kidney tissues obtained from AAGN patients, strong cytoplasmic staining of YKL-40 was found in cells present in inflammatory lesions. In addition, AAV patients had higher levels of serum YKL-40 compared to those with systemic lupus erythematosus, rheumatoid arthritis, osteoarthritis, and healthy control. The proportion of patients having severe AAV and high FFS was significantly higher in those with serum YKL-40 > 221.3 ng/mL and > 227.1 ng/mL than those without (relative risk 2.852 and 7.000). In 12 patients with serial YKL-40 testing, 11 patients (91.7%) exhibited a reduction in serum YKL-40 levels following a decrease in disease activity (p < 0.001).

Conclusion

Our findings suggest that serum YKL-40 may be a clinically useful biomarker to assess AAV disease activity.

Trial registration

Retrospectively registered.
Proposal of initial and maintenance dosing regimens with linezolid for renal impairment patients
Authors: Kawasuji Hitoshi , Tsuji Yasuhiro , Ogami Chika , Kimoto Kou , Ueno Akitoshi , Miyajima Yuki , Kawago Koyomi , Sakamaki Ippei , Yamamoto Yoshihiro
Published: March 2021

Background

Linezolid is administered as a fixed dose to all patients despite evidence of overexposure and thrombocytopenia in renal impairment. The aims of this study were to evaluate the risk of thrombocytopenia and the utility of therapeutic drug monitoring (TDM), and to propose alternate dosing regimens in patients with renal impairment.

Methods

We retrospectively reviewed patients ≥13 years old for whom serum linezolid trough concentration (Cmin) was measured during linezolid treatment. Patients with episodes of infection were divided into groups by presence of renal impairment (RI group) or absence of renal impairment (non-RI group), and by use of Cmin-based TDM (TDM group) or not (non-TDM group) during linezolid treatment.

Results

In the 108 patients examined by multivariable analyses, renal impairment was independently associated with increased risk of thrombocytopenia (OR 3.17, 95%CI 1.10–9.12) and higher Cmin. Analysis of the utility of TDM in the RI group showed that clinical failure rate was significantly lower in the TDM subgroup than in the non-TDM subgroup. Furthermore, in the RI group, dosage adjustments were needed in 90.5% of the TDM subgroup. All episodes administered a reduced dose of 300 mg every 12 h in the RI group showed Cmin ≥ 2.0 mg/L. Additional analysis of 53 episodes in which Cmin was measured within 48 h after starting administration showed that the initial standard dose for 2 days was sufficient to rapidly reach an effective therapeutic concentration in the RI group.

Conclusions

Empirical dose reduction to 300 mg every 12 h after administration of the initial fixed dose for 2 days and Cmin-based TDM may improve safety outcomes while maintaining appropriate efficacy among patients with renal impairment.
Radio-adaptive response and correlation of non-homologous end joining repair gene polymorphisms [XRRC5 (3R/2R/1R/0R), XRCC6(C/G) and XRCC7 (G/T)] in human peripheral blood mononuclear cells exposed to gamma radiation
Authors: Shelke Shridevi , Das Birajalaxmi
Published: March 2021

Background

Radio-adaptive response (RAR) is transient phenomena, where cells conditioned with a small dose (priming) of ionizing radiation shows significantly reduced DNA damage with a subsequent high challenging dose. The role of DNA double strand break repair gene polymorphism in RAR is not known. In the present study attempt was made to find out the influence of NHEJ repair gene polymorphisms [a VNTR; XRCC5 (3R/2R/1R/0R); two single nucleotide polymorphisms (SNPs); XRCC6 (C/G) and XRCC7 (G/T)] with DNA damage, repair and mRNA expression in human PBMCs in dose and adaptive response studies. Genomic DNA extracted from venous blood samples of 20 random healthy donors (16 adaptive and 4 non-adaptive) and genotyping of NHEJ repair genes was carried out using PCR amplified length polymorphism.

Results

The dose response study revealed significant positive correlation of genotypes at XRRC5 (3R/2R/1R/0R), XRCC6(C/G) and XRCC7 (G/T) with DNA damage. Donors having genotypes with 2R allele at XRCC5 showed significant positive correlation with mRNA expression level (0R/2R: r = 0.846, P = 0.034; 1R/2R: r = 0.698, P = 0.0001 and 2R/2R: r = 0.831, P = 0.0001) for dose response. Genotypes C/C and C/G of XRCC6 showed a significant positive correlation (P = 0.0001), whereas, genotype T/T of XRCC7 showed significant negative correlation (r = − 0.376, P = 0.041) with mRNA expression.

Conclusion

Interestingly, adaptive donors having C/G genotype of XRCC6 showed significantly higher (P < 0.05) mRNA expression level in primed cells suggesting their role in RAR. In addition, NHEJ repair gene polymorphisms play crucial role with radio-sensitivity and RAR in human PBMCs.
Nivolumab and Ipilimumab as Maintenance Therapy in Extensive-Disease Small-Cell Lung Cancer: CheckMate 451
Authors: Owonikoko Taofeek K. , Park Keunchil , Govindan Ramaswamy , Ready Neal , Reck Martin , Peters Solange , Dakhil Shaker R. , Navarro Alejandro , Rodríguez-Cid Jerónimo , Schenker Michael , Lee Jong-Seok , Gutierrez Vanesa , Percent Ivor , Morgensztern Daniel , Barrios Carlos H. , Greillier Laurent , Baka Sofia , Patel Miten , Lin Wen Hong , Selvaggi Giovanni , Baudelet Christine , Baden Jonathan , Pandya Dimple , Doshi Parul , Kim Hye Ryun
Published: March 2021

PURPOSE

In extensive-disease small-cell lung cancer (ED-SCLC), response rates to first-line platinum-based chemotherapy are robust, but responses lack durability. CheckMate 451, a double-blind phase III trial, evaluated nivolumab plus ipilimumab and nivolumab monotherapy as maintenance therapy following first-line chemotherapy for ED-SCLC.

METHODS

Patients with ED-SCLC, Eastern Cooperative Oncology Group performance status 0-1, and no progression after ≤ 4 cycles of first-line chemotherapy were randomly assigned (1:1:1) to nivolumab 1 mg/kg plus ipilimumab 3 mg/kg once every 3 weeks for 12 weeks followed by nivolumab 240 mg once every 2 weeks, nivolumab 240 mg once every 2 weeks, or placebo for ≤ 2 years or until progression or unacceptable toxicity. Primary end point was overall survival (OS) with nivolumab plus ipilimumab versus placebo. Secondary end points were hierarchically tested.

RESULTS

Overall, 834 patients were randomly assigned. The minimum follow-up was 8.9 months. OS was not significantly prolonged with nivolumab plus ipilimumab versus placebo (hazard ratio [HR], 0.92; 95% CI, 0.75 to 1.12; P = .37; median, 9.2 v 9.6 months). The HR for OS with nivolumab versus placebo was 0.84 (95% CI, 0.69 to 1.02); the median OS for nivolumab was 10.4 months. Progression-free survival HRs versus placebo were 0.72 for nivolumab plus ipilimumab (95% CI, 0.60 to 0.87) and 0.67 for nivolumab (95% CI, 0.56 to 0.81). A trend toward OS benefit with nivolumab plus ipilimumab was observed in patients with tumor mutational burden ≥ 13 mutations per megabase. Rates of grade 3-4 treatment-related adverse events were nivolumab plus ipilimumab (52.2%), nivolumab (11.5%), and placebo (8.4%).

CONCLUSION

Maintenance therapy with nivolumab plus ipilimumab did not prolong OS for patients with ED-SCLC who did not progress on first-line chemotherapy. There were no new safety signals.
Learning media development physical education sport and health that number athletic material based on Android application
Authors: Zuhdi Syukron , Sukarmin Yustinus
Published: March 2021

This study aims to (1) produce development products for physical education sport and health learning media based on android applications on the athletic material of throwing numbers for high school students, (2) to find out the feasibility of developing learning media products for physical education sport and health learning media based on android applications on throwing number athletic materials for high school students and (3) determine the level of effectiveness of the development of learning media products for physical education sport and health based on android applications on athletics throwing numbers for high school students.This research and development are carried out in ten stages which refer to the steps developed by Borg & Gall, which include: (1) Research and information gathering, (2) Planning, (3) Initial product development, (4) Improvement of the initial design, (5) Formation of trial products, (6) Small group trials, (7) Revision of small group trial products, (8) Field trials, (9) Revision of field trial products, (10) Dissemination or dissemination. The subjects of the small group trial were 21 students of class XI SMA N 5 Yogyakarta, the subjects of the field trials were 112 students of class XI SMA N 8 Yogyakarta, the product trials included material expert trials, media experts, and small group trials and field trials. by students. Data obtained through observation, questionnaires, interviews, and learning outcomes tests. Data analysis used a t-test with a significance level of 0.05. Based on the results of the pretest and posttest that have been obtained, then the effectiveness test was carried out using the paired sample t-test using the SPSS program. 16 For Windows.The results of the research of the pretest and posttest data on the field test showed that the learning media had a significant effect on improving student or respondent achievement. The effectiveness of learning media can be seen in the descriptions of the results of the pretest and posttest on respondents or students of SMA N 8 Yogyakarta as follows. At the pretest the lowest score got a score of 33.00, then the highest score got a score of 100.00. The average number of values on the pretest reached 79.91, and if all the respondents' scores on the pretest were added up to reach a value of 8951.00. After being treated with the application of learning media, the lowest score in the posttest increased to 37.00 and the highest score reached a maximum score of 100.00. The average overall score on the posttest increased to 86.62, and the total score at the posttest reached a score of 9702.00.Thus, it can be concluded that the instructional media products of physical education sport and health, athletic number throwing materials based on android applications can be used by students and teachers as a medium in the teaching and learning process.Keywords: learning media, athletics throwing numbers, android applications
The role of Aotearoa New Zealand midwives as positive influencers on food literacy with Samoan families: Report on a small Auckland-based study
Authors: Wong Soon Hoy Neng , Crezee Ineke , Rush Elaine
Published: March 2021

Background: Healthy eating is crucial for optimal development during all stages of life and most particularly during pregnancy. According to Stats NZ, Pasefika people make up 8.1% of the total Aotearoa New Zealand population. Information from the Ministry of Health suggests that Pasefika people have the highest level of food insecurity and the highest level of obesity. Women are more likely than men to be involved with food preparation; therefore, it is important to know to what extent women are aware of what healthy eating means for themselves and their families. Aim: This study aimed to explore an understanding of the levels of food literacy among representatives of three generations of women in five Samoan families; how each of the three generations ensured that their dietary intake contributed to their quality of health; and whether the extent of food literacy was influenced both within and between/across generations. Method: The study used a combined Delphi-Talanoa approach to interview 15 Samoan women about the levels of their understanding of food literacy. Findings: Midwives played an important role in helping pregnant Samoan women understand about healthy eating during pregnancy. Women shared with other female relatives what they had learned about healthy eating from their midwives. Learnings taken from midwives included the importance of choosing healthy foods, portion control and physical activity. Conclusion: All study participants who had received antenatal care in Aotearoa New Zealand mentioned the important role of midwives in increasing their understanding of healthy lifestyle choices. What the women learned from their midwives also informed their wider family or aiga.
STRUKTUR BIROKRASI DAN DISPOSISI DALAM PELAKSANAAN KAWASAN SEHAT BEBAS ASAP ROKOK DI SEKOLAH
Authors: Purnomo Parmadi Sigit , Sundoro Totok , S Pramukti Dian
Published: March 2021

Based on the Health Research and Development Agency in 2013, the Special Province of Yogyakarta tended to be high at 21.2% for the proportion of the population aged over or equal to 10 years who smoked every day. One of the districts in the Yogyakarta Special Region that has a policy on non-smoking areas is Bantul Regency. The regulation regarding the non-smoking areas is regulated in the Bantul Regent's Regulation No. 18 of 2016 concerning Healthy Areas Non-Smoking (HANS). This study aims to determine the structure of the bureaucracy and disposition in the implementation of a Healthy Smoke Free Area in Schools. This research uses descriptive qualitative method. Data analysis using data reduction, data presentation, and drawing conclusions.  The results of interviews about the bureaucratic structure in the implementation of the HANS found that there were no smoking procedures for smokers in schools. General rules are included in the school code of conduct in the form of a slogan / smoking ban. The disposition aspect possessed by the school could not be said to be good in the implementation of the HANS, it was evident that there were still school residents who still smoked in the school area and found cigarette putp in the school area. The conclusion of the research is that the bureaucratic structure does not yet exist and the disposition factor cannot be carried out properly so that it is expected that there will be a follow-up from the Government of Bantul Regency to be able to socialize Bantul Regent Regulation No. 18 of 2016 concerning Smoke-Free Healthy Areas in the school environment involving the role of the Health Office, BNNP and / or the Police and develop a culture of reporting and providing guarantees for reporters from the Principal, as well as making special regulations / SOPs for school residents who have a smoking habit.
Nest Structure, Seasonality and Female Behavior of Epicharis (Anepicharis) dejeanii Lepeletier (Hymenoptera, Apidae, Centridini) in a Restinga Ecosystem, in Southern Brazil
Authors: Uemura Natalia , Gobatto André Luiz , Pina Welber da Costa , Ono Rafael Hideki , Sofia Silvia Helena
Published: March 2021

We investigated the nesting behavior of females of Epicharis dejeanii and the architecture of their nests, in a large aggregation in a Restinga area, on Ilha do Superagui, southern Brazil. Surveys were carried out intermittently through the warm-wet seasons from different years between 2013 and 2017. The nest aggregation occupied an area of approximately 2,000 m2 and was situated on a sand bank and on flat sandy soil. Each nest consisted of a long unbranched tunnel, averaging 1.45 ± 0.35 m (N = 8), connected to a single brood cell with a mean length of 3.13 ± 0.2 cm (N = 13) and mean diameter of 1.2 ± 0.1 cm (N = 11). On average, females carried out 4.0 ± 2.4 foraging trips per day (N = 109) to collect floral resources for provisioning brood cells. Similar times were spent by females in their foraging trips for: only pollen (15.8 ± 14.3 min, N = 72), oil (22.5 ± 15.7 min, N = 45), or both resources (17.0 ± 15.1, N = 63).  Our findings reveal that some variation in both nesting architecture and female behavior of E. dejeanii during nesting activities can occur in different locations from the same region.
Generation of squeezed light vacuum enabled by coherent population trapping
Authors: Neveu P. , Delpy J. , Liu S. , Banerjee C. , Lugani J. , Bretenaker F. , Brion E. , Goldfarb F.
Published: March 2021

We demonstrate the possibility to generate squeezed vacuum states of light by four wave mixing (FWM) enabled coherent population trapping in a metastable helium cell at room temperature. Contrary to usual FWM far detuned schemes, we work at resonance with an atomic transition. We investigate the properties of such states and show that the noise variances of the squeezed and anti-squeezed quadratures cannot be explained by the simple presence of losses. A specific model allows us to demonstrate the role played by spontaneous emitted photons, which experience squeezing while propagation inside of the cell. This theoretical model, which takes into account both residual absorption and spontaneous emission, leads to an excellent agreement with the experimental data without any adjusted parameter.
Analyzing the effect of incident angle on echo intensity acquired by hyperspectral lidar based on the Lambert-Beckman model
Authors: Qian Xu , Yang Jian , Shi Shuo , Gong Wei , Du Lin , Chen Biwu , Chen Bowen
Published: March 2021

Hyperspectral light detection and ranging (HSL) can acquire the spatial and spectral information simultaneously, which can provide more information than hyperspectral imaging and single band lidar. However, the echo intensity from targets is influenced by incident angle, and relative studies were still limited which result in the effect of incident angle on HSL not being completely understood. In this study, the incident angle effect in the whole band of HSL was analyzed and corrected. Then, five types of vegetation sample with different spectral characteristics were collected at the leaf level. Spectral range changing from 550 to 830 nm with a 1 nm spectral resolution was obtained. Lambert-Beckman model was applied to analyze the effect of the incident angle on the echo intensity. The experimental results demonstrated that the Lambert-Beckman model can efficiently apply in fitting the changing of echo intensity with incidence angle and efficiently eliminate the specular effect of target. In addition, the coefficient of variation ratio is significantly improved compared to the reference target-based model. The results illustrated that, compared to reference target-based model, the Lambert-Beckman model can efficiently explain and correct the incident angle effect with specular reflection in HSL. In addition, it was found that the specular fraction Ks, which is reduced with the increasing of reflectance, is dominating the incident angle effect in the whole band, while roughness m keeps stable at different wavelengths. Thus, this research will provide notably advanced insight into correcting the echo intensity of HSL.
Compressed ultrafast tomographic imaging by passive spatiotemporal projections
Authors: Lai Yingming , Shang Ruibo , Côté Christian-Yves , Liu Xianglei , Laramée Antoine , Légaré François , Luke Geoffrey P. , Liang Jinyang
Published: March 2021

Existing streak-camera-based two-dimensional (2D) ultrafast imaging techniques are limited by long acquisition time, the trade-off between spatial and temporal resolutions, and a reduced field of view. They also require additional components, customization, or active illumination. Here we develop compressed ultrafast tomographic imaging (CUTI), which passively records 2D transient events with a standard streak camera. By grafting the concept of computed tomography to the spatiotemporal domain, the operations of temporal shearing and spatiotemporal integration in a streak camera’s data acquisition can be equivalently expressed as the spatiotemporal projection of an

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datacube from a certain angle. Aided by a new, to the best of our knowledge, compressed-sensing reconstruction algorithm, the 2D transient event can be accurately recovered in a few measurements. CUTI is exhibited as a new imaging mode universally adaptable to most streak cameras. Implemented in an image-converter streak camera, CUTI captures the sequential arrival of two spatially modulated ultrashort ultraviolet laser pulses at 0.5 trillion frames per second. Applied to a rotating-mirror streak camera, CUTI records an amination of fast-bouncing balls at 5,000 frames per second.
Buildup dynamics of a pulsating dissipative soliton in an all-normal-dispersion PM Yb-doped fiber laser with a NALM
Authors: Deng Decai , Zhang Haitao , Zu Jiaqi , Chen Junyu
Published: March 2021

A pulsating soliton exists in various passively mode-locked fiber lasers. Versatile categories of pulsating solitons have been investigated in a steady regime. However, the formation dynamics of pulsating solitons have not been fully revealed. Herein, we experimentally captured both single pulsating soliton and two pulsating soliton formation processes in an all-normal-dispersion laser. With the help of the time-stretch dispersion Fourier transform technique, the real-time temporal and spectral evolutions of pulsating solitons, during the buildup process, were investigated. It is found that pulsation directly derives from the background noise. In addition, both types of pulsations experience several characteristic stages, including an unstable

Q

-switch, spectral shaping, broadening, oscillating, and narrowing, which might be induced by the transient non-balance between the gain and loss of the cavity. We anticipate that the work in this Letter can improve the understanding of pulsating behaviors and bring new insights into the dynamic phenomenon of nonlinear optical systems.
Effects of a combined water and sanitation intervention on biomarkers of child environmental enteric dysfunction and associations with height-for-age z-score: A matched cohort study in rural Odisha, India
Authors: Sinharoy Sheela S. , Reese Heather E. , Praharaj Ira , Chang Howard H. , Clasen Thomas
Published: March 2021

Poor water, sanitation and hygiene (WaSH) conditions are hypothesized to contribute to environmental enteric dysfunction (EED), a subclinical condition that may be associated with chronic undernutrition and impaired linear growth. We evaluated the effect of a combined water and sanitation intervention on biomarkers of EED, and then assessed associations of biomarkers of EED with height-for-age z-scores (HAZ), in children under five. We conducted a sub-study within a matched cohort study of a household-level water and sanitation infrastructure intervention in rural Odisha, India, in which we had observed an effect of the intervention on HAZ. We collected stool samples (N = 471) and anthropometry data (N = 209) for children under age 5. We analyzed stool samples for three biomarkers of EED: myeloperoxidase (MPO), neopterin (NEO), and α1-anti-trypsin (AAT). We used linear mixed models to estimate associations between the intervention and each biomarker of EED and between each biomarker and HAZ. The intervention was inversely associated with AAT (-0.25 log μg/ml, p = 0.025), suggesting a protective effect on EED, but was not associated with MPO or NEO. We observed an inverse association between MPO and HAZ (-0.031 per 1000 ng/ml MPO, p = 0.0090) but no association between either NEO or AAT and HAZ. Our results contribute evidence that a transformative WaSH infrastructure intervention may reduce intestinal permeability, but not intestinal inflammation and immune activation, in young children. Our study also adds to observational evidence of associations between intestinal inflammation and nutritional status, as measured by HAZ, in young children.

Trial Registration: ClinicalTrials.gov (NCT02441699).
Global blood gene expression profiles following a breast cancer diagnosis—Clinical follow-up in the NOWAC post-genome cohort
Authors: Olsen Karina Standahl , Holden Marit , Thalabard Jean-Christophe , Rasmussen Busund Lill-Tove , Lund Eiliv , Holden Lars
Published: March 2021

Objective

This explorative study aimed to assess if there are any time-dependent blood gene expression changes during the first one to eight years after breast cancer diagnosis, which can be linked to the clinical outcome of the disease.

Material and methods

A random distribution of follow-up time from breast cancer diagnosis till blood sampling was obtained by a nested, matched case-control design in the Norwegian Women and Cancer Post-genome Cohort. From 2002–5, women were invited to donate blood samples, regardless of any cancer diagnosis. At end of the study period in 2015, any cancer diagnoses in the 50 000 participants were obtained via linkage to the Norwegian Cancer Registry. For each breast cancer patient (n = 415), an age- and storage time-matched control was drawn. The design gave a uniform, random length of follow-up time, independent of cancer stage. Differences in blood gene expression between breast cancer cases and controls were identified using the Bioconductor R-package limma, using a moving window in time, to handle the varying time elapsed from diagnosis to blood sample.

Results

The number of differentially expressed genes between cases and controls were close to 2,000 in the first year after diagnosis, but fell sharply the second year. During the next years, a transient second increase was observed, but only in women with metastatic disease who later died, both compared to invasive cases that survived (p<0,001) and to metastatic cases that survived (p = 0.024). Among the differentially expressed genes there was an overrepresentation of heme metabolism and T cell-related processes.

Conclusion

This explorative analysis identified changing trajectories in the years after diagnosis, depending on clinical stage. Hypothetically, this could represent the escape of the metastatic cancer from the immune system.
Comparative study on the effect of hyperthermic massage and mechanical squeezing in the patients with mild and severe meibomian gland dysfunction: An interventional case series
Authors: Han Dongkyun , Kim Hoon , Kim Sehwan , Park Yuli , Cho Kyong Jin
Published: March 2021

Background

Meibomian glands exist beneath the palpebral conjunctiva; thus, it is invisible to the naked eye without infrared imaging. This study used meibography to group patients with meibomian gland dysfunction (MGD) and assessed the effects of hyperthermic massage and mechanical squeezing in both groups.

Materials and methods

Patients with MGD were divided into two groups, according to the degree of meibomian gland loss: group 1, in which the sum of eyelid scores ranged from 0 to 4 (mild to moderate gland loss) and group 2, in which the sum of eyelid scores ranged from 5 to 6 (severe gland loss). Hyperthermic massage and mechanical squeezing were given to both groups once a week for 4 weeks, and only non-preservative artificial tears were allowed. Ocular surface disease index (OSDI), Schirmer’s test, meibography score, tear break-up time (TBUT), ocular surface staining, expressible meibomian gland, and quality before and after treatment were compared.

Results

Of the 49 patients who completed the 4 weeks of treatment and the evaluation at week 5, 29 were assigned to group 1 and 20 were assigned to group 2. Meibography scores, OSDI, TBUT, and expressibility of meibum had significant differences before and after treatments in both groups. However, there was no significant difference between the changes in clinical signs between group 1 and 2 after treatment. Without grouping, all patients showed significant decreases in meibography score, OSDI, cornea staining score, and increases in TBUT and expressibility of meibum after treatment.

Conclusions

Considering the results of the current study, hyperthermic massage and mechanical squeezing may be effective in patients with meibomian gland loss, regardless of the degree of severity.
Identification of success factors in elite wrestlers—An exploratory study
Authors: Cieśliński Igor , Gierczuk Dariusz , Sadowski Jerzy
Published: March 2021

Identification of success factors in wrestling as well as establishing their hierarchy are crucial from a cognitive and practical standpoint. It may provide a lot of practical recommendations related to wrestling-specific training. The aim of this study was to identify and establish the hierarchy of success factors in wrestling regardless of a fighting style and weight class. This study included 168 elite male freestyle and Greco-Roman wrestlers. They were divided into two groups: athletes who won medals (successful wrestlers) in high-rank competitions (Polish Championships or higher) and those who did not win any medals (less successful wrestlers) in those competitions. The following elements were assessed: anthropological measurements, body composition, dynamic strength, strength endurance, agility, special endurance, wrestling-specific fitness, response time, technical wrestling skills and anaerobic capacity. For initial data analysis, one-way ANOVA (α = 0.005) was used. Random Forests classifier was employed to identify success factors and to determine the importance of each of these factors in terms of sports performance. Seven key success factors were identified: anaerobic power, strength endurance, response time, special endurance, wrestling-specific fitness and technical wrestling skills performed in a horizontal position. Random Forests turned out to be an effective method of modelling success in wrestling (compared to SVM and KNN, which were also used in the study). These findings suggest that wrestling-specific training can be effectively monitored by controlling several vital indicators of athletes’ preparedness: anaerobic power, strength endurance, response time, special endurance, wrestling-specific fitness and technical wrestling skills (the performance of reverse waistlock from a standing position and trunk grip gut wrench assessed by experts).
The overexpression of DNA repair genes in invasive ductal and lobular breast carcinomas: Insights on individual variations and precision medicine
Authors: Mohamed Ruwaa I. , Bargal Salma A. , Mekawy Asmaa S. , El-Shiekh Iman , Tuncbag Nurcan , Ahmed Alaa S. , Badr Eman , Elserafy Menattallah
Published: March 2021

In the era of precision medicine, analyzing the transcriptomic profile of patients is essential to tailor the appropriate therapy. In this study, we explored transcriptional differences between two invasive breast cancer subtypes; infiltrating ductal carcinoma (IDC) and lobular carcinoma (LC) using RNA-Seq data deposited in the TCGA-BRCA project. We revealed 3854 differentially expressed genes between normal ductal tissues and IDC. In addition, IDC to LC comparison resulted in 663 differentially expressed genes. We then focused on DNA repair genes because of their known effects on patients’ response to therapy and resistance. We here report that 36 DNA repair genes are overexpressed in a significant number of both IDC and LC patients’ samples. Despite the upregulation in a significant number of samples, we observed a noticeable variation in the expression levels of the repair genes across patients of the same cancer subtype. The same trend is valid for the expression of miRNAs, where remarkable variations between patients’ samples of the same cancer subtype are also observed. These individual variations could lie behind the differential response of patients to treatment. The future of cancer diagnostics and therapy will inevitably depend on high-throughput genomic and transcriptomic data analysis. However, we propose that performing analysis on individual patients rather than a big set of patients’ samples will be necessary to ensure that the best treatment is determined, and therapy resistance is reduced.