bluuebunny/crossref_metadata_2025 huggingface dataset:
Restrição de Conteúdo e Impusionamento: Como a Justiça Eleitoral Vem Construindo Sua Estratégia de Controle
Authors: Silveira Marilda de Paula , Fernandes Leal Amanda
Published: March 2022

O presente artigo busca analisar como a Justiça Eleitoral brasileira vêm onstruindo sua estratégia de controle de conteúdo e restrição nas regras de impulsionamento da propaganda eleitoral. A análise parte da coleta de julgados relativos às eleições gerais de 2018 e tem como hipótese que o controle de conteúdo no contexto do processo eleitoral brasileiro impõe severas limitações à liberdade de expressão que podem dificultar o ingresso de entrantes, favorecendo a manutenção do status quo. Em que pese a regulação geral do contexto confirme a hipótese, a coleta jurisprudencial revela conclusão diversa: especificamente quanto à propaganda na Internet, o Tribunal Superior Eleitoral adota posicionamento defensivo da liberdade de expressão e impõe restrição apenas em hipóteses consideradas limítrofes.
Efficient Uncertainty Quantification and Sensitivity Analysis on the Aerothermal Performance of Turbine Blade Squealer Tip
Authors: Huang Ming , Li Zhigang , Li Jun , Song Liming
Published: March 2022

It is important to accurately estimate the impact of flow and geometric variations for engineering design and manufacture. In this paper, an efficient uncertainty quantification analysis framework based on the combination of Universal Kriging (UK) metamodels and sparse Polynomial Chaos Expansion (PCE) is proposed. A challenging analytical test function and an engineering test are considered to investigate the response performance of the UK-PCE method. Then, this method was applied to the uncertainty quantification on the aerodynamic and heat transfer performance of GE-E3 rotor blade squealer tip. Meanwhile, a global parameter sensitivity analysis using the Sobol Indice method is carried out to identify the key parameters for the aerothermal performance of the squealer tip. Wherein, the inlet total temperature is considered as flow condition uncertainty parameters and tip clearance and cavity depth are considered as geometrical uncertainty parameters. The results show that the UK-PCE method reduces the computational cost by more than 70% in comparison to the typical PCE method. Under the influence of the uncertain geometry and operating conditions, the heat flux of the squealer tip basically conforms to the normal distribution and the statistical mean value of it increased by 5.32% relative to the design value and the probability of it deviating from the design value by 5% is as high as 44.62%. The result of sensitivity analysis reveals that the uncertainty of the aerodynamic characteristics of the squealer tip is almost entirely caused by the tip clearance which accounts for 90.31% and 98.77% of the variance of the leakage flow rate and total pressure loss coefficient. And it is also a key variable for the uncertainty of the heat transfer performance considering that its variance indexes for tip heat flux and blade heat flux are 31.23% and 73.14%, respectively. Finally, the influence mechanisms of the uncertainty parameters on the aerothermal performance of the squealer tip are investigated by detailed flow and thermal field analysis.
Modeling and Multi-Objective Optimization of a Miniature Refrigeration System
Authors: Moctezuma-Hernández J. A. , Belman-Flores J. M. , Soria-Alcaraz J. A. , Espinal-Jiménez A. , Rubio-Maya C.
Published: March 2022

In this study, the development of a physical model for a miniature refrigeration system is presented. The model is based on physical foundations and the incorporation of information provided in the manufacturers’ catalogs. The model is able to adequately predict the energy behavior of the refrigeration system, showing a maximum error of 10% in comparison with the experimental information found in the literature. Thus, the model is used to perform a multi-objective optimization by comparing two algorithms, nondominated storing genetic algorithm II and multi-objective particle swarm optimization algorithm. For this purpose, three scenarios are proposed whose objective functions involve parameters such as coefficient of performance, compressor discharge temperature, energy consumption, and refrigerant mass flowrate. The decision variables are the evaporation and condensation temperatures, the rotational speed of the compressor, and the degrees of subcooling and superheating. Thus, an overview of the optimal operating conditions that represent the best energy performance of the refrigeration system is provided.
Transgenerational sublethal effects of spiromesifen on Tetranychus urticae (Acari: Tetranychidae) and on its phytoseiid predator Neoseiulus californicus (Acari: Phytoseiidae)
Authors: Rajaee Fahimeh , Maroofpour Nariman , Ghane-Jahromi Mojtaba , Sedaratian-Jahromi Amin , Narciso Carvalho Guedes Raul
Published: March 2022

One of the farmers' significant challenges is controlling mites and preventing their damage, especially the two-spotted spider mite Tetranychus urticae. Meanwhile, the insecticides introduced for controlling T. urticae need to be investigated for direct and indirect effects. This study investigated the low concentrations (LC10 and LC30) impacts of spiromesifen on the life table parameters of T. urticae and its natural enemy, Neoseiulus californicus. The results indicate that spiromesifen caused significant effects on all parameters of the T. urticae life table through successive generations. The insecticide also had significant effects on N. californicus life table parameters. Therefore, spiromesifen was effective against successive generations of T. urticae, but we caution against its use under incidence of N. californicus.
Horizontal refraction and diffraction of underwater sound around an island
Authors: Lin Ying-Tsong , Van Uffelen Lora J. , Miller James H. , Potty Gopu R. , Vigness-Raposa Kathleen J.
Published: March 2022

The three-dimensional (3D) propagation effects of horizontal refraction and diffraction were measured on a tetrahedral hydrophone array deployed near the coast of Block Island, RI. Linear frequency modulated chirp signals, centered at 1 kHz with a 400 Hz bandwidth, were transmitted from a ship moving out of the acoustic shadow zone blocked by the island from the perspective of the hydrophone array. The observed shadow zone boundary was consistent with the prediction made by a 3D sound propagation model incorporating high-resolution bathymetry and realistic sound speed obtained from a data-assimilated regional ocean model. The 3D modal ray calculation provided additional insight into the frequency dependence of the signal spreading. This analysis found that the modes at higher frequencies can propagate closer to the coast of the island with shallower modal cutoff depths, where the sound energy penetrates the sloping seafloor at supercritical incidence. The evidence of horizontal caustics of the sound was shown in the parabolic equation and modal ray models by comparing to the arrival pattern observed in the data. The arrival angle measurements on the tetrahedral array show the complex propagation patterns, including the diffracted energy in the island shadow and acoustic energy refracted away from the island.
Three Simulated Goalball Games in the Same Day Cause Central Fatigue and Can Impair Game Technical Performance
Authors: Cursiol Jônatas Augusto , de Arruda Tarine Botta , Nakamura Fábio Yuzo , Barbieri Ricardo Augusto
Published: March 2022

The purpose of this study was to investigate the effects of three simulated goalball games on neuromuscular, physiological, perceptual, and technical parameters. Ten male players underwent assessments before and immediately after each game. Heart rate was recorded at rest and during all games that were entirely filmed for further technical performance analysis. Exercise significantly decreased knee extensor muscles peak force and percentage of voluntary activation after the second and third games, indicating the presence of central fatigue. Heart rate responses remained predominantly in a range equivalent to moderate activity intensity in all games. In addition, perceptual parameters were associated with reduced frequency of throws and density of actions. These findings suggest significant implications for the management of physical training, game strategy during a competition, and fixture change from three to two games per day.
CsrA-Controlled Proteins Reveal New Dimensions of Acinetobacter baumannii Desiccation Tolerance
Authors: Oda Yasuhiro , Shapiro Madelyn M. , Lewis Nathan M. , Zhong Xuefei , Huse Holly K. , Zhong Weizhi , Bruce James E. , Manoil Colin , Harwood Caroline S.
Published: March 2022

Acinetobacter baumannii
is found in terrestrial environments but can cause nosocomial infections in very sick patients. A factor that contributes to the prevalence of
A. baumannii
in hospital settings is that it is intrinsically resistant to dry conditions.
Teaching Basic Calculations in an Introductory Biology Lab
Authors: Horne John H. , Woolley Henry W. , Roy Aubrey , Schluchter Wendy M. , Howard Jerome J.
Published: March 2022

Quantitative reasoning is one of the core competencies identified as a priority for transforming the undergraduate biology curriculum. However, first-year biology majors often lack confidence in their quantitative skills.
Chondroitin Sulfate Proteoglycans Are De Facto Cellular Receptors for Human Papillomavirus 16 under High Serum Conditions
Authors: Fons Nathan R. , Kines Rhonda C. , Thompson Cynthia D. , Day Patricia M. , Lowy Douglas R. , Schiller John T.
Published: March 2022

Heparan sulfate proteoglycans (HSPGs) have previously been identified as primary attachment factors for the initial binding of human papillomaviruses (HPVs) prior to infection. Here, we demonstrate that
in vitro
, HPV binding to HSPGs is strongly dependent on the surrounding experimental conditions, including the concentration of fetal bovine serum (FBS).
Mouse Adenovirus Type 1 E4orf6 Induces PKR Degradation
Authors: Tejera-Hernández Berto , Goodman Danielle E. , Nevarez Juan M. , Spindler Katherine R.
Published: March 2022

Viruses have evolved to counteract the immune system to successfully replicate in the host. Downregulation of several antiviral proteins is important for productive viral infection.
Complete Genome Sequences of Gram-Positive Opportunistic Pathogens Isolated from Hospitals in Almaty, Kazakhstan
Authors: Korotetskiy Ilya S. , Jumagaziyeva Ardak B. , Kerimzhanova Bahkytzhan , Reva Oleg N. , Shilov Sergey V. , Kuznetsova Tatyana , Ivanova Ludmila , Korotetskaya Nadezhda , Bekmukhamedova Aimana , Satylgankyzy Ganiya , Klivleyeva Nailya G.
Published: March 2022

The appearance of drug-resistant pathogens reduces the therapeutic applicability of antibiotics and increases the rate of hospital infections among patients. Complete genome sequences of four Gram-positive clinical isolates of
Streptococcus
and
Staphylococcus
were obtained and analyzed to serve as model microorganisms for further studies on drug-induced antibiotic resistance reversion.
Episodic massive release of methane during the mid-Cretaceous greenhouse
Authors: Chang Biao , Huang Junhua , Algeo Thomas J. , Pancost Richard D. , Wan Xiaoqiao , Xue Yunsong , Jia Jianzhong , Wang Zhou , Hu Jun , Wang Jiasheng , Wang Sheng , Wu Jiaqi , Xie Shucheng
Published: March 2022

Methane-derived carbonates (MDCs) are common along modern and ancient continental margins, and the majority of such formations are associated with seafloor cold seeps. Here, we document petrographic, rare earth element + yttrium (REE + Y), carbonate clumped isotope temperature (TΔ47), and carbon-isotopic evidence from a shale succession in southern Tibet spanning a ~28 m.y. interval (ca. 113–85 Ma) that coincided with the mid-Cretaceous greenhouse event. At least nine limestone nodule-bearing horizons exhibit seep-associated sedimentary structures, including carbonate fabrics (e.g., micritic crusts, crystal fans, and botryoidal textures) and 13C-depleted isotopic compositions (δ13Ccarb < –32.3‰), which are indicative of methane-derived carbon sources. Along with sedimentary evidence, the patterns of TΔ47–δ13Ccarb–δ18Ocarb support precipitation of these MDCs over a large temperature range. The REE + Y compositions and europium (Eu) anomalies indicate that the release of methane was associated with hydrothermal fluids. Methane may have been derived from both thermogenic and biogenic sources based on the inorganic carbon isotopic signatures of the carbonate. These nodular carbonate horizons document multiple episodes of seafloor methane release during the mid-Cretaceous and represent exceptionally long-lived, active methane seepage. Massive methane release events may have played a role in generating the greenhouse climate of the mid-Cretaceous.
Refractory focal segmental glomerulosclerosis caused by Alport syndrome detected by genetic testing after three decades
Authors: Oda Yasuhiro , Sawa Naoki , Nozu Kandai , Ubara Yoshifumi
Published: March 2022

A woman in her 50s with a three-decade history of biopsy-proven focal segmental glomerulosclerosis and a family history of end-stage kidney disease presented with worsening proteinuria and declining kidney function after three decades of immunosuppressive therapy. While a repeat kidney biopsy did not reveal findings diagnostic of Alport syndrome, genetic testing demonstrated a heterozygous mutation inCOL4A5, which confirmed the diagnosis of X-linked Alport syndrome. The heterozygous in-frame deletion mutation may explain her intact hearing and relatively mild symptoms. Genetic testing enables diagnosis of Alport syndrome of various phenotypes, some of which cannot be diagnosed conventionally with clinical course and kidney biopsy. Genetic disorders including collagen IV nephropathy should be considered as a differential diagnosis in patients with focal segmental glomerulosclerosis, especially when a patient has early-onset proteinuria, a family history of kidney disease, syndromic features or proteinuria refractory to glucocorticoid treatment.
Three-hole oesophagectomy following bilateral lung transplant for cystic fibrosis
Authors: Hilzenrat Roy Avraham , Yee John
Published: March 2022

Cystic fibrosis (CF) is associated with increased rates of malignancy, particularly in lung transplant recipients requiring long-term immunosuppression. We present a unique case of post-bilateral lung transplant (LTx) three-hole oesophagectomy for de-novo oesophageal adenocarcinoma. Preoperative planning and careful fluid management allowed for a successful treatment course. Given the increased risk of de-novo malignancy in LTx recipients for CF, their improved quality of life and survival longevity, consideration of aggressive surgical management is imperative with appropriate patient selection.
Resolution of outer retinal abnormalities in eyes with vitreomacular traction without macular hole in the OASIS trial
Authors: Thomas Akshay S , Duchateau Luc , Kozma-Wiebe Petra , Jaffe Glenn
Published: March 2022

Background/aims

To describe the clinical impact of external limiting membrane (ELM) disruption, ellipsoid zone (EZ) disruption and subretinal fluid (SRF) seen on optical coherence tomography (OCT) in eyes with vitreomacular traction (VMT) without macular hole (MH) in the Ocriplasmin for Treatment for Symptomatic Vitreomacular Adhesion Including Macular Hole study.

Methods

Phase 3b randomised double-blind sham-controlled multicentre study including 144 eyes with VMT without MH. Eyes were randomised to receive a single intravitreal injection of ocriplasmin or sham injection and were followed for 24 months. Eyes were analysed for presence, course and clinical impact of ELM disruption, EZ disruption and SRF on OCT.

Results

ELM disruption, EZ disruption and SRF were present in 32.6%, 52.2% and 45.8% of ocriplasmin-treated eyes and 39.6%, 42.6% and 37.5% of sham-treated eyes at baseline. VMT resolution was associated with resolution of ELM and EZ disruption and SRF. A small number of eyes had persistent ELM disruption, EZ disruption and/or SRF at the seventh visit or later (17 months or later) following medical or surgical VMT resolution. Resolution of ELM disruption, EZ disruption and/or SRF was associated with an improvement of visual acuity from baseline. Following VMT resolution, ELM recovery usually preceded EZ recovery and SRF resolution.

Conclusions

ELM disruption, EZ disruption and/or SRF are present in a significant percentage of eyes with VMT without MH. Release of VMT is usually associated with outer retinal recovery and an associated improvement in visual acuity. ELM recovery typically precedes EZ recovery and SRF resolution following VMT release.
Pathologic myopia: advances in imaging and the potential role of artificial intelligence
Authors: Li Yong , Foo Li-Lian , Wong Chee Wai , Li Jonathan , Hoang Quan V , Schmetterer Leopold , Ting Daniel S W , Ang Marcus
Published: March 2022

Pathologic myopia is a severe form of myopia that can lead to permanent visual impairment. The recent global increase in the prevalence of myopia has been projected to lead to a higher incidence of pathologic myopia in the future. Thus, imaging myopic eyes to detect early pathological changes, or predict myopia progression to allow for early intervention, has become a key priority. Recent advances in optical coherence tomography (OCT) have contributed to the new grading system for myopic maculopathy and myopic traction maculopathy, which may improve phenotyping and thus, clinical management. Widefield fundus and OCT imaging has improved the detection of posterior staphyloma. Non-invasive OCT angiography has enabled depth-resolved imaging for myopic choroidal neovascularisation. Artificial intelligence (AI) has shown great performance in detecting pathologic myopia and the identification of myopia-associated complications. These advances in imaging with adjunctive AI analysis may lead to improvements in monitoring disease progression or guiding treatments. In this review, we provide an update on the classification of pathologic myopia, how imaging has improved clinical evaluation and management of myopia-associated complications, and the recent development of AI algorithms to aid the detection and classification of pathologic myopia.
Characterising the health and social care segment of the BCS (The Chartered Institute for IT) membership and their continuing professional development needs
Authors: MacLure Katie , MacLure Andrew , Levy Sharon , Dearing Wendy
Published: March 2022

Objectives

The aim of this study was to identify and characterise the health and social care membership of the British Computer Society (BCS), an international informatics professional organisation, and to determine their ongoing development needs.

Methods

A prepiloted online survey included items on professional regulatory body, job role, work sector, qualifications, career stage, BCS membership (type, specialist group/branch activity (committees, event attendance)), use of BCS.org career planning/continuing professional development (CPD) tools, self-reported digital literacy and other professional registrations. The quantitative data were analysed using descriptive statistics in JASP V.0.9.2 to report frequencies and correlations.

Results

Responses were received from 152 participants. Most were male (n=103; 68%), aged 50–59 years (n=41; 28%), working in England (n=107; 71%) with master’s or honours degrees (n=80; 53%). Most were either new (5 years or less; n=61; 40%) or long-term members (21 years or more; n=43; 28%) of BCS. Most were not interested in health specialist groups (n=57; 38%) preferring non-health specialist groups such as information management (n=54; 37%) and project management (n=52; 34%).

Discussion

This is the first paper to characterise the health and social care membership of an IT-focused professional body and to start to determine their CPD needs. There are further challenges ahead in curating the content and delivery.

Conclusion

This study is the starting point from which members’ CPD needs, and ongoing interest, in being recognised as health and social care professional members, can be acknowledged and explored. Further research is planned with the participants who volunteered to be part of designing future CPD content and delivery.
Over-the-counter provision of emergency contraceptive pills: a systematic review
Authors: Atkins Kaitlyn , Kennedy Caitlin E , Yeh Ping Teresa , Narasimhan Manjulaa
Published: March 2022

Objective

To synthesise evidence around over-the-counter (OTC) emergency contraceptive pills (ECPs) to expand the evidence base on self-care interventions.

Design

Systematic review (PROSPERO# CRD42021231625).

Eligibility criteria

We included publications comparing OTC or pharmacy-access ECP with prescription-only ECPs and measuring ECP uptake, correct use, unintended pregnancy, abortion, sexual practices/behaviour, self-efficacy and side-effects/harms. We also reviewed studies assessing values/preferences and costs of OTC ECPs.

Data sources

We searched PubMed, CINAL, LILACS, EMBASE, clinicaltrials.gov, WHO International Clinical Trials Registry Platform, Pan African Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, Cochrane Fertility Regulation and International Consortium for Emergency Contraception through 2 December 2020.

Risk of bias

For trials, we used Cochrane Collaboration’s tool for assessing risk of bias; for other studies, we used the Evidence Project risk of bias tool.

Data extraction and synthesis

We summarised data in duplicate using Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence Profile tables, reporting findings by study design and outcome. We qualitatively synthesised values/preferences and cost data.

Results

We included 19 studies evaluating effectiveness of OTC ECP, 56 on values/preferences and 3 on costs. All studies except one were from high-income and middle-income settings. Broadly, there were no differences in overall ECP use, pregnancy or sexual behaviour, but an increase in timely ECP use, when comparing OTC or pharmacy ECP to prescription-only ECP groups. Studies showed similar/lower abortion rates in areas with pharmacy availability of ECPs. Users and providers generally supported OTC ECPs; decisions for use were influenced by privacy/confidentiality, convenience, and cost. Three modelling studies found pharmacy-access ECPs would lower health sector costs.

Conclusion

OTC ECPs are feasible and acceptable. They may increase access to and timely use of effective contraception. Existing evidence suggests OTC ECPs do not substantively change reproductive health outcomes. Future studies should examine OTC ECP’s impacts on user costs, among key subgroups and in low-resource settings.
Association between control status of blood pressure and frailty among middle-aged and older adults with hypertension in China: a longitudinal study
Authors: Shen Feifei , Chen Jiangyun , Yang Ruijing , Yang Jun , Li Haomiao
Published: March 2022

Objective

To assess the association between blood pressure (BP) control and frailty among middle-aged and older populations with hypertension in China from 2013 to 2018.

Design

Prospective longitudinal study.

Setting

This study analysed data from the China Health and Retirement Longitudinal Study, a nationally representative survey administered in 28 provinces of China.

Participants

A total of 3254 participants diagnosed with hypertension previous to 2013 were taken into analysis. 1932 participants who were not frail in 2013 were enrolled to calculate relative risk.

Outcome measures

The frailty score was constructed following Rookwood’s Cumulative deficit frailty index, with a score >0.25 defined as frailty (outcome variable). The self-reported status of BP control (exposure variable) represented the general status of the participant’s BP level. A fixed-effects model was used to analyse the association between BP control and frailty. A Cox proportional hazard model was further used to further calculate the relative risk of frailty for different BP control levels.

Results

The fixed-effects model showed that compared with well-controlled BP, poorly controlled BP exhibited a positive association with frailty score (β=0.015; 95% CI 0.011 to 0.019; p<0.001). The Cox proportional hazard model also revealed a higher risk of frailty in the poorly controlled group (HR=1.96; 95% CI 1.49 to 2.56; p<0.001). Based on subgroup analyses, poorly controlled BP was positively associated with frailty in respondents aged <60 years old (fix-effects model: β=0.015, p=0.021; Cox model: HR=2.25, p<0.001), but not significant among those aged ≥75 years old.

Conclusions

We provide new evidence of a negative association between BP control and frailty risk, but the findings differ among different age groups. Individualised strategies for BP management should be developed, especially for older hypertension patients.
Impact of the implementation of the WHO Safe Childbirth Checklist on essential birth practices and adverse events in two Brazilian hospitals: a before and after study
Authors: Sousa Kelienny de Meneses , Saturno-Hernández Pedro Jesús , Rosendo Tatyana Maria Silva de Souza , Freitas Marise Reis de , Molina Rose L , Medeiros Wilton Rodrigues , Silva Edna Marta Mendes da , Gama Zenewton André da Silva
Published: March 2022

Objective

The WHO Safe Childbirth Checklist (SCC) is a promising initiative for safety in childbirth care, but the evidence about its impact on clinical outcomes is limited. This study analysed the impact of SCC on essential birth practices (EBPs), obstetric complications and adverse events (AEs) in hospitals of different profiles.

Design

Quasi-experimental, time-series study and pre/post intervention.

Setting

Two hospitals in North-East Brazil, one at a tertiary level (H1) and another at a secondary level (H2).

Participants

1440 women and their newborns, excluding those with congenital malformations.

Interventions

The implementation of the SCC involved its cross-cultural adaptation, raising awareness with videos and posters, learning sessions about the SCC and auditing and feedback on adherence indicators.

Primary and secondary outcome measures

Simple and composite indicators related to seven EBPs, 3 complications and 10 AEs were monitored for 1 year, every 2 weeks, totalling 1440 observed deliveries.

Results

The checklist was adopted in 83.3% (n=300) of deliveries in H1 and in 33.6% (n=121) in H2. The hospital with the highest adoption rate for SCC (H1) showed greater adherence to EBPs (improvement of 50.9%;p<0.001) and greater reduction in clinical outcome indicators compared with its baseline: percentage of deliveries with severe complications (reduction of 30.8%;p=0.005); Adverse Outcome Index (reduction of 25.6%;p=0.049); Weighted Adverse Outcome Score (reduction of 39.5%;p<0.001); Severity Index (reduction of 18.4%;p<0.001). In H2, whose adherence to the SCC was lower, there was an improvement of 24.7% compared with before SCC implementation in the composite indicator of EBPs (p=0.002) and a reduction of 49.2% in severe complications (p=0.027), but there was no significant reduction in AEs.

Conclusions

A multifaceted SCC-based intervention can be effective in improving adherence to EBPs and clinical outcomes in childbirth. The context and adherence to the SCC seem to modulate its impact, working better in a hospital of higher complexity.
Impact of maternal morbidities on the longitudinal health-related quality of life trajectories among women who gave childbirth in four hospitals of Northwest Ethiopia: a group-based trajectory modelling study
Authors: Malaju Marelign Tilahun , Alene Getu Degu , Azale Telake
Published: March 2022

Objectives

To identify distinct trajectories of health-related quality of life and its predictors among postpartum women in Northwest Ethiopia.

Design

Health facility-linked community-based prospective follow-up study.

Setting

South Gondar zone, Northwest Ethiopia.

Participants

We recruited 775 mothers (252 exposed and 523 non-exposed) after childbirth and before discharge. Exposed and non-exposed mothers were identified based on the criteria published by the WHO Maternal Morbidity Working Group.

Outcome measures

The primary outcome measure of this study was trajectories of health-related quality of life. The Stata Traj package was used to determine the trajectories using a group-based trajectory modelling. Multinomial logistic regression model was used to identify predictors of trajectory membership.

Results

Four distinct trajectories for physical and psychological and five trajectories for the social relationships and environmental health-related quality of life were identified. Direct and indirect maternal morbidities, lower educational status, poor social support, being government employed and merchant/student in occupation, vaginal delivery, lower monthly expenditure, stress, fear of childbirth and anxiety were found to be predictors of lower health-related quality of life trajectory group membership.

Conclusions

Health professionals should target maternal morbidities and mental health problems when developing health intervention strategies to improve maternal health-related quality of life in the postpartum period. Developing encouraging strategies for social support and providing health education or counselling for women with less or no education are essential to avert the decrease in health-related quality of life trajectories of postpartum women.
Prevalence and significance of anaemia in childhood bacterial meningitis: a secondary analysis of prospectively collected data from clinical trials in Finland, Latin America and Angola
Authors: Pelkonen Tuula , Roine Irmeli , Kallio Markku , Jahnukainen Kirsi , Peltola Heikki
Published: March 2022

Objectives

To describe the prevalence and severity of anaemia and to examine its associations with outcome in children with bacterial meningitis (BM).

Design

Secondary analysis of descriptive data from five randomised BM treatment trials.

Setting

Hospitals in Finland, Latin America and Angola.

Participants

Consecutive children from 2 months to 15 years of age admitted with BM and who had haemoglobin (Hb) measured on admission.

Outcome measures

Prevalence and degree of anaemia using the WHO criteria, and their associations with recovery with sequelae or death.

Results

The median Hb was 11.8 g/dL in Finland (N=341), 9.2 g/dL in Latin America (N=597) and 7.6 g/dL in Angola (N=1085). Of the children, 79% had anaemia, which was severe in 29%, moderate in 58% and mild in 13% of cases. Besides study area, having anaemia was independently associated with age <1 year, treatment delay >3 days, weight-for-age z-score <−3 and other than meningococcal aetiology. Irrespective of the study area, anaemia correlated with the markers of disease severity. In children with severe to moderate anaemia (vs mild or no anaemia), the risk ratio for death was 3.38 and for death or severe sequelae was 3.07.

Conclusion

Anaemia, mostly moderate, was common in children with BM, especially in Angola, in underweight children, among those with treatment delay, and in pneumococcal meningitis. Poor outcome was associated with anaemia in all three continents.

Trial registration number

The registration numbers of Angolan trials were ISRCTN62824827 and NCT01540838.
Quality of refractive error care (Q.REC) in Cambodia, Malaysia and Pakistan: protocol for a cross-sectional unannounced standardised patient study
Authors: Burnett Anthea M , Lee Ling , McGuinness Myra , Varga Beatrice , Perez Hazel Yadira , Ho Suit May
Published: March 2022

Introduction

There are 161 million people living with vision impairment, due to uncorrected refractive errors. A further 510 million people are living with near-vision impairment. There is a need for clearly defined indicators that capture the quality of refractive error service outputs and outcomes and provide insights to shape, change and stimulate action. This study aims to evaluate the quality of refractive error care (Q.REC) in Cambodia, Malaysia and Pakistan, by using unannounced standardised patients (USPs) to identify the proportion of prescribed and dispensed spectacles appropriate for people’s refractive error needs and pinpoint/detail opportunities for quality improvement.

Method and analysis

A cross-sectional Q.REC study will be conducted in randomly selected optical services in Cambodia (180 services, 900 USP visits), the Klang Valley in Malaysia (66 services, 198 USP visits) and in Jhang, Sahiwal and Khanewal districts of Punjab region/state in Pakistan (64 services, 256 USP visits). USPs will receive baseline refractions by three skilled study optometrists/refractionists trained in the Q.REC protocol. USPs will then visit individual optical services, undergo a refraction, purchase spectacles or lenses (if recommended) and record observations about which elements of a refraction and dispensing were conducted. The study optometrist/refractionist will assess each pair of dispensed spectacles by examining the USP’s aided visual acuity and visual comfort at distance and/or near and compare the lens prescription to the averaged baseline refraction.

Ethics and dissemination

This study has been approved by the University of New South Wales Human Research Ethics Committee (HC210102), the National Ethics Committee for Health Research in Cambodia (043 NECHR), National Medical Research Registry and the Medical Research and Ethics Committee (NMRR-21-689-59279) in Malaysia and the College of Ophthalmology & Allied Vision Sciences Ethical Review Board (COAVS 545/2021) in Pakistan. Written informed consent will be obtained from USPs. Service owners will have the opportunity to opt-out verbally or in writing. Results will be disseminated locally through workshops including the relevant local ministry of health personnel and stakeholders, published in peer-reviewed publications and presented at national and international conferences.
Analysing MyOptions: experiences of Ireland’s abortion information and support service
Authors: Grimes Lorraine , O'Shaughnessy Aideen , Roth Rachel , Carnegie Anna , Duffy Deirdre Niamh
Published: March 2022

Background

In 2018, the Irish government enacted a liberalised abortion law permitting expanded access to abortion from January 2019. A dedicated information and support service – MyOptions – was established to provide non-directive counselling and clinical advice about unplanned pregnancy. MyOptions provides contact details for abortion providers but does not make appointments for abortion-seekers. In 2020, the Abortion Rights Campaign (ARC) conducted research into Irish residents’ experiences of abortion care under the new law, including their experiences with MyOptions.

Methods

Between September 2020 and March 2021, ARC administered an online survey. Qualitative data were coded using NVIVO software and analysed through thematic analysis. Quantitative data were analysed descriptively. This article analyses a subsection of these data to answer the question: What were abortion-seekers’ experiences of using MyOptions?

Results

Many respondents were unaware of MyOptions before becoming pregnant. Some described MyOptions as useful and compassionate. Others noted a lack of clarity from MyOptions about the scope of its service and a lack of information on accessing abortion after 12 weeks. Respondents reported frustration that the service did not arrange appointments, explaining that having to contact general practitioners (GPs) themselves was stressful and time-consuming, as was GPs’ refusal to provide care or refer to a willing provider.

Conclusions

MyOptions primarily benefits abortion-seekers whose pregnancies are under 12 weeks and who are comfortable contacting a GP themselves. The addition of an appointments booking service and guidance on how to access abortion for medical reasons and abortion after 12 weeks could improve the service.
Lipoprotein(a): a risk factor for atherosclerosis and an emerging therapeutic target
Authors: Di Fusco Stefania Angela , Arca Marcello , Scicchitano Pietro , Alonzo Alessandro , Perone Francesco , Gulizia Michele Massimo , Gabrielli Domenico , Oliva Fabrizio , Imperoli Giuseppe , Colivicchi Furio
Published: March 2022

Lipoprotein(a) (Lp(a)) is a complex circulating lipoprotein, and increasing evidence has demonstrated its role as a risk factor for atherosclerotic cardiovascular disease (ASCVD) and as a possible therapeutic target. Lp(a) atherogenic effects are attributed to several potential mechanisms in addition to cholesterol accumulation in the arterial wall, including proinflammatory effects mainly mediated by oxidised phospholipids. Several studies have found a causal and independent relationship between Lp(a) levels and cardiovascular risk. Furthermore, several studies also suggest a causal association between Lp(a) levels and calcific aortic valve stenosis. Available lipid-lowering agents have at best moderate impact on Lp(a) levels. Among available therapies, antibody proprotein convertase subtilisin/kexin type 9 inhibitors are the most effective in reducing Lp(a). Potent Lp(a)-lowering treatments that targetLPAexpression are under development. Lp(a) level measurement poses some challenges due to the absence of a definitive reference method and the reporting of Lp(a) values as molar (nanomoles per litre (nmol/L)) or mass concentrations (milligrams per decilitre (mg/dL)) by different assays. Currently, Lp(a) measurement is recommended to refine cardiovascular risk in specific clinical settings, that is, in individuals with a family history of premature ASCVD, in patients with ASCVD not explained by standard risk factors or in those with recurrent events despite optimal management of traditional risk factors. Patients with high Lp(a) levels should be managed with more intensive approaches to treat other modifiable cardiovascular risk factors. Overall, this review focuses on Lp(a) as an ASCVD risk factor and therapeutic target. Furthermore, it reports practical recommendations for Lp(a) measurement and interpretation and updated evidence on Lp(a)-lowering approaches.
Surgeon-performed pericapsular nerve group (PENG) block for total hip arthroplasty using the direct anterior approach: a cadaveric study
Authors: Kitcharanant Nitchanant , Leurcharusmee Prangmalee , Wangtapun Pakawat , Kantakam Perada , Maikong Naraporn , Mahakkanukrauh Pasuk , Tran De Q
Published: March 2022

Background

During total hip arthroplasty (THA) using the direct anterior approach, orthopaedic surgeons can identify all anatomical landmarks required for pericapsular nerve group (PENG) blocks and carry out the latter under direct vision. This cadaveric study investigated the success of surgeon-performed PENG block. Success was defined as dye staining of the articular branches of the femoral and accessory obturator nerves.

Methods

11 cadavers (18 hip specimens) were included in the current study. To simulate THA in live patients, an orthopaedic surgeon inserted trial prostheses using the direct anterior approach. Subsequently, a block needle was advanced until contact with the bone (between the anterior inferior iliac spine and iliopubic eminence). 20 mL of 0.1% methylene blue was injected. Cadavers were then dissected to document the presence and dye staining of the femoral, lateral femoral cutaneous, obturator and accessory obturator nerves as well as the articular branches of the femoral, obturator and accessory obturator nerves.

Results

Methylene blue stained the articular branches of the femoral nerve and the articular branches of the accessory obturator nerve (when present) in all hip specimens. Therefore, surgical PENG block achieved a 100% success rate. Dye stained the femoral and obturator nerve in one (5.6%) and two (11.1%) hip specimens, respectively. No dye staining was observed over the accessory obturator nerve in the pelvis nor the lateral femoral cutaneous nerve.

Conclusion

Surgeon-performed PENG block during direct anterior THA reliably targets the articular branches of the femoral and accessory obturator nerves. Future trials are required to compare surgeon-performed PENG block with anaesthesiologist-performed, ultrasound-guided PENG block, and surgeon-performed periarticular local anaesthetic infiltration.
THE FISCAL IMBALANCE AND CLIMATE CHANGE OBLIGATIONS: WHAT IS FEASIBLE FOR DEVELOPING ECONOMIES?
Authors: CHENG BEINAN , ZHONG ZIQI , ALHARTHI MAJED , ABBAS QAISER , KOUSER ROBINA
Published: March 2022

The developing world is facing multidirectional challenges of socioeconomics in the era of Sustainable Development Goals (SDGs-2030). Fiscal indicators like fiscal imbalance and debt financing are the key hurdles in financing sustainable environment projects. This study attempted to probe the impact of the fiscal indicators on the environmental conditions of the South Asian region. For a comprehensive analysis, the study utilized a dataset of all eight countries of South Asia for 19 years. Per capita greenhouse gas emission has been used as a dependent indicator, while fiscal imbalance anddebt to gross domestic product (GDP) have been taken as independent indicators along with energy consumption, energy intensity and GDP growth rate. The generalized least squares and quantile autoregressive distributive lag methods have been adopted from econometric for this empirical analysis. Both ways confirm that fiscal imbalance and debt financing play a significant role in greenhouse gas emissions accumulation in the entire region of South Asia. Energy consumption and the cost of producing energy (energy intensity) are the other sources of greenhouse gas emissions accumulation in the area. This study suggested that developing economies of South Asia may not be able to fulfill their commitments regarding SDGs-2030 if their issues of fiscal imbalance and debt financing have not been treated initially.
A study of a nonlinear interaction between a two-mode cavity field and ♢-type four-level with field damping
Authors: Obada A-S. F. , Ahmed M. M. A. , Eied A. A. , Khalil E. M. , Elkhouly E. S.
Published: March 2022

In this paper, the effects of the field damping and Kerr-like medium on a system of a four-level atom in the [Formula: see text]-type interacting nonlinearly with a two-mode field are studied. Analytical solution of the system of differential equations resulting from the Schrödinger equation is obtained. The effects of detuning parameters, Kerr-like parameter, coupling function and damping rate are discussed for atomic population inversion, the second-order correlation function, Shannon information entropy, and linear entropy. Under justifiable all conditions, extreme entanglement states may appear periodically with the evolution of time. The arrival of the quantum system to a pure state can be controlled by variations of the Kerr medium and the damping parameters. The results also exhibit that the periods of strong and weak entanglement between the parts of the system are achieved during the periods of collapses and revivals of the atomic population inversion. Moreover, the photon distribution changes from non-classical to classical by increasing the damping rate.
Two-party quantum private comparison based on eight-qubit entangled state
Authors: Fan Peiru , Rahman Atta Ur , Ji Zhaoxu , Ji Xiangmin , Hao Zhiqiang , Zhang Huanguo
Published: March 2022

The purpose of quantum private comparison (QPC) is to solve “Tiercé problem” using quantum mechanics laws, where the “Tiercé problem” is to judge whether the secret data of two participants are equal under the condition of protecting data privacy. Here we consider for the first time the usefulness of eight-qubit entangled states for QPC by proposing a new protocol. The proposed protocol only adopts necessary quantum technologies such as preparing quantum states and quantum measurements without using any other quantum technologies (e.g. unitary operations and entanglement swapping), thus the protocol has advantages in quantum device consumption. The measurements adopted only include single-particle measurements, which is easier to implement than entangled-state measurements under the existing technical conditions. The proposed protocol takes advantage of the entanglement characteristics of the eight-qubit entangled state, and uses joint computation, decoy photon technology, the keys generated by a quantum key distribution protocol to ensure data privacy. We show that when all single-particle measurements in the proposed protocol are replaced by Bell measurements, the purpose of the protocol can also be achieved. We also show that the proposed protocol can be changed into a semi-quantum protocol with a few small changes.
A double Λ-five-level moving atom interacting with a two-mode field in the presence of damping and nonlinear Kerr medium
Authors: Salah Ahmed , Thabet L. E. , El-Shahat T. M. , El-Wahab N. H. Abd , Edin Manal G.
Published: March 2022

In this paper, we present the interaction between a five-level [Formula: see text]-configuration atom and a two-mode quantized field in the presence of the damping with the nonlinearity. According to the generalized nonlinear Jaynes–Cummings model (JCM) and the analytical solution of the Schrödinger equation, the general formula of the wave function for this system under special conditions, where the atom (the field) is initially prepared in the excited state (coherent state), has been found. Under some particular conditions, the five-level [Formula: see text]-type atom can be reduced to the three-level [Formula: see text]-type atom. Some physical aspects of the atom-field entangled state showing the entanglement degree, such as the field entropy. Moreover, we evaluate some of their non-classical statistical aspects such as atomic inversion. The effects of the physical parameters such as a Kerr medium, detuning parameter and the intensity-dependent coupling on the temporal behavior of the latter mentioned non-classical statistical aspects have been explored. We show that by choosing the evolved parameters in the interaction process, each of the above non-classical statistical features can be treated. We found that the parameters have an important influence on the properties of these phenomena.
Influence of nucleon structure on spin correlation coefficients in elastic lepton-deuteron scattering
Authors: Darwish Eed M. , Mindil A.
Published: March 2022

Spin correlation coefficients in elastic scattering of leptons on the deuteron are studied in the one-photon-exchange Born approximation within the limit of zero lepton mass. Numerical estimations for the spin correlation coefficients caused by a polarized beam and a vector polarized target are presented and analyzed at various beam energies and scattering angles in two coordinate systems which are relevant for experiment. The influence of the obtained results on the nucleon structure is investigated, and a considerable dependence at incident beam energies greater than 1[Formula: see text]fm[Formula: see text] and backward scattering angles is found. The estimated results are of particular interest for encouragement of experimental measurements of lepton-deuteron scattering which aim for accurate calculation of the charge radius of the proton to a high degree of precision. These results may also stimulate new generation of measurements of different physical observables very sensitive to the spin structure of the nucleon and light nuclei.