bluuebunny/crossref_metadata_2025 huggingface dataset:
Health literacy among members of the Nepalese immigrant population in Canada
Authors: Thapa-Bajgain Kalpana , Bajgain Bishnu Bahadur , Dahal Rudra , Adhikari Kamala , Chowdhury Nashit , Chowdhury Mohammad ZI , Turin Tanvir C
Published: January 2023

Background:

Health literacy is an important public health concern and can be defined as ‘the degree or extent to which the individuals have the capacity to obtain, process and understand basic health information and services to make appropriate health decisions’. Research on health literacy among recent immigrants to Canada is not that extensive.

Objective:

The purpose of this paper was to describe health literacy status among Nepalese immigrants residing in Calgary, Alberta, Canada.

Methods:

In 2019, a cross-sectional study, using a self-administered questionnaire, was conducted among Nepalese immigrants in Calgary. The questionnaire comprised 38 questions including sociodemographic information, self-rated health status, having a chronic disease or not, health literacy, sources of health information and preference to gain health information.

Results:

We received 401 responses: 49.63% were from women, 51.37% were aged 36–55 years, 37.00% had graduate-level education, 44.96% had immigrated to Canada less than 5 years ago and 81.05% were employed full-time/part-time or self-employed. Findings revealed that 17.21% of survey participants had limited health literacy, followed by 40.15% who had marginal health literacy. The majority of the survey participants (71.82%) either always or often got health information from healthcare professionals, followed by online resources (56.61%).

Conclusion:

Noteworthy levels of limited health literacy and marginal health literacy were observed among the Nepalese immigrant population. Multidirectional, culturally tailored, community-led, collaborative initiatives are needed to improve health literacy among the immigrant population, to lessen health disparities and to promote better health outcomes.
The Peasant Question Under Nyerere’s Socialism
Authors: Shivji Issa G.
Published: January 2023

This essay is a succinct overview of the manner in which the first president of Tanzania attempted to address the peasant question in the country. In the immediate aftermath of independence (1961–1966), Nyerere’s government bought into the World Bank’s recommendation of village settlement schemes and range development to pull the peasantry and the pastoralist out of the backward, traditional agriculture to modern, more productive agriculture and pastoralism spearheaded by what the WB called progressive farmers. Selected ‘progressive farmers’ would be resettled in new environment administered by hired management which would teach them modern husbandry under close supervision. Village settlement scheme was established at a great cost. By 1966 it was clear that both these projects were disastrous. With the adoption of the country’s socialist blueprint, the government adopted the policy of ‘small is beautiful’, so to speak. Peasant agriculture would be improved through extension services and collective production in Ujamaa villages. Peasants were not particularly enthusiastic about Ujamaa villages. Very few were established making the party diehards, including Nyerere, exasperated. In 1973 the President ordered that living in villages was compulsory and thus began the forced villagisation from 1971–1974 by which time it was estimated that some five million people were forcefully resettled in the so-called development villages. In hindsight, it can be surmised that this move both discredited the Ujamaa project and Nyerere could have lost his peasant base.

Beginning late 1970s and early 1980s the country experienced its worst economic crisis due to a variety of internal and external reasons providing imperialism and internal proto-bourgeoisies an entry point for imposing the notorious structural adjustment programmes. The essay briefly discusses the fate and the fight of the peasant under the subsequent neo-liberal phase predicated on the so-called free market, private property regime and private investment exposing the peasant to the vagaries of capitalism and its crisis. The essay ends with outlining some elements of an alternative discourse to spearhead the peasant struggle for autonomous, sovereign development.

JEL Codes: P32, Q15, Q24
WTO Agreement on Agriculture: Worsening India’s Agrarian Crisis
Authors: Dhar Biswajit
Published: January 2023

India’s accession to the WTO in 1995 brought a new set of challenges for its agriculture. Most of the policies supporting agriculture, especially price support and input subsidies, labelled by the agreement on agriculture (AoA) as domestic support measures, were under the scanner. The price support measure that India uses, namely, the minimum support price (MSP) provided to most of the major crops now faces a problem as the methodology of calculating the extent of subsidies on account of MSP is working against India. Further, the AoA prevents India from using export subsidies since it was not using this instrument in the past. But the agreement allows the advanced countries that were using export subsidies to continue using this instrument, albeit at a lower level. Equally problematic for India is the fact that AoA rules are constraining the implementation of the National Food Security Act, which provides subsidised foodgrains to the disadvantaged sections.

JEL codes: F13, Q17, Q18
Revisiting the Debate on Farm Size and Utilisation of Agricultural Land: Recent Trends in India
Authors: Mondal Dinabandhu , Sen Sucharita
Published: January 2023

This paper revisits the debate on the relationship between farm size and utilisation of agricultural land. Since the 1960s, a large number of studies have been examining this relationship and suggesting possible explanations supporting their thoughts. Three significant hypotheses exist in the literature forwarded by different scholars in this regard: an inverse relationship, a positive and a U-shaped one. Using the recent data from the Agriculture Census of India, this paper attempts to analyse the spatio-temporal trends of the relationship between farm size and land utilisation and examine the hypotheses and explanations already advanced, taking a state-level analysis in India. We found an inverse relationship where smaller farms are more fully and intensively used compared to the larger farms; however, the increasing share of unutilised land among the small and medium farms in the recent decade of 2005–2006 to 2015–2016 indicates a losing ground of small farmers because of ongoing agrarian distress.
The Forest Rights Act and Adivasi Landlessness in Kerala
Authors: Krishnan Shilpa , Mallick Sambit
Published: January 2023

This article is an attempt to understand the Adivasi landlessness in the context of the implementation of the Forest Rights Act (FRA) in Kerala. Kerala has been projected as a model of development so far as social development indicators are concerned. Based on in-depth personal interviews with 72 Adivasis and three Adivasi and human rights activists in eight districts of Kerala, this article examines whose landholding has been a topic of debate in various political platforms. The study was carried out to explore whether the State’s development initiatives and economic growth trajectory had any space for the Adivasis of Kerala. Adivasi landlessness and lack of efficient land distribution may be attributed to the so-called State-led development narratives.
Targeting critical pathways in ferroptosis and enhancing antitumor therapy of Platinum drugs for colorectal cancer
Authors: Wang Gang , Wang Jun-Jie , Zhi-Min Zhu , Xu Xiao-Na , Shi Feng , Fu Xing-Li
Published: January 2023

Colorectal cancer (CRC) can be resistant to platinum drugs, possibly through ferroptosis suppression, albeit the need for further work to completely understand this mechanism. This work aimed to sum up current findings pertaining to oxaliplatin resistance (OR) or resistance to ascertain the potential of ferroptosis to regulate oxaliplatin effects. In this review, tumor development relating to iron homeostasis, which includes levels of iron that ascertain cells’ sensitivity to ferroptosis, oxidative stress, or lipid peroxidation in colorectal tumor cells that are connected with ferroptosis initiation, especially the role of c-Myc/NRF2 signaling in regulating iron homeostasis, coupled with NRF2/GPX4-mediated ferroptosis are discussed. Importantly, ferroptosis plays a key role in OR and ferroptotic induction may substantially reverse OR in CRC cells, which in turn could inhibit the imbalance of intracellular redox induced by oxaliplatin and ferroptosis, as well as cause chemotherapeutic resistance in CRC. Furthermore, fundamental research of small molecules, ferroptosis inducers, GPX4 inhibitors, or natural products for OR coupled with their clinical applications in CRC have also been summarized. Also, potential molecular targets and mechanisms of small molecules or drugs are discussed as well. Suggestively, OR of CRC cells could significantly be reversed by ferroptosis induction, wherein this result is discussed in the current review. Prospectively, the existing literature discussed in this review will provide a solid foundation for scientists to research the potential use of combined anticancer drugs which can overcome OR via targeting various mechanisms of ferroptosis. Especially, promising therapeutic strategies, challenges ,and opportunities for CRC therapy will be discussed.
The experience economy in UK city centres: A multidimensional and interconnected response to the ‘death of the high street’?
Authors: White James T , Hickie James , Orr Allison , Jackson Cath , Richardson Robert
Published: January 2023

Since the 1990s the UK’s city centre high streets have been losing market share to out-of-town shopping and e-retailing. The shocks of the Global Financial Crisis and COVID-19 have hastened this and precipitated widespread store closures. The experience economy is increasingly promoted as a means to avert the ‘death of the high street’, and this prompts our study of its evolution. An exploration of the literature reveals the experience economy to be an interconnected phenomenon focused on the creation of a memorable event that elicits a sensory response via multi-dimensional innovation and design. Using this to guide our empirical work, we undertake a comparative mixed method longitudinal case study of five UK city centres. We initially chart the changing manifestations of experience uses before analysing supporting interviews and observations that reveal three interconnected layers of the experience economy: in-store commercial experiences; leisure and entertainment-orientated adaptations to shopping centres and department stores; and the wider regeneration of the public realm. Implications for city centre management are discussed.
Parliamentarizing war: explaining legislative votes on Canadian military deployments
Authors: Lagassé Philippe , Massie Justin
Published: January 2023

The parliamentarization of military deployments is a burgeoning area of study but has tended to neglect the peculiar cases of legislatures deprived of any war powers. This article contributes to this literature by examining the curious case of Canada. Since Canadian governments are not required to secure parliamentary support to deploy the military, it analyzes why they occasionally have and increasingly do. We propose and test four hypotheses to explain why and when governments willingly choose to involve parliament in war decisions absent constitutional or legal obligation to do so: executive ideology, mission risk, minority parliament, and blame shifting. Our findings suggest that ideology and mission risk have the strongest explanatory and predictive power for when the executive will invite the legislature to vote on a military deployment in Canada. While the desire to avoid blame may contribute to the decision to hold a vote, this is not as influential or statistically relevant. The association between holding a vote and being in a minority parliament, for its part, is negligible and statistically insignificant.
Exploring the Impact of a Serious Game in the Academic Success of Entrepreneurship Students
Authors: Almeida Fernando , Buzady Zoltan
Published: January 2023

Serious games are increasingly present in higher education and many researchers are reflecting on how to use them in the development and training of new skills. However, an unexplored area is the analysis of the impact that serious games have on students’ academic performance in an entrepreneurship course. In this sense, this study simultaneously seeks to explore the impact of the use of a serious game, titled FLIGBY, on the development of hard and soft skills through the use of a mixed methods approach, in which quantitative and qualitative methods are combined by adopting the convergent parallel design model. The findings did not allow us to establish a correlation between the parameters assessed in the FLIGBY and the students’ academic performance. However, it was possible to identify several benefits in the development of soft skills with potential impact on the students’ academic and professional careers.
The Deliberative Referendum: An Idea Whose Time has Come?
Authors: Hendriks Frank , Wagenaar Charlotte
Published: January 2023

While deliberative citizens’ assemblies and plebiscitary referendums have long been perceived as antithetical, the idea of combining the two democratic instruments for better connecting administration and society has come to the fore in both theory and practice in more recent years. In this article, three ways of linking citizens’ assemblies to the referendum process are distinguished, exemplified, institutionally compared, and reflectively discussed. The three—the referendum-preparing, referendum-scrutinizing, and referendum-elaborating citizens’ assembly—come with their distinctive features, potential merits, scope limits, and related design questions. Fitting the “square peg of deliberative democracy” into the “round hole of direct democracy” and embedding hybrid design in diverging political systems are overarching challenges of institutional design. The article concludes that considering recent developments in theory and practice, the idea of a deliberative referendum linking citizens’ assemblies to direct voting on issues, seems an idea whose time has come, but also comes with challenges and questions that design thinkers and practitioners have only begun to tackle and answer.
Public service media and public funding: A three-country study of willingness to pay versus perceived dispensability
Authors: Sehl Annika
Published: January 2023

Recent public debates in several European countries have shown that public service medias’ (PSM) public funding has become a topic of controversial discussion. Based on an online survey in France, Germany, and the UK, this study analyses how the willingness to pay (WTP) versus perceived dispensability of PSM relates to various factors identified in the current literature. Across the three countries, most respondents doubt that PSM are dispensable. However, if they determine the sum of the licence fee themselves, it would clearly be a smaller amount than it is currently. Assessment of the overall information quality of PSM and the assumed state or government influence thereon, have a significant influence on the WTP for PSM versus the perceived dispensability thereof. Understanding the factors driving and hindering WTP versus perceived dispensability is crucial, providing insights relevant to understanding PSM and public funding.
Rural outmigration generates a carbon sink in South China karst
Authors: Chang Jingyi , Yue Yuemin , Tong Xiaowei , Brandt Martin , Zhang Chunhua , Zhang Xuemei , Qi Xiangkun , Wang Kelin
Published: January 2023

China karst is a global hotspot of increasing vegetation cover, with ecological conservation projects being considered as the main driver. New research using global datasets also indicates that rural outmigration has contributed to increasing biomass at national scale. However, the link between rural outmigration and vegetation cover increase has not been established at regional scale, and it remains unclear as to whether increases in biomass do, in fact, improve the environmental conditions. In this study, we use local field and statistical data on population density and rocky desertification areas to study population movements and changes in aboveground biomass in relation to rocky desertification in South China karst during 2000–2017. Our results show that the urban population in this region increased by 8.3 million people between 2005 and 2015, and the rural population decreased by 4.8 million people. We find that aboveground biomass increased most in rural areas with low human pressure, and that there was an almost linear relationship between increase in biomass and rural outmigration, with the highest increase in aboveground biomass density (1.5 MgC ha−1 yr−1) observed in areas where rural outmigration was highest, and the lowest increase in aboveground biomass density (1.1 MgC ha−1 yr−1) where rural outmigration was lowest. Rocky desertification areas decreased with a higher level of rural outmigration. Using local field data, our study confirmed that rural outmigration can generate a carbon sink at regional scale by reducing rocky desertification.
Open-label trials for CGRP-targeted drugs in migraine prevention: A narrative review
Authors: Raffaelli Bianca , De Icco Roberto , Corrado Michele , Terhart Maria , Ailani Jessica
Published: January 2023

Background

Calcitonin gene-related peptide-targeted drugs have proven safe and effective for migraine prevention in large randomized-controlled, double-blind trials with an average duration of six months. Open-label studies may provide additional information on the long-term safety and efficacy of these substances.

Methods

We searched PubMed for open-label trials with calcitonin gene-related peptide(-receptor) monoclonal antibodies and calcitonin gene-related peptide-receptor antagonists. We summarized and critically analyzed the literature in a narrative way.

Results

Overall, 13 open-label trials were included in this review (n = 4 for erenumab, n = 4 for galcanezumab, n = 3 for fremanezumab, n = 1 for eptinezumab, n = 1 for atogepant). Open-label trial duration ranged between 12 and 264 weeks. No safety concerns emerged, and the adverse events profile was similar to the double-blind study phase. Discontinuation rates were generally low with >75% of patients remaining in the trials after one year. Efficacy data showed a sustained reduction of migraine frequency throughout the trials, along with a lasting improvement in quality of life.

Conclusions

The open-label study program for calcitonin gene-related peptide-targeted migraine preventives confirms the favorable safety and efficacy profile of these drugs over time. Treatment adherence appears higher than with previous unspecific migraine preventives. Real-world data and post-marketing surveillance studies may corroborate and complement open-label results.
A Retrospective Review of Dental Care and Related Husbandry of Captive Great Apes Over 37 Years (1982–2019) at Milwaukee County Zoo
Authors: Scheels John L.
Published: January 2023

Milwaukee County Zoo (MCZ) has cared for 25 lowland gorillas ( Gorilla gorilla gorilla), 17 orangutans ( Pongo pygmaeus) and 38 bonobos ( Pan paniscus) since 1982. MCZ has one of the largest captive populations of bonobos in the world, with a current troop of 19 animals and historically as many as 24 in the troop. This article reviews the dental care provided to these animals from 1982–2019.
Outcome of Surgical Extraction of Linguoverted Deciduous Mandibular Canine Teeth, Performed as an Interceptive Orthodontic Procedure in Puppies, on Permanent Occlusion
Authors: Godziebiewski Piotr , Johnston Norman , Thorne Susan , Adams Vicki J.
Published: January 2023

Linguoversion of deciduous mandibular canine teeth can be a painful condition, interferes with the development and growth of the jaws, and potentially leads to further malocclusions affecting permanent dentition. Extraction of linguoverted deciduous mandibular canines is considered an interceptive orthodontic procedure that would allow unimpeded development of the jaws and permanent teeth. This study assessed clinical records of 124 dogs that had linguoverted deciduous mandibular canine teeth surgically extracted between October 2010 and September 2019 in a veterinary dental referral clinic. Seventy-seven cases fulfilled the study criteria. Fifty-one percent of these patients required further orthodontic treatment of the permanent occlusion and forty-nine percent demonstrated atraumatic permanent occlusion. The study found no correlation of the outcome with age at the time of surgery. The class of malocclusion (class 1 or class 2) at the time of surgery was also not associated with the outcome.
Radiocarbon sampling efforts for high-precision lake sediment chronologies
Authors: Rey Fabian , Mustaphi Colin J. Courtney , Szidat Sönke , Gobet Erika , Heiri Oliver , Tinner Willy
Published: January 2023

High-resolution chronologies with the best time control are key for comparing palaeoenvironmental studies with independent high-precision historical, archaeological or climatic data. Precise chronologies are also essential for inter-site comparisons of palaeo records at decadal to centennial time scales. We present an updated sediment chronology from Burgäschisee, a small and well-studied lake in the Swiss lowlands. The new age-depth relationship was generated using a large number of new radiocarbon samples of terrestrial plant remains extracted from the Burgäschisee sediments and Bayesian age-depth modelling. The results reveal 2σ uncertainties of only ±19 years for the entire record covering the Early Bronze Age (3800 cal. BP) to the Early Middle Ages (1150 cal. BP). The differences between four age-depth modelling techniques (Bayesian and non-Bayesian) are minor (around 25 years) and remain stable with lower radiocarbon date availability. The maximum age offset between the preliminary previously published and the refined chronology from Burgäschisee is 225 years. Our results demonstrate the importance of a rigorous subsampling strategy that includes a careful selection of the best terrestrial plant material and avoiding radiocarbon calibration plateaus whenever possible. The new chronology from Burgäschisee now allows a more accurate site-to-site comparison with archaeological, historical and other palaeoecological evidence from the region.
Exploring ‘quality’ in science communication online: Expert thoughts on how to assess and promote science communication quality in digital media contexts
Authors: Fähnrich Birte , Weitkamp Emma , Kupper J. Frank
Published: January 2023

In recent years, the public visibility of science has greatly increased. In the digital media landscape, a wide range of players is now engaged in science communication via various online channels. While these developments offer opportunities, they also entail risks for the quality of science communication. This study explores how the quality of science communication can be assessed and promoted in the increasingly complex digital ecosystem. A two-wave survey with international science communication experts served as a basis to develop a quality framework for digital science communication and to formulate strategies to promote the quality of science communication online. Besides these outcomes, results hint at blind spots in the discourse of science communication quality that demand further investigation and reflection.
Political Constitutionalism and Referendums: The Case of Brexit
Authors: Bellamy Richard
Published: January 2023

The UK's political constitution rests on the checking and balancing operations of a representative system in which parliament is sovereign. By contrast, referendums are often considered instances of popular sovereignty. Critics condemn them as populist appeals to a singular will of the people that risk majority tyranny, supporters believe they allow citizens to check and balance the elitism of politicians. Such arguments lay behind the criticism and praise of the Brexit referendum. This article argues that while the criticism is justified when referendums form an alternative to representative democracy, they can usefully supplement such a system provided they are embedded within and constrained by it. So conceived, the Brexit referendum can be regarded as consistent with political constitutionalism. Yet, this conception challenges claims that it represented the sovereign will of the people. The result remained subject to ratification by a sovereign parliament and could be legitimately overturned by that body.
Re-viewing Video Evidence and Police Violence in the Criminal Courts in Turkey
Authors: Konuk Deniz Pınar
Published: January 2023

This article offers an analysis of audiovisual evidence claims in the struggle for identifying and documenting police violence in Turkish criminal courts. Focusing on a fatal police shooting in an urban district predominantly populated by leftist groups and marginalized communities, it aims to illustrate the limits of both criminal trials and audiovisual technologies of proof. The “culture of impunity” has been the prevailing framework to describe courts’ denial of the ongoing violence of law enforcement. Instead, this article pays attention to the formation of facts, regulation of sensory perceptions, and affective engagements in the courtroom. Drawing on the ethnographically grounded examination of the hearings and the case file, I argue that criminal trials establish the particular legibility of video evidence and police violence. Furthermore, the breach between the ways of seeing, hearing, and interpreting these media serves to delineate different political communities, challenging the assumed unity over which the law has authority.
Teachers’ Voices, Pedagogy and Discursive Practices in Ability Grouping Classrooms in Delhi Government Schools
Authors: Bali Megha
Published: January 2023

This article discusses the pedagogic practice of ability grouping in government schools in Delhi. Despite practical evidence against homogenous student settings, ability grouping is implemented as a policy solution to reduce the huge variance in students’ learning levels within a classroom. Research data is drawn from interviews with 110 government schoolteachers in Delhi, where achievement data from baseline surveys conducted by the Delhi government was used to group students. Using Bourdieu’s (1998) theoretical tools, this article explores how the objective practice of ability grouping positions teachers and their pedagogical practices as intending to obtain performance measurement. Ability grouping creates an environment for teachers in which they submit to consigning students with low achievement results to low ability classrooms. Their habitus is less empowering as teachers’ ability to be teachers and in developing their own curricular content is curtailed by ability setting. The findings of this study reveal that most of the teachers’ pedagogic practice take the shape of educational triage. This had implications for enacted pedagogies and curriculum, as there is an extensive application of the exam-oriented technique of teaching, including selective and abbreviated curriculum in low-ability classrooms as teachers selectively cover less curriculum.
Anorectal Malformations: Practical Tips
Authors: Kureel S.N. , Malik G.K.
Published: January 2023

The spectrum of anorectal malformations (ARM) ranges from non-complex low malformation with well developed rectum, anal canal, sphincters and sensory receptors to the complex high malformation with variable development of sphincters and sensory receptors associated with other anomalies. In addition to promptly detect the presence of ARM and associated life threatening defects, the clinician attending the newborn with absence of anal orifice is entrusted with the task of completing the primary evaluation process to decide whether the defect is low which can be corrected with relatively simple procedures like anoplasty or the defect is high necessitating colostomy for relief of obstruction and definitive surgery later. In majority of cases clinical evaluation can establish the working diagnosis to decide the management protocol. In clinically indeterminate cases invertogram can pin point the diagnosis. In cases with doubtful diagnosis, blind perineal exploration is absolutely contraindicated and colostomy is performed leaving the sphincters intact for subsequent work up and definite surgery.
Disseminated Herpes Simplex Infection in a Neonate
Authors: Basu Maitreyi , Ghosh Sibarjun , Dutta Abhijit , Saha Sudip
Published: January 2023

Herpes simplex virus (HSV) infection in a newborn is commonly due to HSV 2 and less commonly due to HSV 1.1,2 Mixed HSV 1 & 2 infection in newborn is rarely reported.3 Neonatal HSV infection can present as- a) Localized skin, eye and mouth (SEM) affection; b) Central nervous system (CNS) disease or c)Disseminated disease.1,4,5

We report an unusual case of HSV infection in a neonate due both HSV 1 & HSV 2. It led to initial manifestation just like septicemia and ultimately prolonged cholestasis that responded to acyclovir therapy.
Blistering Disorders: Clues to Diagnosis
Authors: Mehendiratta Vibhu
Published: January 2023

Blistering diseases in neonates could be primary due to either a genetic mutation or autoimmune response or they may be secondary to infections, local injury of the skin or passive transfer of maternal antibodies, resulting in fluid accumulation within a specific layer of the skin. Some diseases are characterized by self limiting lesions and are considered benign.
Nevi and Developmental Defects- How to Manage
Authors: Sharma Rajeev , Ranjan Nitin
Published: January 2023

Birthmarks in newborns are common and cause great anxiety in the parents. Developmental defects include malformations, deformations and disruptions. Nevi are nonneoplastic proliferations of tissue, usually present at or soon after birth. They are broadly classifies according to the tissue of origin into epidermal, melanocytic, dermal, subcutaneous and vascular nevi. As many nevi have associated developmental defects, a multidisciplinary examination to rule out neurological, ocular, skeletal and cardiovascular complications may be required. Many of these nevi do not require active management except for cosmetic reasons. Those nevi that cause functional impairment such as vascular nevi or complications like malignancy require active intervention at an early stage. Large congenital melanocytic nevi require evaluation for removal, whereas smaller nevi may be observed for malignant changes. High- and intermediate-risk skin markers of spinal dysraphism such as dermal sinuses, tails, atypical dimples require evaluation with magnetic resonance imaging or ultrasonography. Pediatricians should be familiar with various birthmarks and be comfortable discussing disease prevention and cosmetic strategies.
Nappy Rash - How to Manage
Authors: Oberai Chetan
Published: January 2023

Nappy rash or diaper dermatitis is common among neonates. It is seen as erythema, scaling and chafing on the convex surfaces of the buttocks and other areas in contact with nappies, with sparing of the deeper folds. It has a multifactorial aetiology. Factors which may contribute to nappy rash are water and ammonia in stool and urine, excessive wetness, friction between nappy and skin, soap and detergents, powders and creams and Candida albicans in faeces. Management includes use of good quality napkins, application of emollients, treatment of Candida and bacterial infection and avoidance of powders.
Topical Therapy in Neonates
Authors: Raval Ranjan C , Singh Kuldeep , Gandhi Avani V
Published: January 2023

Topical therapy offers the potential to achieve higher concentrations of a drug in the skin with minimal exposure of other organs. This can greatly increase efficacy and safety relative to systemic administration1-2. Successful topical therapy depends not only on selection of the most appropriate pharmacologically active ingredient but also on the most optimal vehicle for delivery. Gels enhance penetration through the epidermis, while lotions offer the convenience of easy spreadability over large areas3,4. Creams are emulsions of oil and water and the ratio of these ingredients determines the texture, emollient and occlusive properties of the product. Ointments are water-insoluble occlusive mixtures of animal, vegetable or mineral lipids. Several antibiotics, antifungal, antiviral and antiparasitic agents are commercially available, but due consideration should be given to their efficacy and side effects before prescribing them in neonates56. Children are more susceptible to local and systemic effects of topical corticosteroids than are adults. Several types of adverse reactions are possible following the use of topical corticosteroids, so they should be used more cautiously and only when specifically indicated.
Mechanically-driven energy harvester in railway freight system: Integrated modeling and performance analysis
Authors: Dong Liwei , Yu Jie , Yang Fan
Published: January 2023

Vibration energy harvesters (VEHs) convert mechanical energy of unpowered freight wagons into electricity and unlock more smart devices to improve operating conditions. In this paper, the nut-screw-based mechanically-driven VEHs (MD-VEHs) along with several mechanical motion rectifiers (MMRs) are proposed and compared in nonlinear railway freight system. Firstly, the working principles of harvesters with non-MMR, half-wave and full-wave MMRs are researched, and equivalent circuit models are established to better reveal the engagement and disengagement of one-way clutches, followed by the integrated model of wagon-harvester system which studies the suspension vibration response and assesses harvester performance. The harvester equivalent circuit model is validated on a horizontal test bench, and presents a good consistency with test data. In addition, the effects of harvester equivalent damping and inertia on performance are explored systematically. The analysis results indicate that full-wave MMR presents the best power performance under the same parameter configuration. The increase of flywheel inertia will decrease the power generation capacity of non-MMR configuration, but further enhance those of half-wave and full-wave MMRs and narrow the performance gap between both. This analysis based on system coupling will be instructive for the engineering design and application of railway VEHs.
Qualitative Story Completion: Opportunities and Considerations for Health Research
Authors: Urry Kristi , Hunter Sarah , Feo Rebecca , Scholz Brett
Published: January 2023

Qualitative story completion (QSC) is an innovative research method that offers researchers a range of unique opportunities for generating and analysing data. Participants are asked to write a ‘story’ in response to a hypothetical ‘story stem’, often in the third-person and involving fictional characters, rather than reporting on their direct experiences. QSC is being developed and increasingly taken up by researchers working across a range of fields; but it has been little used in health research, especially in the fields of nursing, health services research, medicine, and allied health. This means that health researchers have few examples to draw on when considering what QSC can offer them and how to rigorously design, conduct, and report a QSC study within health-related fields. We aim to address this gap and contribute to existing QSC literature by promoting increased use of QSC by health researchers and supporting them to produce rigorous QSC research. We outline three case examples illustrating how we have used QSC to conduct multidisciplinary health research relevant to nursing, medicine and nutrition. Drawing on these case examples, we reflect on challenges that we encountered, describe decision-making processes, and offer recommendations for conducting rigorous health research using QSC.
Early Diagnosis of Pancreatic Cancer: Clinical Premonitions, Timely Precursor Detection and Increased Curative-Intent Surgery
Authors: Søreide Kjetil , Ismail Warsan , Roalsø Marcus , Ghotbi Jacob , Zaharia Claudia
Published: January 2023

Background

The overall poor prognosis in pancreatic cancer is related to late clinical detection. Early diagnosis remains a considerable challenge in pancreatic cancer. Unfortunately, the onset of clinical symptoms in patients usually indicate advanced disease or presence of metastasis.

Analysis and Results

Currently, there are no designated diagnostic or screening tests for pancreatic cancer in clinical use. Thus, identifying risk groups, preclinical risk factors or surveillance strategies to facilitate early detection is a target for ongoing research. Hereditary genetic syndromes are a obvious, but small group at risk, and warrants close surveillance as suggested by society guidelines. Screening for pancreatic cancer in asymptomatic individuals is currently associated with the risk of false positive tests and, thus, risk of harms that outweigh benefits. The promise of cancer biomarkers and use of ‘omics’ technology (genomic, transcriptomics, metabolomics etc.) has yet to see a clinical breakthrough. Several proposed biomarker studies for early cancer detection lack external validation or, when externally validated, have shown considerably lower accuracy than in the original data. Biopsies or tissues are often taken at the time of diagnosis in research studies, hence invalidating the value of a time-dependent lag of the biomarker to detect a pre-clinical, asymptomatic yet operable cancer. New technologies will be essential for early diagnosis, with emerging data from image-based radiomics approaches, artificial intelligence and machine learning suggesting avenues for improved detection.

Conclusions

Early detection may come from analytics of various body fluids (eg ‘liquid biopsies’ from blood or urine). In this review we present some the technological platforms that are explored for their ability to detect pancreatic cancer, some of which may eventually change the prospects and outcomes of patients with pancreatic cancer.
Changing therapeutic landscape in advanced Kaposi sarcoma: Current state and future directions
Authors: Goff Catherine B , Dasanu Constantin A
Published: January 2023

Kaposi sarcoma is a malignant neoplasm arising from the endothelial cell lining of blood and lymphatic vessels. Herein, we discuss etiopathogenesis, clinical presentation, diagnostic criteria, updated guideline-based approach to its management and newer experimental approaches. Given its efficacy and side effect profile, pegylated doxorubicin is the currently preferred first-line therapy in advanced disease. Paclitaxel remains an alternative first-line option. At the time of relapse, patients can be retreated with the same agents as they often maintain their clinical efficacy. New therapeutic options are on the rise, with pomalidomide being approved in 2020 as a second-line therapy. Optimal control of retroviral infection in human immunodeficiency virus (HIV) positive is instrumental in preventing disease occurrence in most patients. Suppressing human herpes virus type 8 (HHV-8) infection might also play a role in controlling Kaposi sarcoma growth, yet clinical trials are lacking. Unraveling the molecular and genetic intricacies of Kaposi sarcoma's pathogenesis might allow for the emergence of novel and effective therapeutic strategies. Clinical trials are currently underway to establish potential roles for various targeted agents, immune checkpoint inhibitors (ICIs) and experimental agents in the treatment of advanced Kaposi sarcoma.
Long-term physicochemical stability of 5-fluorouracil at selected standardised rounded doses in polyolefin bags
Authors: Closset Mélanie , Onorati Sabrina , Colsoul Marie-Lise , Goderniaux Nicolas , Bihin Benoît , Jamart Jacques , Soumoy Laura , Hecq Jean-Daniel , Odou Pascal , Galanti Laurence
Published: January 2023

Background

Chemotherapy doses are usually prescribed on the basis of body surface area but dose banding is emerging as an efficient alternative. Dose banding presents the possibility of in-advance preparation in a Centralized Intravenous Admixture Service.

Aim of the study

To evaluate the long-term stability of 5-fluorouracil at banded doses (700 mg and 800 mg) in polyolefin bags.

Materials and methods

Ten polyolefin bags were prepared under aseptic conditions and stored at 23 ± 2°C for 24 days. Five of them were composed of 14 mL 5-fluorocuracil (700 g) in 100 mL 0.9% sodium chloride solution and the five other of 16 mL 5-fluorouracil (800 mg) in 100 mL 0.9% sodium chloride solution. At defined times, physical stability parameters were assessed: optical densities, pH measurements, visual and microscopical inspections. Solutions concentrations were measured using high-performance liquid chromatography coupled with a photodiode array detector.

Results

No change was observed on pH and optical density measurements during the study period. Visual and microscopical inspections remained free of colour change, precipitate, microagregate or crystal. The concentrations of 5-Fluorouracil in 800 mg bags remained stable for 24 days while the concentration in 700 mg bags showed a stability of at least 17 days.

Conclusion

Five-fluorouracil at banded doses of 700 and 800 mg in polyolefin bags is physicochemically stable for at least 17 days at 23 ± 2°C. These results support the possibility of in advance centralised preparation.
Risk assessment of personnel exposure in a central cytotoxic preparation unit using the FMECA method
Authors: Bhirich Nihal , Chefchaouni Ali Cherif , Medkouri Safaa El , Shytry Oumaima , Belahcen Mohammed Jaouad , Rahali Younes
Published: January 2023

Introduction

Personnel involved in the preparation of cytotoxics are exposed to them and the resulting risks. To protect themselves, many means of protection are currently implemented. Nevertheless, the exposure of these manipulators remains a possibility to be considered.

Materials and methods

The study was conducted during the period (October–November 2022) in the pharmacy of the National Institute of Oncology (INO), a hospital structure specializing in cancer care. The Failure Mode, Effects and Criticality Analysis method was used to assess the risks of exposure of personnel in a central cytotoxic preparation unit and then calculate the criticality index (CI  =  severity  ×  frequency  ×  detectability). The risks were classified into toxic, traumatic, chemical, and environmental risks. We have cited 12 failure modes of which nine are minor and three are major. The three major modes cited are essentially related to the particulate environment, direct contact and daily passive inhalation of handling.

Conclusion

Our study shows that in our institution, the analysis of the risk of exposure of personnel to cytotoxics remains important, hence the interest of automaton in charge of preparations and which will gradually take charge of all the preparations. The existing procedures and the pharmacotechnical equipment used also contribute to protection and risk reduction.
Development and validation of a prognostic model based on a single-cell RNA-seq in Wilms tumor in children
Authors: He Tian-Qu , Zhao Yao-Wang , Ning Feng , Liu Yu , Tu Lei , He Jun
Published: January 2023

To analyze the heterogeneity between different cell types in pediatric Wilms tumor (WT) tissue, and identify the differentially expressed genes (DEGs) of malignant tumor cells, thereby establishing a prognostic model. The single-cell sequencing data of pediatric WT tissues were downloaded from the public database. Data filtration and normalization, principal component analysis, and T-distributed stochastic neighbor embedding cluster analysis were performed using the Seurat package of R language. Cells were divided into different clusters, malignant tumor cells were extracted, and DEGs were obtained. Then, the pseudo-time trajectory analysis was performed. Prognostic biomarkers were determined by univariate and multivariate COX regression analyses and LASSO regression analysis. Kaplan–Meier survival analysis and receiver operator characteristic curve analysis were performed. Combined with the prognostic biomarkers and clinical characteristics, a nomogram was generated to predict WT prognosis. The prognostic power was validated in the external datasets. Cells in the WT tissue were divided into 10 clusters. Three prognostic biomarkers that affected the survival time of patients were screened from 215 DEGs in malignant tumor cells, and a nomogram was constructed using the three genes and clinical characteristics. The area under the curve (AUC) values of 3- and 5-year disease-free survival were 0.756 and 0.734, respectively. In the external validation dataset, the AUC value of this nomogram model was 0.826. Based on the single-cell RNA-seq, we recognized cell clusters in the WT tissue of children, identified prognostic biomarkers in malignant tumor cells, and established a comprehensive prognostic model. Our findings might provide new ideas and methods for the diagnosis and treatment of WT.
Tech sharing, not tech hoarding: Covid-19, global solidarity, and the failed responsibility of the pharmaceutical industry
Authors: Geiger Susi , Gross Nicole
Published: January 2023

The Covid-19 pandemic has highlighted the importance of health technologies to mitigate against the spread of the disease and improve care, dominantly including life-saving vaccines. But the pandemic has also highlighted that the current biopharmaceutical business model, based on the enclosure of these technologies and on the immense accumulation of capital it enables, leads to vast inequalities in healthcare particularly in low and middle-income countries. We believe that the pharmaceutical industry has a moral duty to enable and enact global solidarity through tech sharing instead of tech hoarding, but judging by current technology transfer practices we question their willingness to assume their role in organizing healthcare markets through solidaristic principles. In the absence of a voluntary adoption of solidaristic principles and practices by biopharmaceutical firms, the institutionalization of global solidarity as a fundamental organizing principle for healthcare markets is necessary to strengthen resilience and know-how globally. With this call, we add to existing conceptualizations of solidarity by (a) introducing a global level of solidarity and (b) thinking through the concept not as an abstract humanistic stance but as a concrete organizing principle for global healthcare markets.
Robot-delivered tourism and hospitality services: How to evaluate the impact of health and safety considerations on visitors’ satisfaction and loyalty?
Authors: Soliman Mohammad , Gulvady Samskrati , Elbaz Ahmed Mohamed , Mosbah Maha , Wahba Marwa S
Published: January 2023

Due to the COVID-19 epidemic, visitors’ worries about health and safety in tourist destinations have become paramount. Consequently, this research aims to evaluate the impact of health and safety considerations on visitors’ satisfaction. It also examines the influence of health consciousness and satisfaction on visitors’ willingness toward robot-delivered tourism and hospitality services usage and the impact of destination healthcare system and satisfaction on loyalty intentions. Applying a quantitative-based methodology, 650 responses were collected from domestic tourists visiting Egyptian tourism destinations using multiple non-probability sampling techniques. Using PLS-SEM, the results articulated that emotional well-being, perceived safety, and perceived green image positively impacted visitors’ satisfaction, which in turn, positively affected their willingness toward service robot’s usage and loyalty. Tourists’ health consciousness also positively affected their satisfaction and intentions to use robot-delivered services. Additionally, destination healthcare system significantly influenced visitors’ satisfaction and loyalty intentions. Theoretical and managerial contributions as well as future research are outlined.