bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond household income: the role of commercial vegetable farming in moderating socio-cultural barriers for women in rural Nepal
Authors: Balayar Ramesh , Mazur Robert
Published: April 2022

Background

Promoting rural women’s agricultural entrepreneurship in the Global South has become a major policy and program priority for governments and development partners. Women’s income earning is viewed as a pathway to their empowerment and gender equality. The research goal was to understand how patriarchal socio-cultural norms and practices influence women’s participation in commercial vegetable farming (CVF) in the mid-hills of Sudurpashchim Pradesh, Nepal, and identify the specific and evolving strategies that women use to negotiate these changes.

Methodology

Data for the study were generated through in-depth interviews with 16 smallholder couples, eight each in Dadeldhura and Achham districts. Additionally, 17 key informants who were government agency and development organization agriculture support officials at the district and national level were interviewed. Besides in-depth interviews, focus group discussions (FGDs) with women’s groups, women leaders, development actors, and government officials at district, regional, and national level were also conducted. Interview data analysis using NVivo was complemented with field notes, observations and government agency and development organization reports.

Results

CVF possibilities initially motivated a few women to discuss with their husbands, organize self-help groups, and seek development program subsidies. With strong support from husbands and parents-in-law, they actively engage in CVF, generate income, form cooperatives for savings and credit, and improve household food security and their own economic status. CVF-associated groups, cooperatives, meetings, exposure visits, skill development training, knowledge sharing, counseling, and advocacy are vital tools. Through them, women build self-confidence, contest and transform entrenched socio-cultural barriers, and negotiate new socio-cultural norms and practices within and outside the household. Dissolving gender stereotypes regarding the division of labor in CVF plays a significant role in encouraging more women to join CVF and increases gender parity. However, a diminishing minority of women still struggle to overcome the legacy of prior negative experiences and subconsciously fear community backlash, especially regarding extended travel outside their village.

Conclusion

Socio-cultural practices restricting women’s income-generating roles can be transformed through investment in women’s group initiatives, enhancing husbands’ and wives’ communication and livelihood planning, and community members increased appreciation for women’s role in contributing household income and food security.
Chain and silk: alternative futures of blockchain governance in Kyrgyzstan
Authors: Anvar kyzy Saikal , Dunn Gregory J. , Sweeney John A.
Published: April 2022

Few technologies have been mired in hype more than blockchain, which is the underlying peer-to-peer network protocol for cryptocurrencies such as Bitcoin. Given the technology’s emphasis on purported “immutable ledgers” and trust-less sharing models, there has been a great deal of interest in applying blockchain to democratic reforms. From localized decision-making to national-scale voting systems, blockchain has spurred a surge of interest in how democracy might “get a software update”. While significant research exists on socio-technological imaginaries (perceptions) and potential applications (experiments) within the Global North, few studies have looked at more dynamic contexts, particularly Central Asia. In light of the violence surrounding elections in October 2020 and previous revolutions against the country’s central government, the status of democracy in Kyrgyzstan is, at best, fragile and, at worst, non-existent. This article explores alternative futures scenarios for localized, blockchain-driven governance futures in Kyrgyzstan and concludes with a proposal for deeper investigation.
Implementation of exclusive enteral nutrition in pediatric patients with Crohn’s disease—results of a survey of CEDATA-GPGE reporting centers
Authors: Peters Sarah , Cantez Serdar , De Laffolie Jan ,   CEDATA Study Group
Published: April 2022

Background

Exclusive enteral nutrition (EEN) is the first-line therapy for pediatric-onset Crohn’s disease (CD) patients. CEDATA-GPGE® is the largest patient registry for children and adolescents with inflammatory bowel disease (IBD) in Europe, collecting data from over 5000 patients since 2004 in Germany and Austria. Since the application of EEN over 8 weeks is difficult and a high dropout rate is often described, the mode of application including a supporting structure is crucial for success. The aim of this study was to ascertain the variation in the application of EEN across the participating centers and to associate these with the outcome.

Results

Thirty-one centers responded to the survey (81.6%). 88.5% of CD patients were recommended EEN for induction therapy, 71.8% actually started with EEN, and 22.1% terminated the EEN prematurely. The duration of EEN typically lasted 6 to 8 weeks, and the polymeric formula was mainly used. 80.6% of the clinics added flavorings to the formulas. After EEN, the most preferred diet for maintenance therapy was a healthy, well-balanced diet considering individual intolerances.

Conclusions

EEN is widely recommended as an induction therapy by the German and Austrian pediatric gastroenterologists for children and adolescents with CD. However, this questionnaire-based study has shown a wide variation in EEN protocols used by the different pediatric clinics of CEDATA-GPGE®.
Equal opportunities for all? Analyzing within-country variation in school effectiveness
Authors: Steinmann Isa , Olsen Rolf Vegar
Published: April 2022

Background

The present study addresses the equality of school effectiveness across schools. One central aim of compulsory education is for students to learn equally well at all schools in a country even if these schools differ in terms of student composition. However, measuring equality of learning gains independently from selection effects usually requires longitudinal data. This study suggests a different approach and proposes a new measure for the equality of school effectiveness across schools.

Methods

We applied a two-level regression discontinuity approach to estimate the between-school variation in added-year effects on mathematics and science achievement that result from an additional year of schooling, after controlling for the effects of age and student selection—i.e., between-school differences in achievement levels. We utilized data from a total of 13 samples. These stemmed from Nordic and other European countries, which assessed students from two adjacent grades at the same schools. The samples stemmed from TIMSS 1995 and 2015 and both primary and secondary school levels.

Results

The main findings indicated that although schools differed in initial achievement levels in all samples, schools in some countries, such as Norway and Cyprus, attained a high degree of equality of school effectiveness—i.e., of the effect of an additional year of schooling. Despite the fact that schools with a more privileged student composition had higher achievement levels than less privileged schools, their school effectiveness did not usually differ significantly. Both age and an additional year of schooling resulted in positive effects on mathematics and science achievement, however, effect sizes differed considerably between the 13 samples.

Conclusions

We discuss the implications of the proposed school effectiveness measure, which is based on a regression discontinuity approach. We conclude that countries, such as Nordic ones, should consider extending their participation in international large-scale assessments with additional grades from the same schools in future cycles. This design would enable a multitude of robust school effectiveness studies in the future.
Tellurite and Selenite: how can these two oxyanions be chemically different yet so similar in the way they are transformed to their metal forms by bacteria?
Authors: Kessi Janine , Turner Raymond J. , Zannoni Davide
Published: April 2022

This opinion review explores the microbiology of tellurite, TeO32− and selenite, SeO32− oxyanions, two similar Group 16 chalcogen elements, but with slightly different physicochemical properties that lead to intriguing biological differences. Selenium, Se, is a required trace element compared to tellurium, Te, which is not. Here, the challenges around understanding the uptake transport mechanisms of these anions, as reflected in the model organisms used by different groups, are described. This leads to a discussion around how these oxyanions are subsequently reduced to nanomaterials, which mechanistically, has controversies between ideas around the molecule chemistry, chemical reactions involving reduced glutathione and reactive oxygen species (ROS) production along with the bioenergetics at the membrane versus the cytoplasm. Of particular interest is the linkage of glutathione and thioredoxin chemistry from the cytoplasm through the membrane electron transport chain (ETC) system/quinones to the periplasm. Throughout the opinion review we identify open and unanswered questions about the microbial physiology under selenite and tellurite exposure. Thus, demonstrating how far we have come, yet the exciting research directions that are still possible. The review is written in a conversational manner from three long-term researchers in the field, through which to play homage to the late Professor Claudio Vásquez.
Optical coherence tomography angiography metrics in different stages of diabetic macular edema
Authors: Han Ruyi , Gong Ruowen , Liu Wei , Xu Gezhi
Published: April 2022

Background

To investigate the optical coherence tomography angiography (OCTA) characteristics of diabetic macular edema (DME) at different stages.

Methods

This study was a cross-sectional study. Patients diagnosed with DME were recruited. DME was classified into early, advanced, and severe DME. The vessel density (VD) in the superficial vascular plexus (SVP), deep vascular plexus (DVP) and foveal avascular zone (FAZ) parameters, including FAZ area, FAZ perimeter, acircularity index and foveal VD in a 300-μm-wide region around the FAZ (FD-300), were calculated by the AngioVue software. A multivariate generalized estimating equation was used to evaluate the associations between visual acuity and OCTA metrics.

Results

Ninety-two eyes from 74 patients with DME were included in this study. Compared to early (P = 0.006) and advanced DME (P = 0.003), the acircularity index was higher in severe DME. Both whole and parafoveal VD in the DVP decreased in eyes with severe DME compared to early DME (P = 0.018, P = 0.005, respectively) and advanced DME (P = 0.035, P = 0.012, respectively). In the multivariate generalized estimating equation, DME severity, FAZ area and foveal thickness were positively associated with worse visual acuity (P = 0.001, P = 0.007 and P = 0.001, respectively).

Conclusion

Compared to early and advanced DME, severe DME showed increased irregularity in the FAZ and more extensive vessel damage in the DVP. Greater severity level of DME, larger FAZ area, and increased foveal thickness could be risk factors for poor visual acuity.

Trial registration The protocol was published in the Chinese Clinical Trial Registry (ChiCTR2000033082).
Toward equity-oriented cancer care: a Strategy for Patient-Oriented Research (SPOR) protocol to promote equitable access to lung cancer screening
Authors: Sayani Ambreen , Manthorne Jackie , Nicholson Erika , Bloch Gary , Parsons Janet A. , Hwang Stephen W. , Amenu Bikila , Freedman Howard , Rathbone Marlene , Jeji Tara , Wathen Nadine , Browne Annette J. , Varcoe Colleen , Lofters Aisha
Published: April 2022

Background

Screening for lung cancer with low dose CT can facilitate the detection of early-stage lung cancers that are amenable to treatment, reducing mortality related to lung cancer. Individuals are considered eligible for lung cancer screening if they meet specific high-risk criteria, such as age and smoking history. Population groups that are at highest risk of lung cancer, and therefore, the target of lung cancer screening interventions, are also the least likely to participate in lung cancer screening. This can lead to a widening of health inequities. Deliberate effort is needed to both reduce lung cancer risk (through upstream interventions that promote smoking cessation) as well as midstream interventions that promote equitable access to lung cancer screening.

Methods

This protocol paper describes an equity-informed patient-oriented research study. Our study aims to promote equitable access to lung cancer screening by partnering with patients to co-design an e-learning module for healthcare providers. The learning module will describe the social context of lung cancer risk and promote access to lung cancer screening by increasing equity at the point of care. We have applied the Generative Co-Design Framework for Healthcare Innovation and detail our study processes in three phases and six steps: Pre-design (establishing a study governance structure); Co-design (identifying research priorities, gathering and interpreting data, co-developing module content); and Post-design (pilot testing the module and developing an implementation plan).

Discussion

Patient engagement in research can promote the design and delivery of healthcare services that are accessible and acceptable to patients. This is particularly important for lung cancer screening as those at highest risk of developing lung cancer are also those who are least likely to participate in lung cancer screening. By detailing the steps of our participatory co-design journey, we are making visible the processes of our work so that they can be linked to future outcomes and related impact, and inform a wide range of patient co-led processes.
The state of distance healthcare simulation during the COVID-19 pandemic: results of an international survey
Authors: Buléon C. , Caton J. , Park Y. S. , Eller S. , Buyck M. , Kardong-Edgren S. , Walsh B. M. , Gross I. T. , Maxworthy J. , Reedy G. , Palaganas J. C.
Published: April 2022

Background

The coronavirus pandemic continues to shake the embedded structures of traditional in-person education across all learning levels and across the globe. In healthcare simulation, the pandemic tested the innovative and technological capabilities of simulation programs, educators, operations staff, and administration. This study aimed to answer the question: What is the state of distance simulation practice in 2021?

Methods

This was an IRB-approved, 34-item open survey for any profession involved in healthcare simulation disseminated widely and internationally in seven languages from January 14, 2021, to March 3, 2021. Development followed a multistep process of expert design, testing, piloting, translation, and recruitment. The survey asked questions to understand: Who was using distance simulation? What driving factors motivated programs to initiate distance sim? For what purposes was distance sim being used? What specific types or modalities of distance simulation were occurring? How was it being used (i.e., modalities, blending of technology and resources and location)? How did the early part of the pandemic differ from the latter half of 2020 and early 2021? What information would best support future distance simulation education? Data were cleaned, compiled, and analyzed for dichotomized responses, reporting frequencies, proportions, as well as a comparison of response proportions.

Results

From 32 countries, 618 respondents were included in the analysis. The findings included insights into the prevalence of distance simulation before, during, and after the pandemic; drivers for using distance simulation; methods and modalities of distance simulation; and staff training. The majority of respondents (70%) reported that their simulation center was conducting distance simulation. Significantly more respondents indicated long-term plans for maintaining a hybrid format (82%), relative to going back to in-person simulation (11%, p < 0.001).

Conclusion

This study gives a perspective into the rapid adaptation of the healthcare simulation community towards distance teaching and learning in reaction to a radical and quick change in education conditions and environment caused by COVID-19, as well as future directions to pursue understanding and support of distance simulation.
New polymethylmethacrylate membrane, NF-U, improves nutritional status and reduces patient-reported symptoms in older dialysis patients
Authors: Chida Tetsuro , Igarashi Hiroyuki , Masakane Ikuto
Published: April 2022

Introduction

We previously reported the nutritional advantage of polymethylmethacrylate (PMMA) membranes to prevent the progression of malnutrition in dialysis patients. In this study, we examined whether a new PMMA dialyzer, NF-U, has advantages to improve the nutritional condition, patient-reported symptoms, and other clinical parameters in older dialysis patients.

Methods

We selected ten older chronic dialysis patients who were treated with NF-U for improving their worsening nutritional parameters and retrospectively evaluated nutrition and patient-reported symptoms. Patient-reported symptoms were surveyed by our original questionnaire including 20 items of symptom.

Results

Serum albumin concentration, geriatric nutritional risk index, and percent creatinine generation rate increased from 3.01 ± 0.16 to 3.25 ± 0.17 g/dL, 87.7 ± 5.8 to 91.4 ± 6.2, 100.2 ± 21.6 to 111.9 ± 20.9% at 1 and 4 months after switching to NF-U, respectively. For patient-reported outcomes, fatigue and the total score of patient-reported outcomes were improved after switching to NF-U.

Conclusion

Our results suggest that NF-U is a good choice for older dialysis patients to ameliorate their nutritional status and patient-reported outcomes.
Comparison of antibody response following the second dose of SARS-CoV-2 mRNA vaccine in elderly patients with late-stage chronic kidney disease
Authors: Matsunami Masatoshi , Suzuki Tomo , Fukuda Junko , Terao Toshiki , Ukai Kohei , Sugihara Shinnosuke , Toishi Takumi , Nagaoka Kanako , Nakata Mayumi , Ohara Mamiko , Yashima Jun , Kuji Hiroshi , Matsue Kosei
Published: April 2022

Background

Currently, it is unclear whether the progression of chronic kidney disease (CKD) could be an independent predictor of antibody response after administration of a COVID-19 vaccine. This study aimed to investigate the immune response to COVID-19 vaccination in patients with CKD stage G4 to G5 without renal replacement therapy and G5D using the recommended dose and schedule.

Methods

This retrospective single-center cohort study evaluated immunogenicity regarding antibody response after COVID-19 vaccination in our hospital for late-stage CKD patients aged ≥ 60 years. We evaluated antibody responses in 48 patients with CKD G4, 35 patients with CKD G5, and 70 patients undergoing hemodialysis (HD; CKD G5D).

Results

After the second vaccination, anti-SARS-CoV-2-S (Spike) IgG levels were found to be positive (> 0.8 U/mL) in all CKD G4 and G5 patients (100%), and 69 of 70 HD patients (98.5%). The median (interquartile range [IQR] S-IgG level (Ab titers) was 358 [130.2–639.2], 218 [117–377], and 185.5 [95.1–323.5] U/mL in the CKD G4, G5, and HD groups, respectively. The median S-IgG levels were significantly lower in the HD group than in the CKD G4 group (p < 0.01). However, there was no significant difference in the antibody titers between the CKD G4 and G5 groups. To further analyze the decline in S-IgG levels after 6 months, we additionally assessed and compared antibody titers at 1 month and 6 months after the second vaccination in the HD group. Compared with the median S-IgG levels of 185.5 [95.1–323.5] U/mL 1 month after the second dose, the median S-IgG level 6 months thereafter was significantly decreased at 97.4 [62.5–205.5] U/mL (p < 0.05).

Conclusions

We highlight two major factors of variability in the vaccine response. First, in elderly patients with late-stage CKD, antibody titers tended to be lower in the G5D group than in the G4 and G5 groups despite the shorter time since vaccination; therefore, CKD stage progression might cause a decline in antibody titers. Second, waning immune responses were observed 6 months after second dose administration in HD patients advocating a potential need for a third booster dose vaccine after 6 months.
Video feedback and Foreign Language Anxiety in online pronunciation tasks
Authors: Martin Sidney , Alvarez Ibis M. , Espasa Anna
Published: April 2022

Despite many studies about video feedback in both face-to-face and online settings, little research has been carried out exploring how this technique is perceived by students learning the pronunciation of specific sounds in a foreign language. Adopting grounded theory as the methodology and a dialogic approach as the conceptual framework, the present study shows that anxious students welcome video feedback. The design of a learning activity for students to practise a specific problematic pronunciation target in English, carried out in an e-learning environment, more specifically in an online English language course, is described. The results show three aspects of teacher's corrective video feedback, perceived as more relevant: the Emotional input of feedback, referred to the feelings around the feedback delivery which foster dialogue, closeness, motivation and empathy; Enhanced understanding, related to the clarity, the usability and personalization of the feedback; and feedback engagement, which are the conditions favouring agentic engagement that involves the students sharing responsibility for making feedback processes effective. Implications related to video feedback practices are also discussed.
Health-related quality of life and treatment satisfaction in Palestinians with rheumatoid arthritis: a cross-sectional study
Authors: Abu Hamdeh Heba , Al-Jabi Samah W. , Koni Amer , Zyoud Sa’ed H.
Published: April 2022

Background

Studying health-related quality of life (HRQoL) and treatment satisfaction have helped in understanding how to optimize rheumatoid arthritis (RA) treatment outcomes and find ways to alleviate signs and symptoms among patients.

Objective

In this study, our objective was to evaluate the association between satisfaction with care and HRQoL among RA patients from northern Palestine. In addition, this study also aimed to determine the associations between the clinical characteristics of patients with RA with treatment satisfaction and HRQoL.

Methods

This was a multicenter cross-sectional study conducted between July and October 2018. Patients with RA diagnosis who presented at rheumatology clinics were interviewed. The SF-36 short questionnaire was used to assess HRQoL and Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4 to assess treatment satisfaction among study groups. We use descriptive and comparative statistics to present the results.

Results

A total of 283 patients were included. Several sociodemographic and clinical characteristics were found to be associated with poor HRQoL scores and low treatment satisfaction. The physical component summary (PCS) was negatively associated with age, patients’ self-reported disease activity, duration of the disease, and the total number of medications taken by the patient, and was positively associated with educational background, employment, and household income. The mental component summary (MCS) was negatively associated with patients’ self-reported disease activity and the patient's total number of comorbid diseases. The number of comorbid diseases was negatively associated with effectiveness. All HRQoL subscales were significantly correlated with treatment satisfaction. The range of correlation with PCS was between 0.272 for convenience and 0.425 for side effects (p < 0.001). Similarly, the highest correlation with MCS was 0.458 for side effects, and the lowest was 0.337 for convenience (p < 0.001).

Conclusions

The current study found that HRQoL was significantly correlated with treatment satisfaction. Furthermore, the results of this study showed that HRQoL and treatment satisfaction are likely to be affected by sociodemographic and clinical characteristics. These results may be beneficial in clinical practice, mainly in the early treatment of patients with RA, at a stage where it is still possible to increase treatment satisfaction.
Theoretical activity prediction, structure-based design, molecular docking and pharmacokinetic studies of some maleimides against Leishmania donovani for the treatment of leishmaniasis
Authors: Ugbe Fabian Audu , Shallangwa Gideon Adamu , Uzairu Adamu , Abdulkadir Ibrahim
Published: April 2022

Background

Leishmaniasis is a neglected tropical disease caused by a group of protozoan of the genus Leishmania and transmitted to humans majorly through the bite of the female sand fly. It is prevalent in the tropical regions of the world especially in Africa and estimated to affect a population of about 12 million people annually. This theoretical study was therefore conducted in support of the search for more effective drug candidates for the treatment of leishmaniasis. This study focuses on the in silico activity prediction of twenty-eight (28) maleimides, structure-based design, molecular docking study and pharmacokinetics analysis of the newly designed maleimides. All the studied compounds were drawn using ChemDraw Ultra and optimized by the density functional theory (DFT) approach using B3LYP with 6-31G⁄ basis set.

Results

The built QSAR model was found to satisfy the requirement of both internal and external validation tests for an acceptable QSAR model with R2 = 0.801, R2adj = 0.748, Q2cv = 0.710, R2test = 0.892 and cRp2 = 0.664 and has shown excellent prediction of the studied compounds. Among the five (5) protein receptors utilized for the virtual docking screening, pyridoxal kinase (PdxK) receptor (Pdb id = 6k91) showed the strongest binding interactions with compounds 14, 21 and 24 with the highest binding affinities of − 7.7, − 7.7 and − 7.8 kcal/mol, respectively. The selected templates (14, 21 and 24) were used to design twelve (12) new compounds (N1–N12) with higher docking scores than the templates. N7 (affinity =  − 8.9 kcal/mol) and N12 (− 8.5 kcal/mol) showed higher binding scores than the reference drug pentamidine (− 8.10 kcal/mol), while N3 and N7–N12 showed higher predicted pIC50 than the templates. Also, the pharmacokinetics properties prediction revealed that the newly designed compounds, obeyed the Lipinski’s rule for oral bio-availability, showed high human intestinal absorption (HIA), low synthetic accessibility score, CNS and BBB permeability and were pharmacologically active.

Conclusions

The activities of the various maleimides were predicted excellently by the built QSAR model. Based on the pharmacokinetics and molecular docking studies therefore, the newly designed compounds are suggested for further practical evaluation and/or validation as potential drug candidates for the treatment of leishmaniasis.
Assessment of interleukin 32 as a novel biomarker for non-alcoholic fatty liver disease
Authors: Mohamed Manal Sabry , Ghaly Sameh , Azmy Karim Hamed , Mohamed Ghada Abdelrahman
Published: April 2022

Background

Non-alcoholic fatty liver disease (NAFLD) is a metabolic disorder characterised by enhanced hepatic fat deposition and inflammation. Efforts to manage NAFLD are limited by the poorly characterised pathological processes and the lack of precise non-invasive markers, thus, proving the need to further study the involved cytokines, which, in turn, may represent novel molecular targets with possible diagnostic and therapeutic applications. Hence, we aimed to assess the diagnostic utility of serum interleukin 32 (IL-32) in NAFLD cases. This case-control study included 40 NAFLD patients and 40 healthy controls. The serum IL-32 concentrations were assessed by the enzyme-linked immunosorbent assay (ELISA).

Results

The serum IL-32 concentrations were significantly higher in NAFLD cases than controls (76 [45.5–111.125] vs. 13 [8–15] pg/mL, P < 0.001, respectively). IL-32 at a cut-off point > 22.5 pg/mL had 100% sensitivity, 87.50% specificity, 88.9% positive predictive value, 100% negative predictive value, and 98.2% accuracy in detecting the NAFLD cases.

Conclusion

Serum IL-32 could be considered a novel non-invasive marker for NAFLD. Further investigations are warranted to verify the potential utility of IL-32 in the clinical setting.
Fast and robust hierarchical simulated annealing of erosion method for stochastic reconstructions
Authors: Chen DongDong , Xu Zhi , Wang XiaoRui , Wang Mei , Du ZhongZhou
Published: April 2022

Due to the high computational cost of the annealing optimization procedure, the application of stochastic reconstruction techniques based on correlation functions is seriously affected. To improve the accuracy and computational efficiency of reconstructions, we propose a novel hierarchical simulated annealing of erosion (HSAE) method, whose computational efficiency can be improved by an order of magnitude. Our proposed method that provides a robust multi-scale framework to solve the upscaling or downscaling problem can add high-order statistics functions to further improve the accuracy of the reconstruction. In this letter, the HSAE method has been widely performed on different binary (two-phase) microstructures, and their reconstructions have significant improvements. But the realization of the proposed HSAE method still leaves a huge space for the improvements of accuracy and computational efficiency, which will be solved in the future research.
Effect of a Rapid Response Team on the Incidence of In-Hospital Mortality
Authors: Factora Faith , Maheshwari Kamal , Khanna Sandeep , Chahar Praveen , Ritchey Michael , O’Hara Jerome , Mascha Edward J. , Mi Junhui , Halvorson Sven , Turan Alparslan , Ruetzler Kurt
Published: April 2022

BACKGROUND:

Approximately half of the life-limiting events, such as cardiopulmonary arrests or cardiac arrhythmias occurring in hospitals, are considered preventable. These critical events are usually preceded by clinical deterioration. Rapid response teams (RRTs) were introduced to intervene early in the course of clinical deterioration and possibly prevent progression to an event. An RRT was introduced at the Cleveland Clinic in 2009 and transitioned to an anesthesiologist-led system in 2012. We evaluated the association between in-hospital mortality and: (1) the introduction of the RRT in 2009 (primary analysis), and (2) introduction of the anesthesiologist-led system in 2012 and other policy changes in 2014 (secondary analyses).

METHODS:

We conducted a single-center, retrospective analysis using the medical records of overnight hospitalizations from March 1, 2005, to December 31, 2018, at the Cleveland Clinic. We assessed the association between the introduction of the RRT in 2009 and in-hospital mortality using segmented regression in a generalized estimating equation model to account for within-subject correlation across repeated visits. Baseline potential confounders (demographic factors and surgery type) were controlled for using inverse probability of treatment weighting on the propensity score. We assessed whether in-hospital mortality changed at the start of the intervention and whether the temporal trend (slope) differed from before to after initiation. Analogous models were used for the secondary outcomes.

RESULTS:

Of 628,533 hospitalizations in our data set, 177,755 occurred before and 450,778 after introduction of our RRT program. Introduction of the RRT was associated with a slight initial increase in in-hospital mortality (odds ratio [95% confidence interval {CI}], 1.17 [1.09–1.25]; P < .001). However, while the pre-RRT slope in in-hospital mortality over time was flat (odds ratio [95% CI] per year, 1.01 [0.98–1.04]; P = .60), the post-RRT slope decreased over time, with an odds ratio per additional year of 0.961 (0.955–0.968). This represented a significant improvement (P < .001) from the pre-RRT slope.

CONCLUSIONS:

We found a gradual decrease in mortality over a 9-year period after introduction of an RRT program. Although mechanisms underlying this decrease are unclear, possibilities include optimization of RRT implementation, anesthesiology department leadership of the RRT program, and overall improvements in health care delivery over the study period. Our findings suggest that improvements in outcome after RRT introduction may take years to manifest. Further work is needed to better understand the effects of RRT implementation on in-hospital mortality.
Spinal Cord Stimulation Alleviates Neuropathic Pain by Attenuating Microglial Activation via Reducing Colony-Stimulating Factor 1 Levels in the Spinal Cord in a Rat Model of Chronic Constriction Injury
Authors: Sun Cong , Tao Xueshu , Wan Chengfu , Zhang Xiaojiao , Zhao Mengnan , Xu Miao , Wang Pinying , Liu Yan , Wang Chenglong , Xi Qi , Song Tao
Published: April 2022

BACKGROUND:

Spinal cord stimulation (SCS) is an emerging, minimally invasive procedure used to treat patients with intractable chronic pain conditions. Although several signaling pathways have been proposed to account for SCS-mediated pain relief, the precise mechanisms remain poorly understood. Recent evidence reveals that injured sensory neuron-derived colony-stimulating factor 1 (CSF1) induces microglial activation in the spinal cord, contributing to the development of neuropathic pain (NP). Here, we tested the hypothesis that SCS relieves pain in a rat model of chronic constriction injury (CCI) by attenuating microglial activation via blocking CSF1 to the spinal cord.

METHODS:

Sprague-Dawley rats underwent sciatic nerve ligation to induce CCI and were implanted with an epidural SCS lead. SCS was delivered 6 hours per day for 5 days. Some rats received a once-daily intrathecal injection of CSF1 for 3 days during SCS.

RESULTS:

Compared with naive rats, CCI rats had a marked decrease in the mechanical withdrawal threshold of the paw, along with increased microglial activation and augmented CSF1 levels in the spinal dorsal horn and dorsal root ganglion, as measured by immunofluorescence or Western blotting. SCS significantly increased the mechanical withdrawal threshold and attenuated microglial activation in the spinal dorsal horn in CCI rats, which were associated with reductions in CSF1 levels in the spinal dorsal horn and dorsal roots but not dorsal root ganglion. Moreover, intrathecal injection of CSF1 completely abolished SCS-induced changes in the mechanical withdrawal threshold and activation of microglia in the spinal dorsal horn in CCI rats.

CONCLUSIONS:

SCS reduces microglial activation in the spinal cord and alleviates chronic NP, at least in part by inhibiting the release of CSF1 from the dorsal root ganglion ipsilateral to nerve injury.
Queer Companions
Authors: Kasmani Omar
Published: April 2022

In Queer Companions Omar Kasmani theorizes saintly intimacy and the construction of queer social relations at Pakistan’s most important site of Sufi pilgrimage. Conjoining queer theory and the anthropology of Islam, Kasmani outlines the felt and enfleshed ways in which saintly affections bind individuals, society, and the state in Pakistan through a public architecture of intimacy. Islamic saints become lovers and queer companions just as a religious universe is made valuable to critical and queer forms of thinking. Focusing on the lives of ascetics known as fakirs in Pakistan, Kasmani shows how the affective bonds with the place’s patron saint, a thirteenth-century antinomian mystic, foster unstraight modes of living in the present. In a national context where religious shrines are entangled in the state’s infrastructures of governance, coming close to saints further entails a drawing near to more-than-official histories and public forms of affect. Through various fakir life stories, Kasmani contends that this intimacy offers a form of queer world making with saints.
The Emancipation Circuit
Authors: Davis Thulani
Published: April 2022

In The Emancipation Circuit Thulani Davis provides a sweeping rethinking of Reconstruction by tracing how the four million people newly freed from bondage created political organizations and connections that mobilized communities across the South. Drawing on the practices of community they developed while enslaved, freedpeople built new settlements and created a network of circuits through which they imagined, enacted, and defended freedom. This interdisciplinary history shows that these circuits linked rural and urban organizations, labor struggles, and political culture with news, strategies, education, and mutual aid. Mapping the emancipation circuits, Davis shows the geography of ideas of freedom---circulating on shipping routes, via army maneuvers, and with itinerant activists---that became the basis for the first mass Black political movement for equal citizenship in the United States. In this work, she reconfigures understandings of the evolution of southern Black political agendas while outlining the origins of the enduring Black freedom struggle from the Jim Crow era to the present.
Incentives for pregnant mothers during antenatal care for better maternal and neonatal health outcomes: A systematic review protocol
Authors: Holla Ramesh , Unnikrishnan Bhaskaran , Vijayamma Ratheebhai , T V Bhumika , Sinha Anju , BB Darshan , T Rekha , Mithra P Prasanna , Kumar Nithin , Kulkarni Vaman , N Ravishankar , Johnson K Rosemol
Published: April 2022

Background: Universal access to maternal new-born and child healthcare services (MNCH) is detrimental for attainment of Sustainable Development Goal (SDG) three pertaining to promotion of health at all ages. Incentivization in the form of cash, vouchers, and goods have been used as part of strategies to improve maternal and neonatal health outcomes around the world. However, there exists uncertainties regarding the effectiveness of various incentive-based programmes targeted for pregnant mothers in low- and middle-income countries during their antenatal period.

Methods: We will search six electronic databases, namely the Medical Literature Analysis and Retrieval System Online (Medline), Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, and Embase in addition to Google Scholar. Manual searching of the reference lists of included studies will also be done. The reporting of this protocol will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 statement [29]. Only interventional studies that follow randomized, quasi randomized, and cluster randomized controlled study designs will be included. A three-stage screening process will be adopted to select articles. Risk of bias for the included studies will be assessed using the tools and criteria specified in the Cochrane handbook. In addition, the GRADE approach will be used to assess the quality of evidence for the maternal and neonatal health outcomes.

Conclusion: This review of trials is essential to inform the effectiveness of incentive-based programmes targeted for pregnant women in low- and middle-income countries. It will help the policy makers to utilise the resources more effectively and to integrate the evidence based public health initiatives into the health system. This can also help build the continuum of care financial packages for all pregnant women.
A systematic review: Male engagement in adolescent and young adults’ sexual and reproductive health in the Americas
Authors: Salinas Ivonne , Freire Erick , Guevara Jane , Herrán Keren , Ortiz Andrea , Palacios Iván
Published: April 2022

Progress towards sexual and reproductive health (SRH) goals for adolescents across the Americas has stagnated. Of all the regions worldwide, Latin America has experienced the slowest decline in adolescent fertility rates. Reports published by the United Nations and multiple nongovernmental organizations demonstrate a growing consensus for a masculinities framework that engages men and boys in public health and social change. Male engagement acts as a complement - and not a replacement - of current SRH. Emerging evidence indicates that Coronavirus disease in 2019  has worsened SRH outcomes, especially related to gender-based violence; new evidence-based interventions are ever more urgent. 

This systematic review includes a focus on education-based male engagement, a special consideration of gender equity, and systematic searches by fluent speakers in three most populous languages in the Americas (English, Spanish, and Portuguese). PubMed, EBSCO, SCOPUS, and Google Scholar databases were digitally searched. Publications were excluded if their focus did not align directly with sexual reproductive health, their location was outside the scope of study, its content derived from information collected before 2010, or its study’s population’s age of focus was not between 15-24 years of age. After abstract screening and full-text review, the original 10,721 articles identified were narrowed down to 13 articles whose references were further examined through hand searching, leading us to a total of 32 final articles chosen for analysis. The results were classified by geographic regions of the American continent.

The literature emphasized that society often defines masculinity as a hegemonic role grounded in aggressive high-risk sexual behavior. Adolescent males internalize this and hold their peers to these expectations. These beliefs have detrimental SRH consequences that have yet to be fully understood among adolescent boys and males. The efficacy of future interventions will depend on further exploration of these topics, especially among minority populations.
Case Report: Isolated, unilateral oculomotor palsy with anti-GQ1b antibody following COVID-19 vaccination
Authors: Kubota Takafumi , Hasegawa Takafumi , Ikeda Kensuke , Aoki Masashi
Published: April 2022

Neurological complications following vaccinations are extremely rare, but cannot be eliminated. Here, we report the first case of unilateral oculomotor nerve palsy (ONP) with anti-GQ1b antibody after receiving the Pfizer-BioNTech COVID-19 (BNT162b2) mRNA vaccine.

A 65-year-old man developed diplopia and ptosis in the right eye 17 days after vaccination, without preceding infection. Neurological examination revealed mild blepharoptosis, limitation of adduction, and vertical gaze on the right side. Increased levels of anti-GQ1b ganglioside antibody in the serum and albuminocytologic dissociation in the cerebrospinal fluid were detected. Cranial magnetic resonance imaging showed swelling and enhancement of the right oculomotor nerve. The patient was diagnosed with right ONP accompanied with anti-GQ1b antibody, and intravenous immunoglobulin (IVIG) therapy for 5 days was administered. The limitation of adduction and vertical gaze improved, and ptosis markedly resolved after IVIG treatment. Given the temporal sequence of disease progression, laboratory findings, and a favorable response to IVIG, a causal relationship cannot be ruled out between the occurrence of ONP and COVID-19 immunization. Since immunomodulatory treatments significantly hasten the recovery and minimize the residual symptoms in anti-GQ1b antibody syndrome, clinicians should be aware of this clinical condition following COVID-19 vaccination.
Akceptacja utraty sprawności w słyszeniu a jakość życia seniorów
Authors: Cieplińska Ewa
Published: April 2022

Celem artykułu jest zaprezentowanie rezultatów badań własnych dotyczących problematyki jakości życia osób starszych po 60. roku życia oraz poziomu akceptacji utraty sprawności w słyszeniu przez seniorów. Badania miały na celu zidentyfikowanie i określenie zależności między akceptacją utraty prawidłowego słyszenia a jakością życia seniorów z trudnościami w słyszeniu. Przedmiotem badań była jakość życia oraz związek jakości życia z poczuciem akceptacji utraty sprawności w słyszeniu u osób po 60. roku życia. W badaniach zastosowano metodę sondażu diagnostycznego, technikę ankiety (WHOQOL-BREF – Skrócona Wersja Ankiety Oceniającej Jakość Życia; Wielowymiarowa Skala Akceptacji Trudności w Słyszeniu; Test przesiewowy z baterii TSOS). W artykule można się zapoznać z zagadnieniami teoretycznymi dotyczącymi jakości życia osób starszych z trudnościami w słyszeniu. Przedstawiono podstawy metodologicznych badań własnych i zaprezentowano wyniki przeprowadzonych badań oraz wnioski do wykorzystania w późniejszych działaniach na gruncie pedagogiki. Stwierdzono, że im wyższy poziom akceptacji utraty prawidłowego słyszenia, tym wyższa jakość życia badanych seniorów. Z badań wynika konieczność prowadzenia różnorakich działań mających na celu wspieranie seniorów z trudnościami w słyszeniu w ich psychospołecznym funkcjonowaniu. Niezbędne jest podnoszenie świadomości społecznej w obszarze jakości życia starszych osób z trudnościami w słyszeniu.
A combined anterior and posterior approach for elbow ankylosis
Authors: Kim Yeun Soo , Kim Jihyeung , Kang Kee Soo , Bae Kee Jeong , Baek Goo Hyun
Published: April 2022

Purpose: An ankylosed elbow should be released with consideration of the nature of the stiffness and location of the pathologic structures, and care should be taken to avoid damage to the surrounding musculature and neurovascular structures. We report the clinical results of a combined anterior and posterior approach, which allowed safe access with good visibility, for severe elbow stiffness.Methods: We retrospectively reviewed patients who underwent surgical release for elbow ankylosis from August 2014 to May 2020. All operations were performed by the same surgeon at a single institution. The final outcomes were assessed by measuring the range of motion, calculating the Mayo Elbow Performance Score (MEPS), and reading radiologic images. Results: Eight patients with a mean age of 43 years (range, 21–65 years) were included in the study, and the mean follow-up period was 22 months. The average range of motion was 13° of flexion contracture (range, 0°–40°) and 123° of further flexion (range, 100°–140°) at the last follow-up. The average net improvement in the total arc compared to patients’ preoperative status was 68° (range, –10°–130°). The mean postoperative MEPS was 89 points (range, 70–100 points). The development of heterotopic ossification and recalcitrant rheumatoid arthritis caused relatively poor outcomes.Conclusion: The combined anterior and posterior approach allows safe access with good visibility for elbow ankylosis, while minimizing the risk of neurovascular injury and preserving the medial and lateral muscles.
Redes Universitarias generadoras de inclusión: hacia la educación y la cultura de la sostenibilidad en la Universidad
Authors: Limón Domínguez Dolores , Valderrama Hernández Rocío
Published: April 2022

El propósito del presente trabajo es construir en un contexto europeo y latinoamericano un marco de discusión, que concreten las competencias básicas a desarrollar para consolidar a través de las diferentes universidades una ciudadanía activa y solidaria. La Unión Europea a través de diferentes y ambiciosos proyectos y acciones pretende impulsar una ciudadanía activa que se comprometa y asuma responsabilidades a nivel individual e institucional. El presente libro recoge los resultados de SOLIDARIS, Universidades inclusivas: Competencias clave de la comunidad universitaria para el desarrollo de una ciudadani?a activa. Es un proyecto europeo KA2 - Cooperation for innovation and the exchange of good practices - Capacity Building in the field of Higher Education. La trayectoria del proyecto ha derivado en acciones educativas y transformaciones que van más allá de los objetivos planteados inicialmente. El compromiso del consorcio, la calidad y excelencia del equipo humano formado por unas 11 instituciones internacionales con larga trayectoria y experiencia en materia de inclusión social ha pretendido promover una sociedad inclusiva, participativa y sostenible de cara al desarrollo de un futuro común mediante la transferencia de conocimiento a través de la mejora en competencias trasversales.