bluuebunny/crossref_metadata_2025 huggingface dataset:
The Application of a Genetic Algorithm to the Optimization of a Mesoscale Model for Emergency Response
Authors: Werth David , Buckley Robert
Published: January 2022

Besides solving the equations of momentum, heat, and moisture transport on the model grid, mesoscale weather models must account for subgrid-scale processes that affect the resolved model variables. These are simulated with model parameterizations, which often rely on values preset by the user. Such “free” model parameters, along with others set to initialize the model, are often poorly constrained, requiring that a user select each from a range of plausible values. Finding the values to optimize any forecasting tool can be accomplished with a search algorithm, and one such process—the genetic algorithm (GA)—has become especially popular. As applied to modeling, GAs represent a Darwinian process: an ensemble of simulations is run with a different set of parameter values for each member, and the members subsequently judged to be most accurate are selected as “parents” who pass their parameters onto a new generation. At the U.S. Department of Energy’s Savannah River Site in South Carolina, we are applying a GA to the Regional Atmospheric Modeling System (RAMS) mesoscale weather model, which supplies input to a model to simulate the dispersion of an airborne contaminant as part of the site’s emergency response preparations. An ensemble of forecasts is run each day, weather data are used to “score” the individual members of the ensemble, and the parameters from the best members are used for the next day’s forecasts. As meteorological conditions change, the parameters change as well, maintaining a model configuration that is best adapted to atmospheric conditions.

Significance Statement

We wanted to develop a forecasting system by which a weather model is run over the Savannah River Site each day and repeatedly adjusted according to how well it performed the previous day. To run the model, a series of values (parameters) must be set to control how the model will calculate winds, temperatures, and other desired variables. Each day the model was run several times using different combinations of these parameters and later compared with observed meteorological conditions. Parameters that produced the most accurate forecasts were preferentially reused to create the forecasts for the next day. The process was tested for the summer of 2020 and exhibited lower errors than forecasts produced by the model using default values of the parameters.
A Statistical Intraseasonal Prediction Model of Extended Boreal Summer Western North Pacific Tropical Cyclone Genesis
Authors: Zhao Haikun , Lu Ying , Jiang Xianan , Klotzbach Philip J. , Wu Liguang , Cao Jian
Published: January 2022

An L2 regularized logistic regression model is developed in this study to predict weekly tropical cyclone (TC) genesis over the western North Pacific (WNP) Ocean and subregions of the WNP including the South China Sea (SCS), the western WNP (WWNP), and the eastern WNP (EWNP). The potential predictors for the TC genesis model include a time-varying TC genesis climatology, the Madden–Julian oscillation (MJO), the quasi-biweekly oscillation (QBWO), and ENSO. The relative importance of the predictors in a constructed L2 regression model is justified by a forward stepwise selection procedure for each region from a 0-week to a 7-week lead. Cross-validated hindcasts are then generated for the corresponding prediction schemes out to a 7-week lead. The TC genesis climatology generally improves the regional model skill, and the importance of intraseasonal oscillations and ENSO is regionally dependent. Over the WNP, there is increased model skill over the time-varying climatology in predicting weekly TC genesis out to a 4-week lead by including the MJO and QBWO, whereas ENSO has a limited impact. On a regional scale, ENSO and then either the MJO or QBWO are the two most important predictors over the EWNP and WWNP after the TC genesis climatology. The MJO is found to be the most important predictor over the SCS. The logistic regression model is shown to have comparable reliability and forecast skill scores to the ECMWF dynamical model on intraseasonal time scales.

Significance Statement

Skillful forecasts of tropical cyclone activity on time scales from short-range to seasonal are now issued operationally. Although there has been great progress in the understanding of physical mechanisms driving tropical cyclone (TC) activity, intraseasonal prediction of TCs remains a significant scientific challenge. This study develops a statistically based intraseasonal model to predict weekly TC genesis over the western North Pacific Ocean basin. The intraseasonal prediction model developed here for TC genesis over the western North Pacific basin shows skill extending out to four weeks. We discuss the regional dependence of the model skill on ENSO and other subseasonal climate oscillations. This approach provides skillful intraseasonal forecasting of TCs over the western North Pacific basin.
Energy Efficiency Versus Consumption: An Empirical Investigation of Jevons’ Paradox Across Sectors in India
Authors: Murugasamy Poovitha , Mishra Vandita
Published: January 2022

Modernisation theorists reiterate endogenous growth models by acknowledging technological production for a rise in the efficiency of energy-use. Yet, world system analysts blame economic production for causing environmental degradation. As economic and demographic modernisation continue to raise the magnitude of extraction despite their declining economic intensity, the dichotomy draws attention to Jevons’ paradox. Debates ingeminating ‘The End of Cheap Oil’ raise arguments about India’s energy deficit despite measures to raise its energy self-sufficiency. Do policies aiming at reducing energy consumption through efficiency enhancement fulfil their targets or does the reality reverse the objectives of the policy? Focusing on the two pillars of energy policy (efficiency-demand and supply), Ordinary Least Square (OLS) technique and Granger causality have been employed to model the energy efficiency–consumption nexus and other determinants of energy consumption, across sectors. The magnitude of energy intensity effect is stronger in the agricultural sector than the other sectors. This analysis records evidence of Sectoral Rebound effects confirming Jevons’ paradox, whereby the economy’s energy mix which is strongly inclined towards non-renewable resources combined with the demand for green energy and efficiency, clearly supports the government’s recent policy moves in the direction of renewable energy generation and electricity substitution.

JEL Codes: O13, Q42, Q43, Q48
Middle-class Women and Domestic Work in India and the United States: Caste, Race and Patriarchy
Authors: Nair Gayatri , Hofman Nila Ginger
Published: January 2022

This study compares middle-class women’s experience of domestic work in India and the United States(US), highlighting similarities in how domestic work is organised in its paid and unpaid forms across both sites. The focus on middle-class women’s experience as unpaid workers and employers of domestic workers provides an insight into how the social and economic values of domestic work are determined. Despite social and political differences, the political economies of India and the US and interlocking systems of oppression including patriarchy, neoliberalism, caste and race have produced similarities in the undervaluation of domestic work at both sites.
Accommodating the multi-state constraint Kalman filter for visual-inertial navigation in a moving and stationary flight
Authors: Mahmoudi Arshiya , Mortazavi Mahdi , Sabzehparvar Mehdi
Published: January 2022

For more than a decade, the multi-state constraint Kalman filter is used for visual-inertial navigation. Its advantages are the light-weight calculations, consistency, and similarity to the current mature GPS/INS Kalman filters. For using it in an airborne platform, an important deficiency exists. It diverges while the object stops moving. In this work, this deficiency is accounted for, by changing the state augmentation and measurement update policy from a time-based to horizontal travel-based scheme, and by reusing the oldest tracked point over and over. Besides the computational savings, it works infinitely with no extra errors in full-stops and with minor error build up in very low speeds.
Impact of Targeted Therapy on the Survival of Patients With Advanced-Stage Non-small Cell Lung Cancer in Oncosalud - AUNA
Authors: Aguilar Alfredo , Mas Luis , Enríquez Daniel , Vallejos Carlos , Gutarra Rosa , Flores Claudio J.
Published: January 2022

Background

Lung cancer is still a prevalent and fatal neoplasm in developing countries. In the last decades, chemotherapy (CHT) maintenance occupied an important role in the treatment, as well as targeted therapies. We aimed to evaluate the survival impact of targeted therapy in advanced lung cancer at a private Peruvian institution (Oncosalud - AUNA).

Methods

We reviewed retrospectively medical records of patients with advanced-stage non-small cell lung cancer (NSCLS) (clinical stage III-IV) who received CHT and maintenance treatment with target therapy (TT) or CHT. The impact was assessed by progression-free survival (PFS) and overall survival (OS) using the Kaplan–Meier method, and comparisons of survival curves were performed using log-rank or Breslow test and Cox model.

Results

The median age of the patients was 65 years. Clinical characteristics, as well as the treatment type, showed no significant difference between the two groups. The maintenance schedule in those receiving CHT was generally pemetrexed (70%) and in those receiving TT was erlotinib (60.7%). In patients receiving TT, the median PFS was 13 months compared to 7 months in those receiving CHT; likewise, the median OS was 45 and 17 months, respectively. The PFS and OS curves showed significant differences ( P < .05), achieving a better survival in subjects treated with TT.

Conclusion

Progression-Free Survival and OS were superior in patients who received targeted therapy than those treated only with CHT, the 2 years rate of PFS and OS was nearly double to those who received only CHT-based treatments.
Princivalleite, Na(Mn2Al)Al6(Si6O18)(BO3)3(OH)3O, a new mineral species of the tourmaline supergroup from Veddasca Valley, Varese, Italy
Authors: Bosi Ferdinando , Pezzotta Federico , Skogby Henrik , Altieri Alessandra , Hålenius Ulf , Tempesta Gioacchino , Cempírek Jan
Published: January 2022

Princivalleite, Na(Mn2Al)Al6(Si6O18)(BO3)3(OH)3O, is a new mineral (IMA2020-056) of the tourmaline supergroup. It occurs in the Veddasca Valley, Luino area, Varese, Lombardy, Italy (46°03’30.74’’N, 8°48’24.47’’E) at the centre of a narrow (2–3 cm wide) vertical pegmatitic vein, a few metres long, crosscutting a lens of flaser gneiss. Crystals are subhedral (up to 10 mm in size), azure with a vitreous lustre, conchoidal fracture and white streak. Princivalleite has a Mohs hardness of ~7, a calculated density of 3.168 g/cm3 and is uniaxial (–). Princivalleite has trigonal symmetry, space group R3m, a = 15.9155(2) Å, c = 7.11660(10) Å, V = 1561.15(4) Å3 and Z = 3. The crystal structure was refined to R1 = 1.36% using 1758 unique reflections collected with MoKα X-ray intensity data. Crystal-chemical analysis resulted in the empirical crystal-chemical formula

X(Na0.54Ca0.11□0.35)Σ1.00Y(Al1.82Mn2+0.84Fe2+0.19Zn0.07Li0.08)Σ3.00Z(Al5.85Fe2+0.13Mg0.02)Σ6.00[T(Si5.60Al0.40)Σ6.00O18](BO3)3O(3)[(OH)2.71O0.29]Σ3.00O(1)[O0.66F0.22(OH)0.12]Σ1.00 which recast in its ordered form for classification purposes is:

X(Na0.54Ca0.11□0.35)Σ1.00Y(Al1.67Mn2+0.84Fe2+0.32Zn0.07Mg0.02Li0.08)Σ3.00ZAl6.00[T(Si5.60Al0.40)Σ6.00O18](BO3)3V[(OH)2.71O0.29]Σ3.00W[O0.66F0.22(OH)0.12]Σ1.00.

Princivalleite is an oxy-species belonging to the alkali group of the tourmaline supergroup. The closest end-member compositions of valid tourmaline species are those of oxy-schorl and darrellhenryite, to which princivalleite is related by the substitutions Mn2+ ↔ Fe2+ and Mn2+ ↔ 0.5Al3+ + 0.5Li+, respectively. Princivalleite from Veddasca Valley is a geochemical anomaly, originated in a B-rich and peraluminous anatectic pegmatitic melt formed in situ, poor in Fe and characterised by reducing conditions in the late-stage metamorphic fluids derived by the flaser gneiss. The Mn-enrichment in this new tourmaline is due to absence of other minerals competing for Mn such as garnet.
Formation of neutrophil extracellular traps requires actin cytoskeleton rearrangements
Authors: Sprenkeler Evelien G. G. , Tool Anton T. J. , Henriet Stefanie S. V. , van Bruggen Robin , Kuijpers Taco W.
Published: January 2022

Neutrophils are important effector cells in the host defense against invading microorganisms. One of the mechanisms they use to eliminate pathogens is the release of neutrophil extracellular traps (NETs). Although NET release and subsequent cell death known as NETosis have been intensively studied, the cellular components and factors determining or facilitating the formation of NETs remain incompletely understood. Using various actin polymerization and myosin II modulators on neutrophils from healthy individuals, we show that intact F-actin dynamics and myosin II function are essential for NET formation when induced by different stimuli; that is, phorbol 12-myristate 13-acetate, monosodium urate crystals, and Candida albicans. The role of actin polymerization in NET formation could not be explained by the lack of reactive oxygen species production or granule release, which were normal or enhanced under the given conditions. Neutrophils from patients with very rare inherited actin polymerization defects by either actin-related protein 2/3 complex subunit 1B or megakaryoblastic leukemia 1 deficiency also failed to show NETosis. We found that upon inhibition of actin dynamics, there is a lack of translocation of neutrophil elastase to the nucleus, which may explain the impaired NET formation. Collectively, our data show the essential requirement of an intact and active actin polymerization process, as well as active myosin II to enable the release of nuclear DNA by neutrophils during NET formation.
Family history of FXTAS is associated with age-related cognitive-linguistic decline among mothers with the FMR1 premutation
Authors: Klusek Jessica , Fairchild Amanda , Moser Carly , Mailick Marsha R. , Thurman Angela John , Abbeduto Leonard
Published: January 2022

Background

Women who carry a premutation allele of the FMR1 gene are at increased vulnerability to an array of age-related symptoms and disorders, including age-related decline in select cognitive skills. However, the risk factors for age-related decline are poorly understood, including the potential role of family history and genetic factors. In other forms of pathological aging, early decline in syntactic complexity is observed and predicts the later onset of neurodegenerative disease. To shed light on the earliest signs of degeneration, the present study characterized longitudinal changes in the syntactic complexity of women with the FMR1 premutation across midlife, and associations with family history of fragile X-associated tremor/ataxia syndrome (FXTAS) and CGG repeat length.

Methods

Forty-five women with the FMR1 premutation aged 35–64 years at study entry participated in 1–5 longitudinal assessments spaced approximately a year apart (130 observations total). All participants were mothers of children with confirmed fragile X syndrome. Language samples were analyzed for syntactic complexity and participants provided information on family history of FXTAS. CGG repeat length was determined via molecular genetic testing.

Results

Hierarchical linear models indicated that women who reported a family history of FXTAS exhibited faster age-related decline in syntactic complexity than those without a family history, with that difference emerging as the women reached their mid-50 s. CGG repeat length was not a significant predictor of age-related change.

Conclusions

Results suggest that women with the FMR1 premutation who have a family history of FXTAS may be at increased risk for neurodegenerative disease, as indicated by age-related loss of syntactic complexity. Thus, family history of FXTAS may represent a personalized risk factor for age-related disease. Follow-up study is needed to determine whether syntactic decline is an early indicator of FXTAS specifically, as opposed to being a more general age-related cognitive decline associated with the FMR1 premutation.
MGcount: a total RNA-seq quantification tool to address multi-mapping and multi-overlapping alignments ambiguity in non-coding transcripts
Authors: Hita Andrea , Brocart Gilles , Fernandez Ana , Rehmsmeier Marc , Alemany Anna , Schvartzman Sol
Published: January 2022

Background

Total-RNA sequencing (total-RNA-seq) allows the simultaneous study of both the coding and the non-coding transcriptome. Yet, computational pipelines have traditionally focused on particular biotypes, making assumptions that are not fullfilled by total-RNA-seq datasets. Transcripts from distinct RNA biotypes vary in length, biogenesis, and function, can overlap in a genomic region, and may be present in the genome with a high copy number. Consequently, reads from total-RNA-seq libraries may cause ambiguous genomic alignments, demanding for flexible quantification approaches.

Results

Here we present Multi-Graph count (MGcount), a total-RNA-seq quantification tool combining two strategies for handling ambiguous alignments. First, MGcount assigns reads hierarchically to small-RNA and long-RNA features to account for length disparity when transcripts overlap in the same genomic position. Next, MGcount aggregates RNA products with similar sequences where reads systematically multi-map using a graph-based approach. MGcount outputs a transcriptomic count matrix compatible with RNA-sequencing downstream analysis pipelines, with both bulk and single-cell resolution, and the graphs that model repeated transcript structures for different biotypes. The software can be used as a python module or as a single-file executable program.

Conclusions

MGcount is a flexible total-RNA-seq quantification tool that successfully integrates reads that align to multiple genomic locations or that overlap with multiple gene features. Its approach is suitable for the simultaneous estimation of protein-coding, long non-coding and small non-coding transcript concentration, in both precursor and processed forms. Both source code and compiled software are available at https://github.com/hitaandrea/MGcount.
LuxRep: a technical replicate-aware method for bisulfite sequencing data analysis
Authors: Malonzo Maia H. , Halla-aho Viivi , Konki Mikko , Lund Riikka J. , Lähdesmäki Harri
Published: January 2022

Background

DNA methylation is commonly measured using bisulfite sequencing (BS-seq). The quality of a BS-seq library is measured by its bisulfite conversion efficiency. Libraries with low conversion rates are typically excluded from analysis resulting in reduced coverage and increased costs.

Results

We have developed a probabilistic method and software, LuxRep, that implements a general linear model and simultaneously accounts for technical replicates (libraries from the same biological sample) from different bisulfite-converted DNA libraries. Using simulations and actual DNA methylation data, we show that including technical replicates with low bisulfite conversion rates generates more accurate estimates of methylation levels and differentially methylated sites. Moreover, using variational inference speeds up computation time necessary for whole genome analysis.

Conclusions

In this work we show that taking into account technical replicates (i.e. libraries) of BS-seq data of varying bisulfite conversion rates, with their corresponding experimental parameters, improves methylation level estimation and differential methylation detection.
COVID-19 impact on mental health
Authors: Cui Jingyu , Lu Jingwei , Weng Yijia , Yi Grace Y. , He Wenqing
Published: January 2022

Background

The coronavirus disease 2019 (COVID-19) pandemic has posed a significant influence on public mental health. Current efforts focus on alleviating the impacts of the disease on public health and the economy, with the psychological effects due to COVID-19 relatively ignored. In this research, we are interested in exploring thequantitativecharacterization of the pandemic impact on public mental health by studying an online survey dataset of the United States.

Methods

The analyses are conducted based on a large scale of online mental health-related survey study in the United States, conducted over 12 consecutive weeks from April 23, 2020 to July 21, 2020. We are interested in examining the risk factors that have a significant impact on mental health as well as in their estimated effects over time. We employ the multiple imputation by chained equations (MICE) method to deal with missing values and take logistic regression with the least absolute shrinkage and selection operator (Lasso) method to identify risk factors for mental health.

Results

Our analysis shows that risk predictors for an individual to experience mental health issues include the pandemic situation of the State where the individual resides, age, gender, race, marital status, health conditions, the number of household members, employment status, the level of confidence of the future food affordability, availability of health insurance, mortgage status, and the information of kids enrolling in school. The effects of most of the predictors seem to change over time though the degree varies for different risk factors. The effects of risk factors, such as States and gender show noticeable change over time, whereas the factor age exhibits seemingly unchanged effects over time.

Conclusions

The analysis results unveil evidence-based findings to identify the groups who are psychologically vulnerable to the COVID-19 pandemic. This study provides helpful evidence for assisting healthcare providers and policymakers to take steps for mitigating the pandemic effects on public mental health, especially in boosting public health care, improving public confidence in future food conditions, and creating more job opportunities.

Trial registration

This article does not report the results of a health care intervention on human participants.
Prediction of acute appendicitis among patients with undifferentiated abdominal pain at emergency department
Authors: Su Dai , Li Qinmengge , Zhang Tao , Veliz Philip , Chen Yingchun , He Kevin , Mahajan Prashant , Zhang Xingyu
Published: January 2022

Background

Early screening and accurately identifying Acute Appendicitis (AA) among patients with undifferentiated symptoms associated with appendicitis during their emergency visit will improve patient safety and health care quality. The aim of the study was to compare models that predict AA among patients with undifferentiated symptoms at emergency visits using both structured data and free-text data from a national survey.

Methods

We performed a secondary data analysis on the 2005-2017 United States National Hospital Ambulatory Medical Care Survey (NHAMCS) data to estimate the association between emergency department (ED) patients with the diagnosis of AA, and the demographic and clinical factors present at ED visits during a patient’s ED stay. We used binary logistic regression (LR) and random forest (RF) models incorporating natural language processing (NLP) to predict AA diagnosis among patients with undifferentiated symptoms.

Results

Among the 40,441 ED patients with assigned International Classification of Diseases (ICD) codes of AA and appendicitis-related symptoms between 2005 and 2017, 655 adults (2.3%) and 256 children (2.2%) had AA. For the LR model identifying AA diagnosis among adult ED patients, the c-statistic was 0.72 (95% CI: 0.69–0.75) for structured variables only, 0.72 (95% CI: 0.69–0.75) for unstructured variables only, and 0.78 (95% CI: 0.76–0.80) when including both structured and unstructured variables. For the LR model identifying AA diagnosis among pediatric ED patients, the c-statistic was 0.84 (95% CI: 0.79–0.89) for including structured variables only, 0.78 (95% CI: 0.72–0.84) for unstructured variables, and 0.87 (95% CI: 0.83–0.91) when including both structured and unstructured variables. The RF method showed similar c-statistic to the corresponding LR model.

Conclusions

We developed predictive models that can predict the AA diagnosis for adult and pediatric ED patients, and the predictive accuracy was improved with the inclusion of NLP elements and approaches.
Sample attrition analysis in a prospective cohort study of medical graduates in China
Authors: Li Mingyue , Wang Ziyue , Zhang Baisong , Wei Tiantian , Hu Dan , Liu Xiaoyun
Published: January 2022

Background

A major challenge of prospective cohort studies is attrition in follow-up surveys. This study investigated attrition in a prospective cohort comprised of medical graduates in China. We described status of attrition, identified participants with higher possibility of attrition, and examined if attrition affect the estimation of the key outcome measures.

Methods

The cohort study recruited 3,620 new medical graduates from four medical universities in central and western China between 2015 and 2019. Online follow-up surveys were conducted on an annual basis. Follow-up status was defined as complete (meaning that the participant completed all the follow-up surveys) and incomplete, while incomplete follow-up was further divided into ‘always-out’, ‘rejoin’ and ‘other’. Multivariable logistic and linear regressions were used to examine factors predicting attrition and the influence on the outcome measures of career development.

Results

2364 (65.3%) participants completed all follow-up surveys. For those with incomplete follow-up, 520 (14.4%) were ‘always-out’, 276 (7.6%) rejoined in the 2020 survey. Willingness to participate in residency training (OR=0.80, 95%CI[0.66 - 0.98]) and willingness to provide sensitive information in the baseline survey predicted a lower rate of attrition (providing scores for university entrance exam OR=0.82, 95%CI[0.69 - 0.97]]; providing contact information (OR=0.46, 95%CI[0.32 - 0.66]); providing household income (OR=0.60, 95%CI[0.43 - 0.84]). Participants with compulsory rural service (OR=1.52, 95%CI[1.05 - 2.19]) and those providing university entrance scores (OR=1.64, 95%CI[1.15-2.33)) were more likely to rejoin in the follow-up survey. These factors associated with follow-up status did not have significant impact on key outcome measures of career development.

Conclusions

Graduates who were unwilling to participate in residency training or not providing sensitive information should be targeted early in the cohort study to reduce attrition. More information about the study should be provided to those graduates early to facilitate their understanding of the meaning in participation. On the contrary, medical graduates with compulsory rural service and those who provided university entrance scores were more likely to rejoin in the cohort. The research team should invest more effort in contacting those graduates and returned them to the cohort.
Misbeliefs about non-specific low back pain and attitudes towards treatment by primary care providers in Spain: a qualitative study
Authors: García-Martínez Ester , Soler-González Jorge , Blanco-Blanco Joan , Rubí-Carnacea Francesc , Masbernat-Almenara María , Valenzuela-Pascual Fran
Published: January 2022

Aim

To identify misbeliefs about the origin and meaning of non-specific chronic low back pain and to examine attitudes towards treatment by primary health care providers.

Design

Generic qualitative study.

Methods

Ten semi-structured interviews were conducted between October and November 2016 with physicians and nurses from primary health care centres in Lleida. The interviews were transcribed and analysed using inductive thematic analysis via Atlas.ti-8 software.

Results

Five themes were identified: i. beliefs about the origin and meaning of chronic low back pain, ii. psychosocial aspects of pain modulators, iii. Therapeutic exercise as a treatment for chronic low back pain, iv. biomedical attitudes of primary health care providers, and v. difficulties in the clinical approach to chronic low back pain.

Conclusion

Primary health care providers have a unifactorial view of chronic low back pain and base their approach on the biomedical model. Professionals attribute chronic low back pain to structural alterations in the lumbar spine while psychosocial factors are only recognized as pain modulators. For professionals, therapeutic exercise represents a possible solution to chronic low back pain; however, they still do not prescribe it and continue to educate on postural hygiene and recommend limiting physical and/or occupational activities, as opposed to clinical practice guidelines. These findings suggest that to improve the adherence of primary health care providers to the biopsychosocial model, it may be necessary first to modify their misbeliefs about non-specific chronic low back pain by increasing their knowledge on pain neurophysiology.

Trial registration

ClinicalTrials.govIdentifier:NCT02962817. Date of registration: 11/11/2016.
“Even though they insult us, the delivery they give us is the greatest thing”: a qualitative study contextualizing women’s experiences with facility-based maternal health care in Ethiopia
Authors: Hagaman Ashley , Rodriguez Humberto Gonzalez , Barrington Clare , Singh Kavita , Estifanos Abiy Seifu , Keraga Dorka Woldesenbet , Alemayehu Abiyou Kiflie , Abate Mehiret , Bitewulign Befikadu , Barker Pierre , Magge Hema
Published: January 2022

Background

Globally, amidst increased utilization of facility-based maternal care services, there is continued need to better understand women’s experience of care in places of birth. Quantitative surveys may not sufficiently characterize satisfaction with maternal healthcare (MHC) in local context, limiting their interpretation and applicability. The purpose of this study is to untangle how contextual and cultural expectations shape women’s care experience and what women mean by satisfaction in two Ethiopian regions.

Methods

Health center and hospital childbirth care registries were used to identify and interview 41 women who had delivered a live newborn within a six-month period. We used a semi-structured interview guide informed by the Donabedian framework to elicit women’s experiences with MHC and delivery, any prior delivery experiences, and recommendations to improve MHC. We used an inductive analytical approach to compare and contrast MHC processes, experiences, and satisfaction.

Results

Maternal and newborn survival and safety were central to women’s descriptions of their MHC experiences. Women nearly exclusively described healthy and safe deliveries with healthy outcomes as ‘satisfactory’. The texture behind this ‘satisfaction’, however, was shaped by what mothers bring to their delivery experiences, creating expectations from events including past births, experiences with antenatal care, and social and community influences. Secondary to the absence of adverse outcomes, health provider’s interpersonal behaviors (e.g., supportive communication and behavioral demonstrations of commitment to their births) and the facility’s amenities (e.g., bathing, cleaning, water, coffee, etc) enhanced women’s experiences. Finally, at the social and community levels, we found that family support and material resources may significantly buffer against negative experiences and facilitate women’s overall satisfaction, even in the context of poor-quality facilities and limited resources.

Conclusion

Our findings highlight the importance of understanding contextual factors including past experiences, expectations, and social support that influence perceived quality of MHC and the agency a woman has to negotiate her care experience. Our finding that newborn and maternal survival primarily drove women’s satisfaction suggests that quantitative assessments conducted shortly following delivery may be overly influenced by these outcomes and not fully capture the complexity of women’s care experience.
Effect of peripheral iridectomy on VEGF-A and TGF-β levels in rabbit aqueous humour
Authors: Chew Annabel C. Y. , Seet Li-Fong , Chu Stephanie W. L. , Lwin Nyein C. , Wong Tina T.
Published: January 2022

Background

Peripheral iridectomy (PI), routinely performed during glaucoma filtration surgery, may contribute to scarring. This study aims to determine whether PI alters the concentrations of VEGF-A and TGF-β isoforms in the rabbit aqueous humour.

Methods

Anterior chamber paracentesis (ACP) was performed in both eyes of six New Zealand white rabbits, with additional surgical PI performed in the right eyes. Eyes were examined on postoperative days (PODs) 1, 7, 30 and 60 by means of the tonopen, slit-lamp biomicroscopy, and bead-based cytokine assays for TGF-β and VEGF-A concentrations in the aqueous humor.

Results

ACP caused a significant reduction in intraocular pressure (IOP) from mean preoperative 11.47 ± 1.01 mmHg to 5.67 ± 1.63 mmHg on POD 1 while PI did not cause further IOP reduction. Limbal conjunctival vasculature appeared slightly increased on POD 1 in both ACP and PI eyes with PI also causing mild bleeding from damaged iris vessels. Two PI eyes developed fibrinous anterior chamber reaction and/ or peripheral anterior synechiae. Aqueous VEGF-A levels were not significantly different between eyes treated with ACP and PI. Aqueous TGF-β concentrations distributed in the ratio of 4:800:1 for TGF-β1:TGF-β2:TGF-β3 respectively. While aqueous TGF-β2 was not significantly induced by either procedure at any time point, TGF-β1 and TGF-β3 were significantly induced above baseline levels by PI on POD 1.

Conclusion

PI increases the risk of inflammation. The combined induction of aqueous TGF-β1 and TGF-β3 by PI in glaucoma surgery may impact surgery success in glaucoma subtypes sensitive to these isoforms.
Arterial health during early childhood following abnormal fetal growth
Authors: Olander Rasmus F.W. , Sundholm Johnny K.M. , Suonsyrjä Sanna , Sarkola Taisto
Published: January 2022

Background

Abnormal fetal growth is associated with increased cardiovascular risk in adulthood. We investigated the effect of fetal programming on arterial health and morphology during early childhood.

Methods

We examined 90 children (median age 5.81 years, interquartile range: 5.67; 5.95), born small for gestational age with fetal growth restriction, large or appropriate for gestational age (SGA, N = 23, LGA, N = 19, AGA N = 48). We measured body composition, anthropometrics, blood pressure, pulse wave velocity (PWV), lipids, glucose and inflammatory markers, and assessed carotid, brachial, radial and femoral arterial morphology and stiffness using very-high resolution ultrasound (46–71 MHz).

Results

LGA showed increased anthropometry, lean body mass and body mass index. SGA displayed decreased anthropometry and lean body mass. Blood pressure, PWV, carotid artery stiffness and blood work did not differ groupwise. Differences in lumen diameters, intima-media thicknesses (IMT) and adventitia thicknesses disappeared when adjusted for lean body mass and sex. In multiple regression models arterial dimensions were mainly predicted by lean body mass, with birth weight remaining associated only with carotid and brachial lumen dimensions, and not with IMTs. Carotid-femoral PWV was predicted by height and blood pressure only. No independent effect of adiposity was observed.

Conclusions

Arterial dimensions in childhood associate with current anthropometrics, especially lean body mass, and sex, explaining differences in arterial layer thickness. We found no signs of fetal programming of cardiovascular risk or arterial health in early childhood.
Time to develop severe acute malnutrition and its predictors among children living with HIV in the era of test and treat strategies at South Gondar hospitals, northwest, Ethiopia, 2021: a multicentre retrospective cohort study
Authors: Chanie Ermias Sisay , Legas Getasew , Zewude Shimeles Biru , Mekie Maru , Sewyew Dagne Addisu , Yehuala Enyew Dagnew , Melkie Abenezer , Ambie Minale Bezie , Assefa Mengesha , Admasu Fitalew Tadele , Yitbarek Getachew Yideg , Asnakew Sintayehu , Mersha Mekuant , Feleke Dejen Getaneh
Published: January 2022

Background

Although severe acute malnutrition is a major public issue among HIV infected children, there is no prior evidence in Ethiopia. Hence, this study aims to assess the time to develop severe acute malnutrition and its predictors among children living with human immunodeficiency virus in Ethiopia, 2012.

Methods

An institution based retrospective cohort study was conducted in South Gondar hospitals among 363 HIV infected children from February 10, 2014, to January 7, 2021. Epi-data version 3.1 was used to enter data, which was then exported to STATA version 14 for analysis. Besides, WHO (World Health Organization) Anthro Plus software was used to assess the nutritional status of the children. A standardized data extraction tool was used to collect the data. The Kaplan Meier survival curve was used to estimate the median survival time. The Cox-proportional hazard model assumption was checked via the Schoenfeld residual ph test and a stph plot. Bivariable and multivariable Cox proportional hazard models were employed at 95% confidence intervals (CI). A variable having a p-value < 0.05 was considered a statistically significant predictor of severe acute malnutrition.

Results

A total of 363 children living with HIV, 97 (26.72%) developed severe acute malnutrition during the follow-up period. The overall incidence rate was 5.4 (95% CI: 4.7–5.9) person per year with a total of 21, 492 months or 1791 years of observation. Moreover, the median survival time was 126 months. Treatment failure [AHR =3.4 (95% CI: 2.05–5.75)], CD4 count below threshold [AHR =2.5 (95% CI: 1.64–3.95)], and WHO stage III & IV [AHR =2.9 (95% CI: 1.74–4.73)] were all significant predictors of severe acute malnutrition.

Conclusion

The time to develop severe acute malnutrition was found to be very low. Treatment failure, CD4 count below threshold, and WHO stage III were all significant predictors of severe acute malnutrition. Hence, emphasizing those predictor variables is essential for preventing and controlling the occurrence of severe acute malnutrition among HIV infected children.
Maternal advanced age, single parenthood, and ART increase the risk of child morbidity up to five years of age
Authors: Pettersson Malin Lindell , Bladh Marie , Nedstrand Elizabeth , Svanberg Agneta Skoog , Lampic Claudia , Sydsjö Gunilla
Published: January 2022

Background

Advanced maternal age, single status and use of assisted reproductive technology (ART) are increasing in mothers in high-income countries, and all are known risk factors for negative obstetric outcomes. Less is known about their long-term consequences for childhood morbidity. Thus, the aim of this study was to investigate morbidity up to five years of age, in the children of older, single, and/or ART-treated mothers.

Methods

A cross-sectional using Swedish registers was performed comprising 23 772 children. The prevalence of diagnosis and the number of hospital visits for specialist care, were compared and analyzed in relation to maternal age at childbirth, maternal civil status, and mode of conception. The odds ratio for specialized care within each ICD-chapter were estimated using single and multiple logistic regression.

Results

Children born to single mothers and children conceived using ART had significantly more outpatient visits for specialist care and significantly more diagnoses compared to children with married/cohabiting mothers, and spontaneously conceived children. Children born to mothers of advanced maternal age (≥40) had fewer in- and outpatient visits. However, they were significantly more often diagnosed within ICD-chapters XVI, XVII i.e., they experienced more morbidity in the neonatal period.

Conclusion

The results indicate that children born to single mothers and children of ART-treated mothers have a higher morbidity and consume more specialist care than children of married/cohabiting and spontaneously pregnant mothers. We conclude that the use of ART, maternal single status and advanced maternal age are risk factors of importance to consider in pediatric care and when counseling women who are considering ART treatment.
Secular trends in chronic respiratory diseases mortality in Brazil, Russia, China, and South Africa: a comparative study across main BRICS countries from 1990 to 2019
Authors: Bai Jianjun , Zhao Yudi , Yang Donghui , Ma Yudiyang , Yu Chuanhua
Published: January 2022

Background

As the emerging economies, the BRICS (Brazil, Russia, India, China, and South Africa) shared 61.58% of the global chronic respiratory diseases (CRD) deaths in 2017. This study aimed to assess the secular trends in CRD mortality and explore the effects of age, period, and cohort across main BRICS countries.

Methods

Data were obtained from the Global Burden of Disease Study (GBD) 2019 and analyzed using the age-period-cohort (APC) model to estimate period and cohort effects between 1990 and 2019. The net drifts, local drifts, longitudinal age curves, period/cohort rate ratios (RRs) were obtained through the APC model.

Results

In 2019, the CRD deaths across the BRICS were 2.39 (95%UI 1.95 to 2.84) million, accounting for 60.07% of global CRD deaths. Chronic obstructive pulmonary disease (COPD) and asthma remained the leading causes of CRD deaths. The age-standardized mortality rates (ASMR) have declined across the BRICS since 1990, with the most apparent decline in China. Meanwhile, the downward trends in CRD death counts were observed in China and Russia. The overall net drifts per year were obvious in China (-5.89%; -6.06% to -5.71%), and the local drift values were all below zero in all age groups for both sexes. The age effect of CRD presented increase with age, and the period and cohort RRs were following downward trends over time across countries. Similar trends were observed in COPD and asthma. The improvement of CRD mortality was the most obvious in China, especially in period and cohort effects. While South Africa showed the most rapid increase with age across all CRD categories, and the period and cohort effects were flat.

Conclusions

BRICS accounted for a large proportion of CRD deaths, with China and India alone contributing more than half of the global CRD deaths. However, the declines in ASMR and improvements of period and cohort effects have been observed in both sexes and all age groups across main BRICS countries. China stands out for its remarkable reduction in CRD mortality and its experience may help reduce the burden of CRD in developing countries.
Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey
Authors: Sserwanja Quraish , Nuwabaine Lilian , Kamara Kassim , Musaba Milton W.
Published: January 2022

Background

Within Sub-Saharan Africa, some countries still report unacceptably high rates of maternal and perinatal morbidity and mortality, despite improvements in the utilisation of maternity care services. Postnatal care (PNC) is one of the recommended packages in the continuum of maternity care aimed at reducing maternal and neonatal mortality. This study aimed to determine the prevalence and factors associated with PNC utilisation in Sierra Leone.

Methods

We used Sierra Leone Demographic and Health Survey (UDHS) 2019 data of 7326 women aged 15 to 49 years. We conducted multivariable logistic regression to determine the factors associated with PNC utilisation, using SPSS version 25.

Results

Out of 7326 women, 6625 (90.4, 95% CI: 89.9–91.2) had at least one PNC contact for their newborn, 6646 (90.7, 95% CI: 90.2–91.5) had a postnatal check after childbirth and 6274 (85.6, 95% CI: 85.0–86.6) had PNC for both their babies and themselves. Delivery by caesarean section (aOR 8.01, 95% CI: 3.37–19.07), having a visit by a health field worker (aOR 1.80, 95% CI: 1.46–2.20), having had eight or more ANC contacts (aOR 1.37, 95% CI: 1.08–1.73), having tertiary education (aOR 2.71, 95% CI: 1.32–5.56) and having no big problems seeking permission to access healthcare (aOR 1.51, 95% CI: 1.19–1.90) were associated with higher odds of PNC utilisation. On the other hand, being resident in the Northern (aOR 0.48, 95% CI: 0.29–0.78) and Northwestern regions (aOR 0.54, 95% CI: 0.36–0.80), belonging to a female headed household (aOR 0.69, 95% CI: 0.56–0.85) and being a working woman (aOR 0.66, 95% CI: 0.52–0.84) were associated with lower odds of utilizing PNC.

Conclusion

Factors associated with utilisation of PNC services operate at individual, household, community and health system/policy levels. Some of them can be ameliorated by targeted government interventions to improve utilisation of PNC services.
Physical inactivity in early pregnancy and the determinants in an urban city setting of Kuala Lumpur, Malaysia
Authors: Syed Nor Sharifah Fazlinda , Idris Idayu Badilla , Md Isa Zaleha
Published: January 2022

Background

Physical inactivity in pregnancy has been associated with excessive gestational weight gain, hypertensive disorders, gestational diabetes mellitus and postpartum depression. Despite these risks, physical inactivity level remains high especially in higher income countries. The prevalence of physical inactivity among women in Malaysia aged ≥16 years was 28.2% in 2019 exceeding men by 6.1%. However, little is known regarding the subpopulation of pregnant women especially in Kuala Lumpur which is the most urbanized and highly populated city in Malaysia. Therefore, the aim of this study is to measure the physical inactivity prevalence among first trimester pregnant women in Kuala Lumpur and to identify its determining factors.

Methods

This was a cross-sectional study in which 339 first trimester pregnant women were sampled from 13 maternal and child health clinics located in all four parliament districts of Kuala Lumpur. Self-administered questionnaires which contained the Malay version of the pregnancy physical activity questionnaire (PPAQ) were used. Descriptive analysis was conducted to determine the physical inactivity prevalence followed by simple and multiple logistic regression to identify the determinants of physical inactivity with significant level of 5%.

Results

The prevalence of physical inactivity was 38.3%. The highest activity was seen in the household activity domain, despite only 24.8% of the respondents were housewives/unemployed. There was little to no participation observed in the vigorous intensity category. The determinants of physical inactivity were primigravida (aOR 3.54 95% CI 1.40, 8.97), education level (aOR 3.77 95% CI 1.35, 10.52) and body mass index (aOR 0.88 95% CI 0.80, 0.97) which explained 22.6% variation of physical inactivity in the final adjusted model.

Conclusion

The prevalence of physical inactivity among first trimester pregnant mothers in this study was 38.3%, and the highest activity was seen in the household category. Health education on physical activity in pregnancy should be focused on those who are primigravida and have no tertiary education. The educational content should be updated and tailored to current pandemic situation where self-isolation is the new norm, by advocating for home-based, moderate to vigorous intensity physical activities.