bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of primary staging for newly diagnosed prostate cancer in the era of prostate specific membrane antigen positron emission tomography: A population‐based analysis
Authors: Papa Nathan , Perera Marlon , Murphy Declan G , Lawrentschuk Nathan , Evans Melanie , Millar Jeremy L , Bolton Damien
Published: March 2021

Introduction

There has been a growing body of evidence highlighting the improved sensitivity and specificity for prostate specific membrane antigen (PSMA) positron emission tomography (PET) in advanced prostate cancer imaging. We aimed to assess prostate cancer staging practice patterns in Australia using population‐based data.

Subject and Methods

We extracted data on men diagnosed with prostate cancer between October 2016 and December 2018 from the Prostate Cancer Outcomes Registry‐Victoria (PCOR‐Vic). We evaluated trends and comparisons between patients receiving PET/CT (with or without conventional imaging (CImg)), and CImg alone, and analysed imaging modality as predictor of clinical regional node positive disease (cN1 vs cN0/X), metastatic disease (cM1 vs cM0/X), and treatment received.

Results

In total, 6139 patients in the registry had either a staging PET scan (n = 889, 14%), CImg without PET scan (n = 2464, 40%), or no recorded PET or CImg (n = 2786, 45%). The proportion of allimaged patients who received staging PET increased from 19% to 36% from the first to last three‐month period, and in the high‐risk category the increase was 23–43%. After adjustment for grade group, PET vs CImg‐only patients were observed to have a higher proportion of cN1 disease (OR = 2.46, 95% CI: 1.90–3.20) but not cM1 disease (OR = 1.10, 95% CI: 0.84–1.44).

Conclusions

Our registry data highlights the rapid uptake of PET imaging, particularly in high‐risk disease. Based on this data, we highlight the increased diagnosis of nodal disease, thus potentially optimizing patient selection prior to definitive treatment for prostate cancer.
A prognostic system for epithelial ovarian carcinomas using machine learning
Authors: Grimley Philip M. , Liu Zhenqiu , Darcy Kathleen M. , Hueman Matthew T. , Wang Huan , Sheng Li , Henson Donald E. , Chen Dechang
Published: March 2021

Introduction

Integrating additional factors into the International Federation of Gynecology and Obstetrics (FIGO) staging system is needed for accurate patient classification and survival prediction. In this study, we tested machine learning as a novel tool for incorporating additional prognostic parameters into the conventional FIGO staging system for stratifying patients with epithelial ovarian carcinomas and evaluating their survival.

Material and methods

Cancer‐specific survival data for epithelial ovarian carcinomas were extracted from the Surveillance, Epidemiology, and End Results (SEER) program. Two datasets were constructed based upon the year of diagnosis. Dataset 1 (39 514 cases) was limited to primary tumor (T), regional lymph nodes (N) and distant metastasis (M). Dataset 2 (25 291 cases) included additional parameters of age at diagnosis (A) and histologic type and grade (H). The Ensemble Algorithm for Clustering Cancer Data (EACCD) was applied to generate prognostic groups with depiction in dendrograms. C‐indices provided dendrogram cutoffs and comparisons of prediction accuracy.

Results

Dataset 1 was stratified into nine epithelial ovarian carcinoma prognostic groups, contrasting with 10 groups from FIGO methodology. The EACCD grouping had a slightly higher accuracy in survival prediction than FIGO staging (C‐index = 0.7391 vs 0.7371, increase in C‐index = 0.0020, 95% confidence interval [CI] 0.0012–0.0027, p = 1.8 × 10−7). Nevertheless, there remained a strong inter‐system association between EACCD and FIGO (rank correlation = 0.9480, p = 6.1 × 10−15). Analysis of Dataset 2 demonstrated that A and H could be smoothly integrated with the T, N and M criteria. Survival data were stratified into nine prognostic groups with an even higher prediction accuracy (C‐index = 0.7605) than when using only T, N and M.

Conclusions

EACCD was successfully applied to integrate A and H with T, N and M for stratification and survival prediction of epithelial ovarian carcinoma patients. Additional factors could be advantageously incorporated to test the prognostic impact of emerging diagnostic or therapeutic advances.
Transformative Valuing
Authors: Curren Randall
Published: March 2021

In this essay, Randall Curren addresses four basic questions about transformative experiences in education: Is education necessarily transformative? What must education provide for it to be personally transformative? What standard should educators use in determining whether engaging students in potentially transformative experiences is beneficial or justified? How should schools and educators orchestrate opportunities for beneficial transformative experiences? The focus is on transformative valuing, but also on the importance of a fully transformative nexus of personal attributes and social pathways to living a transformed life. Curren argues that educational decisions on behalf of students can be justified on the basis of necessary goods that persist through transformative changes in what is contingently good for them, and that schools' efforts to orchestrate opportunities for transformative experiences should engage students in activities that can be eudaimonic for them.
Lessons in Self‐Betrayal: On the Pitfalls of Transformative Education
Authors: Kemp Ryan S.
Published: March 2021

In this essay Ryan Kemp makes an unlikely case for value stability, arguing that people should almost never aspire to become radically different and that, given this, some people should be reluctant to pursue educational experiences that wildly broaden their life possibilities. His account is developed and structured around two borrowed examples, one literary and the other historical. Wendell Berry, his novel Hannah Coulter in particular, is the source of the first example; Jonathan Lear, specifically the case of Native American resettlement developed in Radical Hope, provides the second. The essay contains three sections structured around three related ideas. The first section explores the rationality of wanting to be a different person. The second section explores the rationality of wanting to be the same person while doing entirely different things. And the third section explores the rationality of desiring an education that teaches you to be suspicious of being anything in particular.
Impact of penile rehabilitation with phosphodiesterase‐5 inhibitors on recovery of erectile function in patients undergoing robot‐assisted radical prostatectomy: A propensity score‐matched analysis
Authors: Kimura Yusuke , Honda Masashi , Teraoka Shogo , Yumioka Tetsuya , Iwamoto Hideto , Morizane Shuichi , Hikita Katsuya , Takenaka Atsushi
Published: March 2021

Objective

To investigate the impact of penile rehabilitation on the recovery of erectile function after robot‐assisted radical prostatectomy.

Methods

Patients who underwent robot‐assisted radical prostatectomy in our department from 2010 to 2019 were included. For penile rehabilitation, a phosphodiesterase‐5 inhibitor (tadalafil 20 mg) was administered twice a week for 1–6 months postoperatively. The International Index of Erectile Function questionnaire (question 1 and erectile function domain) and the Expanded Prostate Cancer Index Composite questionnaire (sexual function) were used.

Results

After propensity score matching, there were 79 patients in the penile rehabilitation group and 79 patients in the non‐penile rehabilitation group. There was no significant difference in baseline characteristics between the two groups. Significantly higher scores were seen in the penile rehabilitation group compared with the non‐penile rehabilitation group at postoperative 3, 6 and 9 months in the International Index of Erectile Function questionnaire‐question 1, at 3, 6, 9 and 12 months in erectile function domain, and at 3, 6, 12 and 24 months in Expanded Prostate Cancer Index Composite questionnaire sexual function (P < 0.05). There were significant improvements in the erectile recovery rate in the penile rehabilitation group compared with the non‐penile rehabilitation group in the nerve sparing (P = 0.006) and partial nerve sparing (P = 0.037) groups.

Conclusions

The present findings suggest that robot‐assisted radical prostatectomy patients who undergo not only nerve sparing, but also those who undergo patial nerve sparing could benefit from penile rehabilitation using a phosphodiesterase‐5 inhibitor.
School Nutrition Director Perceptions of Flexible Regulations for School Nutrition Programs in One Southeastern State
Authors: Farris Alisha R. , Mann Georgianna , Parks Justin , Arrowood John , Roy Manan , Misyak Sarah
Published: March 2021

BACKGROUND

Schools are a promising site for influencing the dietary intake of children and adolescents. The US Department of Agriculture recently released flexibilities to requirements for whole‐grains, sodium, and low‐fat milk in schools who demonstrated difficulty meeting nutrition standards for school meal programs. The support of School Nutrition Directors (SNDs) is vital to the success of school food environment changes; however, few studies have explored SNDs perceptions to changes in nutrition standards.

METHODS

Experiences and perspectives toward nutrition standards of 10 SNDs, and their satisfaction with flexibilities for whole‐grains, sodium, and low‐fat milk were explored using a semi‐structured interview. Responses were analyzed using an inductive approach with thematic analysis.

RESULTS

Three broad categories emerged challenges with the Healthy, Hunger‐Free Kids Act, food preferences and acceptability, and support and representation. A greater need for internal and external support, assistance in equipment and staff, procurement of foods compliant with regulations and acceptable to students, and more input on federal decisions and policies were perceived as important.

CONCLUSIONS

Results provide critical insight into the implementation of nutrition standards. Future research and changes to school nutrition programs should consider these challenges as they strive to meet the needs of this important population.
Conduction recovery with Wenckebach periodicity at the mitral isthmus
Authors: Nakashima Takashi , Pambrun Thomas , Pintican Gabriela , Takagi Takamitsu , Jaïs Pierre , Derval Nicolas
Published: March 2021

A Wenckebach periodicity at the mitral isthmus (MI) lesion has rarely been reported. We described a case presenting conduction recovery with Wenckebach periodicity at the posterior MI lesion after achieving the MI block. These findings demonstrate a pseudo MI block with Wenckebach periodicity owing to the pacing rate.
Finance, Institutions, and Private Investment in Africa
Authors: Asongu Simplice A. , Nnanna Joseph , Tchamyou Vanessa S.
Published: March 2021

This article extends the debate on finance versus institutions and measurement of property rights institutions (PRI). We assess the relationships between various components of PRI and private investment, notably: political, economic, and institutional governances. Comparative concurrent relationships of financial dynamics of depth, efficiency, activity, and size are also investigated. The findings provide support for the quality of institutions as a better positive correlate of private investment than financial intermediary development. The interaction of finance and governance is not significant in potentially promoting private investment, perhaps due to substantially documented surplus liquidity issues in African financial institutions. The empirical evidence is based on 53 African countries for the period 1996‐2010. Policy measures are discussed for reducing financial deposits, increasing financial activity, and hence, improving financial efficiency.

Related Articles

Aideyan, Osaore. 2016. “Political and Institutional Prerequisites for Monetary Union: Assessing Progress in the Economic Community of West African States (ECOWAS).” Politics & Policy 44 (6): 1192‐1212. https://doi.org/10.1111/polp.12183

Asongu, Simplice A., and Joseph Nnanna. 2019. “Foreign aid, Instability, and Governance in Africa.” Politics & Policy 47 (4): 807‐848. https://doi.org/10.1111/polp.12320

Scarlato, Margherita, and Giorgio d'Agostino. 2019. “The Political Dimension of Cash Transfers in Latin America and Sub‐Saharan Africa: A Comparative Perspective.” Politics & Policy 47 (6): 1125‐1155. https://doi.org/10.1111/polp.12332
The Economic Effects of Volcanic Alerts—A Case Study of High‐Threat U.S. Volcanoes
Authors: Peers Justin B. , Gregg Christopher E. , Lindell Michael K. , Pelletier Denis , Romerio Franco , Joyner Andrew T.
Published: March 2021

A common concern about volcanic unrest is that the communication of information about increasing volcanic alert levels (VALs) to the public could cause serious social and economic impacts even if an eruption does not occur. To test this statement, this study examined housing prices and business patterns from 1974–2016 in volcanic regions with “very‐high” threat designations from the U.S. Geological Survey (USGS)—Long Valley Caldera (LVC), CA (caldera); Mount St. Helens (MSH), Washington (stratovolcano); and Kīlauea, Hawaiʻi (shield volcano). To compare economic trends in nonvolcanic regions that are economically dependent on tourism, Steamboat Springs, CO, served as a control as it is a ski‐tourism community much like Mammoth Lakes in LVC. Autoregressive distributed lag (ARDL) models predicted that housing prices were negatively affected by VALs at LVC from 1982–1983 and 1991–1997. While VALs associated with unrest and eruptions included in this study both had short‐term indirect effects on housing prices and business indicators (e.g., number of establishments, employment, and salary), these notifications were not strong predictors of long‐term economic trends. Our findings suggest that these indirect effects result from both eruptions with higher level VALs and from unrest involving lower‐level VAL notifications that communicate a change in volcanic activity but do not indicate that an eruption is imminent or underway. This provides evidence concerning a systemic issue in disaster resilience. While disaster relief is provided by the U.S. federal government for direct impacts associated with disaster events that result in presidential major disaster declarations, there is limited or no assistance for indirect effects to businesses and homeowners that may follow volcanic unrest with no resulting direct physical losses. The fact that periods of volcanic unrest preceding eruption are often protracted in comparison to precursory periods for other hazardous events (e.g., earthquakes, hurricanes, flooding) makes the issue of indirect effects particularly important in regions susceptible to volcanic activity.
HIV primary drug resistance and associated HIV risk factors among HIV positive blood donors in Brazil from 2007 to 2017
Authors: Moreira Carlos Henrique Valente , Salomon Tassila , Alencar Cecília S. , Gonçalez Thelma T. , Sabino Ester C. , Preiss Liliana , Loureiro Paula , Lopes Maria Esther , Teixeira Carolina Miranda , Mundim Mariana , Carneiro‐Proietti Anna Barbara , de Almeida‐Neto Cesar , Custer Brian
Published: March 2021

Background

Acquisition of HIV primary drug resistant (PDR) infection can lead to poor virologic and clinical outcomes in individuals and hampers public health efforts in epidemic control. Monitoring PDR in HIV‐positive blood donors can be used to inform nationwide trends in the spread of drug‐resistant HIV strains.

Methods

We conducted a cross‐sectional study using genetic sequence analysis to assess HIV pol sequences, PDR, and risk factors for infection using audio computer‐assisted structured interviews in four large blood centers in Brazil from 2007 to 2017.

Results

Of 716 HIV‐positive blood donors, 504 (70.4%) were successfully sequenced. HIV clade B (73.2%) was the most prevalent subtype, followed by a mix of non‐B (21.2%) sub‐types. A twofold increase (from 4% to 8%) in recombinants prevalence was observed during the study period. Sixty‐four (12.7%) presented PDR. Overall, HIV PDR prevalence remained stable during the study period. Drug resistance mutations for non‐nucleoside reverse transcriptase inhibitors were found in 39 (7.7%) donors, while for nucleoside reverse transcriptase inhibitors were found in 26 (5.1%), and for protease inhibitors in 24 (4.8%) of HIV‐infected donors. We did not find statistically significant differences in demographics, behavioural risk factors, or HIV genotypes when comparing volunteers with and without PDR.

Conclusion

The HIV PDR rate among donors remained stable during the study period. HIV‐positive blood donors can be an informative population to monitor primary HIV resistance and ultimately may help to increase the knowledge and awareness of HIV risk factors and PDR.
Enfermería en la monitorización del delirium en cuidado intensivo adulto: una revisión de alcance
Authors: Henao Castaño Ángela María , Baquero Lizarazo Angela Camila , Gonzalez Pabon Nathaly , Burgos Tulcán Gina Fernanda , Lozano Gonzalez Linamaria
Published: March 2021

Introducción. El delirium es una alteración cognitiva secundaria a una situación clínica aguda que puede estar presente en el paciente crítico, y la enfermería juega un rol protagónico en la prevención, monitoreo y tratamiento no farmacológico del delirium en el paciente en unidad de cuidado intensivo. Objetivo. Identificar las investigaciones actuales que describen las estrategias que utilizan las enfermeras para la monitorización del delirium en la unidad de cuidado intensivo adulto. Método. Revisión de alcance, utilizando la pregunta orientadora ¿qué estrategias utiliza enfermería en la monitorización del delirium en la unidad de cuidado intensivo?, estudios obtenidos en las bases de datos PubMed, Biblioteca Virtual en Salud, Science Direct y Cochrane. Se realizó una revisión crítica con el instrumento CASPe, los datos se extrajeron, y se llevaron a cabo registros en tablas de gráficos elaboradas para condensar la información. Resultados. Trece estudios se consideraron relevantes y fueron analizados. Las estrategias de monitorización del delirium empleadas por enfermería son, principalmente, el juicio clínico, la observación de la agitación y, en menor medida, el empleo de instrumentos validados para la detección. Conclusión. La enfermería requiere comprender mejor el delirium, y para esto la educación es vital para mejorar su conocimiento, y aumentar la autoconfianza y competencia en la evaluación a través del uso correcto de instrumentos.
Problem of Determining the Anisotropic Conductivity in Electrodynamic Equations
Authors: Romanov V. G.
Published: March 2021

For a system of electrodynamic equations, the inverse problem of determining an anisotropic conductivity is considered. It is supposed that the conductivity is described by a diagonal matrix σ(x) = $${\text{diag}}({{\sigma }_{1}}(x),{{\sigma }_{2}}(x)$$, σ3(x)) with $$\sigma (x) = 0$$ outside of the domain Ω = $$\{ x \in {{\mathbb{R}}^{3}}|\left| x \right| < R\} $$, $$R > 0$$, and the permittivity ε and the permeability μ of the medium are positive constants everywhere in $${{\mathbb{R}}^{3}}$$. Plane waves coming from infinity and impinging on an inhomogeneity localized in Ω are considered. For the determination of the unknown functions $${{\sigma }_{1}}(x)$$, $${{\sigma }_{2}}(x)$$, and $${{\sigma }_{3}}(x)$$, information related to the vector of electric intensity is given on the boundary S of the domain Ω. It is shown that this information reduces the inverse problem to three identical problems of X-ray tomography.
Spontaneously conceived 17-week heterotopic pregnancy: a challenging and unusual diagnosis
Authors: de Oliveira Sara , Yaron Michal , Dällenbach Patrick
Published: March 2021

A 37-year-old woman, gravida 2 para 1, arrived in our emergency clinic at 16 2/7 weeks of a spontaneously conceived pregnancy for abdominal pain. She was on oral antibiotics for 2 days to treat a suspected urinary tract infection with no improvement. Blood tests, abdominal ultrasound and intrauterine fetus were all normal. She left our emergency unit with laxatives. Four days later, she returned to our clinic with severe abdominal pain. We repeated abdominal and foetal ultrasonography and identified a left para-uterine 7×5 cm mass. As adnexal torsion was suspected, we performed an emergency laparoscopy. At laparoscopy, we found a left haematosalpinx and realised a left salpingectomy. Histology confirmed the presence of a heterotopic pregnancy (HP). This case illustrates the importance of exploring the adnexa in a gravid woman presenting with abdominal pain in the first and early second trimesters. Although rare, excluding a HP may prevent a life-threatening haemorrhage.
Nephrotic syndrome on sickle cell disease: the impact of Hydroxyurea
Authors: Cunha Margarida , Simão Carla , Ferrão Anabela , Palaré Maria João
Published: March 2021

Nephropathy is a common under-recognised complication of sickle cell disease (SCD) and one of the main factors of poor prognosis in these patients. The association between nephrotic syndrome and SCD in children is rare. Strategies for sickle cell nephropathy prevention are still poorly established. Blood pressure control as well as monitoring of microalbuminuria and renal function are mandatory. The use of antiproteinuric drugs, such as anti-ACE inhibitors (ACEis) and hydroxyurea, should be considered in early stages. Here, we report a case of a female adolescent with SCD and inaugural nephrotic syndrome who, after an initial treatment failure with corticotherapy, had a remarkable recovery after treatment with hydroxyurea and ACEis.
Early intravenous immunoglobulin therapy for group A β-haemolytic streptococcal meningitis with toxic shock syndrome
Authors: Adigbli Derick , Rozen Valerie , Darbar Archie , Janin Pierre
Published: March 2021

A woman in her forties was transferred to a Sydney (Australia)-based tertiary hospital, following presentation to a regional hospital with group A Streptococcus (GAS) otomastoiditis; complicated by meningitis, venous sinus thrombosis, haemorrhagic cerebral infarction and subdural empyema. She rapidly deteriorated with profound cardiovascular collapse. Despite initiation of high dose vasoactive therapy, she remained shocked and developed multiorgan dysfunction syndrome. Early intravenous immunoglobulin therapy (140 g in two doses) was initiated as an adjunct to antimicrobial, surgical and supportive care for refractory streptococcal toxic shock syndrome. Over the course of a twelve-day intensive care unit stay she made good progress with de-escalation of her vasoactive supportive care and reversal of her organ injuries. She was subsequently discharged to ward-based care. At her three-month follow-up appointment she had significantly reduced neurological deficit. Five months following her presentation to hospital she had returned to full-time work.
Bacterial meningitis and COVID-19: a complex patient journey
Authors: Hurn Eliot , Dickinson Lauren , Abraham Jijee Annie
Published: March 2021

A woman in her 70s presented to the emergency department with fever, fluctuating cognition and headache. A detailed examination revealed neurological weakness to the lower limbs with atonia and areflexia, leading to a diagnosis of bacterial meningitis, alongside a concurrent COVID-19 infection. The patient required critical care escalation for respiratory support. After stepdown to a rehabilitation ward, she had difficulties communicating due to new aphonia, hearing loss and left third nerve palsy. The team used written communication with the patient, and with this the patient was able to signal neurological deterioration. Another neurological examination noted a different pattern of weakness to the lower limbs, along with new urinary retention, and spinal arachnoiditis was identified. After more than 10 weeks in the hospital, the patient was discharged. Throughout this case, there were multiple handovers between teams and specialties, all of which were underpinned by good communication and examination to achieve the best care.
Rare but serious cause for hypokalaemia and hypertension
Authors: Shah Hussun-Ara , Madathil Asgar , Routh Charlotte
Published: March 2021

Adrenocortical carcinoma is a rare tumour but hypertension conversely is very common. We present the case of a woman in her 30s, with poorly controlled hypertension on four antihypertensive agents. She was referred to the accident and emergency department with hypokalaemia. For a year, she had experienced oedema, weight gain, acne, hirsutism and oligomenorrhea. She had a classic Cushingoid appearance and marked striae. Cushing’s syndrome was confirmed biochemically with an abnormal overnight dexamethasone suppression test. She was diagnosed with metastatic adrenocortical carcinoma following CT imaging. This was resected via a right adrenalectomy, nephrectomy and cholecystectomy. She also received mitotane. Unfortunately, she has a terminal prognosis having experienced a recurrence. This case demonstrates the value of a thorough clinical assessment. More importantly, it highlights the need to refer earlier patients under 40 with resistant hypertension to a specialist. Finally, it encourages clinicians to investigate hypokalaemia in the context of hypertension.
Short-term, medium-term and long-term effects of early parenting interventions in low- and middle-income countries: a systematic review
Authors: Jeong Joshua , Pitchik Helen O , Fink Günther
Published: March 2021

Introduction

Parenting interventions during early childhood are known to improve various child development outcomes immediately following programme implementation. However, less is known about whether these initial benefits are sustained over time.

Methods

We conducted a systematic literature review of parenting interventions in low- and middle-income countries (LMICs) that were delivered during the first 3 years of life and had completed a follow-up evaluation of the intervention cohort at least 1 year after the primary postintervention endpoint. We summarized intervention effects over time by child-level and parent-level outcomes as well as by timing of follow-up rounds in the short-term (1–3 years after programme completion), medium-term (4–9 years), and long-term (10+ years). We also conducted exploratory meta-analyses to compare effects on children’s cognitive and behavioral development by these subgroups of follow-up rounds.

Results

We identified 24 articles reporting on seven randomised controlled trials of parenting interventions delivered during early childhood that had at least one follow-up study in seven LMICs. The majority of follow-up studies were in the short-term. Three trials conducted a medium-term follow-up evaluation, and only two trials conducted a long-term follow-up evaluation. Although trials consistently supported wide-ranging benefits on early child development outcomes immediately after programme completion, results revealed a general fading of effects on children’s outcomes over time. Short-term effects were mixed, and medium-term and long-term effects were largely inconclusive. The exploratory meta-analysis on cognitive development found that pooled effects were significant at postintervention and in the short-term (albeit smaller in magnitude), but the effects were not significant in the medium-term and long-term. For behavioural development, the effects were consistently null over time.

Conclusions

There have been few longer-term follow-up studies of early parenting interventions in LMICs. Greater investments in longitudinal intervention cohorts are needed in order to gain a more comprehensive understanding of the effectiveness of parenting interventions over the life course and to improve the design of future interventions so they can have greater potential for achieving and sustaining programme benefits over time.
Use of social impact bonds in financing health systems responses to non-communicable diseases: scoping review
Authors: Hulse Emily Susannah Grace , Atun Rifat , McPake Barbara , Lee John Tayu
Published: March 2021

There is an interest to understand how social impact bonds (SIBs), a type of innovative financing instrument used in impact investment, can be used to finance the prevention of non-communicable diseases (NCDs). This is the first scoping review that explores the evidence of SIBs for NCDs and their key characteristics and performance. The review used both published and grey literature from eight databases (MEDLINE, NCBI, Elsevier, Cochrane Library, Google, Google Scholar, WHO publications and OECD iLibrary). A total of 83 studies and articles were eligible for inclusion, identifying 11 SIBs implemented in eight countries. The shared characteristics of the SIBs used for NCDs were impact investment companies as investors, local governments as outcome payers, not-for-profit service providers and an average US$2 015 456 private initial investment. The review revealed a lack of empirical evidence on SIBs for NCDs. Conflict of interest and lack of public disclosure were common issues in both the published and grey literature on SIBs. Furthermore, only three SIBs implemented for financing NCDs were meeting all their target outcomes. The common characteristics of the SIBs meeting their target outcomes were evidence-based interventions, multiple service providers and an intermediated structure. Overall, there is a need for more high-quality studies, particularly economic evaluations and qualitative studies on the benefits to target populations, and greater transparency from the private sector, in order to ensure improved SIBs for preventing NCDs.
Blockchain, health disparities and global health
Authors: Vervoort Dominique , Guetter Camila R , Peters Alexander W
Published: March 2021

Health disparities remain vast around the world and are perpetuated by error-prone information technology systems, administrative inefficiencies and wasteful global health spending. Blockchain technology is a novel, distributed peer-to-peer ledger technology that uses unique, immutable and time-stamped blocks of records or sets of data that are linked as chains through cryptography to more reliably and transparently store and transfer data. Various industries have successfully leveraged blockchain technology to disintermediate and reduce costs, but its use in healthcare and global health has remained limited. In this narrative review, we describe blockchain technology and elaborate on the experiences and opportunities for leveraging blockchain within global health in terms of cryptocurrencies and health financing, supply chain management, health records, identification and verification, telehealth and misinformation. We conclude each section with an analysis of the restrictions imposed by the COVID-19 pandemic to highlight blockchain’s unique opportunities for improving healthcare services and access to care during future pandemics or natural disasters.
The impact of in-service physical injury or illness on the mental health of military veterans
Authors: Hynes Celia , Scullion L , Lawler C , Steel R , Boland P
Published: March 2021

Background

Each year approximately 2000 UK service personnel are medically discharged with physical and/or psychological injury or illness. While there is much research on both psychological injury and physical injury, the challenges of transition relating to the intersection between the two has received less attention. This article reports on the first phase of a 2-year funded study with the aim to understand the lived experiences of veterans who have been discharged from service with a physical injury or illness and the impacts of this on their mental health.

Methods

Using a qualitative methodology, 22 veterans who had been discharged from service within the last 8 years were interviewed to identify key aspects of their experience of the transition process.

Results

The article highlights two key themes: how some veterans adjusted to life with a physical injury or condition; and, the intersections that became apparent between physical injury and mental health. The challenges that veterans faced were shaped by the transition process and by the way in which the medical discharge process was conducted.

Conclusions

Consideration of improvements to the medical discharge process could influence better outcomes for those who have left with a physical injury or illness and later find themselves struggling with mental health issues.
Scoping exercise to develop a storybook to support children’s education during the COVID-19 pandemic
Authors: Syeda Rowshonara , Hann Magdalena , Allison Rosalie , Demirjian Alicia
Published: March 2021

Objective

In June 2020, as COVID-19 lockdown measures were eased in the UK, this scoping exercise aimed to rapidly identify topics to cover within a children’s online storybook ‘My Back to School Bubble’, designed to support the return to school.

Methods

An email invitation was sent to 71 known contacts within networks across Public Health England, local authorities, health protection teams and contacts within the Department for Education. Following online publication of ‘My Back to School Bubble’, users were asked to provide informal feedback via an online survey to ask about their impressions of the story.

Results

Findings from the 31 responses highlighted that children are likely to hold differing feelings regarding COVID-19, depending on their own temperament and lockdown experiences, including changes in relationships with family and friends. Following the launch of ‘My Back to School Bubble’ e-storybook, 21 users provided feedback via survey. Fourteen respondents (67%) indicated that the storybook was a useful tool for providing support to children, and twelve (57%) reported that the resource helped children understand their own feelings.

Recommendations

Clear, accurate information about the new school environment should be provided in the context of COVID-19. It is especially important to support children with special educational needs and disabilities, including those with autism. Encouraging children to take ownership of their health and hygiene behaviours, such as handwashing, will help to normalise this and prevent the spread of infection. Lessons learnt from the development of ‘My Back to School Bubble’ online storybook suggest the clarity of imagery could be improved to better support children with autism. Future work should focus on longitudinal and qualitative research. This should include the long-term effects of the pandemic on children’s development and education, effects on mental health and resilience, peer socialisation, and ability to cope with life-changing events.
Abortion provision in Northern Ireland: the views of health professionals working in obstetrics and gynaecology units
Authors: Bloomer Fiona , Kavanagh Jayne , Morgan Leanne , McLaughlin Laura , Roberts Ralph , Savage Wendy , Francome Colin
Published: March 2021

Introduction

Abortion became decriminalised in Northern Ireland in October 2019. Until that point there existed no evidence concerning the views of health professionals on decriminalisation or on their willingness to be involved in abortion care. The purpose of this study was to address this lack of evidence, including all categories of health professionals working in obstetrics and gynaecology units in Northern Ireland.

Methods

The online survey was targeted at medical, nursing and midwifery staff working in the obstetrics and gynaecology units in each Health and Social Care (HSC) Trust in Northern Ireland. The survey was issued via clinical directors in each Trust using the REDCap platform.

Results

The findings showed widespread support for decriminalisation of abortion up until 24 weeks’ gestation (n=169, 54%). The majority of clinicians stated they were willing to provide abortions in certain circumstances (which were undefined) (n=188, 60% medical abortions; n=157, 50% surgical abortions). Despite regional variation, the results show that there are sufficient numbers of clinicians to provide a service within each HSC Trust. The results indicate that many clinicians who report a religious affiliation are also supportive of decriminalisation (n=46, 51% Catholic; n=53, 45% Protestant) and are willing to provide care, countering the assumption that those of faith would all raise conscientious objections to service provision.

Conclusions

The findings of this study are very encouraging for the development, implementation and delivery of local abortion care within HSC Trusts in Northern Ireland and should be of value in informing commissioners and providers about the design of a service model and its underpinning training programmes.
Intensity-dependent and multi-photon Hamiltonian of two two-level atoms and two-mode field in a Kerr medium solved by virtue of supersymmetric unitary transformation
Authors: Abd El-Wahab N. H. , Zait R. A.
Published: March 2021

We consider a generalized multi-photon interaction of two collectively two-level atoms with two-mode of electromagnetic field in the presence of Kerr medium and intensity-dependent coupling. We show that this atomic system possesses supersymmetric structure. We solved this system by virtue of supersymmetric unitary transformation. The supersymmetric generators of this atomic system are constructed. The diagonalization of the corresponding Hamiltonian is performed by introducing a supersymmetric unitary transformation. Accordingly, the eigenvalues and eigenfunctions of the Hamiltonian of the atomic system are obtained. The time evolution of the atom–field wave functions is derived in an exact form for two cases of the initial states of the atoms and the field modes. Some quantum effects such as the second-order correlation function, cross-correlation, purity and Husimi Q-function are investigated. The effects of the Kerr medium, detuning parameter, intensity-dependent coupling and multi-photon transition on the evolution of these quantum effects are examined. We conclude that the supersymmetric unitary transformation method is very simple and can be applied to a variety of atomic systems which possess a supersymmetric structure.
Numerical Simulation of Effects of River Reconstruction on Flooding: A Case Study of the Ba River, China
Authors: Jing Haixiao , Lang Yongbiao , Wang Xinhong , Yang Mingyang , Zhang Zongxiao
Published: March 2021

The local reconstruction of river channels may pose obstacles of flood flow, local eddy currents, or high flow velocity which pose potential threats to human life and infrastructures nearby. In the design of such projects, the effects of local reconstruction of the river channel on flooding are often evaluated by the one‐dimensional method, which is based on the formula of one‐dimensional nonuniform flow. In this study, a two‐dimensional hydrodynamic model based on shallow water equations is employed to investigate the impacts of river reconstruction on flooding in the Ba River, China. The finite volume method and an unstructured triangular mesh are used to solve the governing equations numerically. The numerical model is validated by comparison with the results of a physical model of 1 : 120 scale. The backwater effects and impacts of flood flow fields under two flood frequencies are analyzed by comparing the numerical results before and after local reconstruction. The results show that the backwater length under both 10‐year and 100‐year floods can be reached up to the upstream boundary of the computational domain. However, the maximum water level rises are limited, and the levees in this river channel are safe enough. The flow velocity fields under both floods are changed obviously after local reconstruction in the Ba River. Areas with the potential for scour and deposition of the river bed are also pointed out. The findings of this study are helpful for the evaluation of flood risks of the river.
Early Detection of Radiation‐Induced Injury and Prediction of Cognitive Deficit by MRS Metabolites in Radiotherapy of Low‐Grade Glioma
Authors: Alirezaei Zahra , Amouheidari Alireza , Hassanpour Masoud , Davanian Fariba , Iraji Sajjad , Shokrani Parvaneh , Nazem-Zadeh Mohammad-Reza
Published: March 2021

Purpose. To compare the sensitivity of MRS metabolites and MoCA and ACE‐R cognitive tests in the detection of radiation‐induced injury in low grade glioma (LGG) patients in early and early delayed postradiation stages. Methods. MRS metabolite ratios of NAA/Cr and Cho/Cr, ACE‐R and MoCA cognitive tests, and dosimetric parameters in corpus callosum were analyzed during RT and up to 6‐month post‐RT for ten LGG patients. Results. Compared to pre RT baseline, a significant decline in both NAA/Cr and Cho/Cr in the corpus callosum was seen at the 4th week of RT, 1, 3, and 6‐month post‐RT. These declines were detected at least 3 months before the detection of declines in cognitive functions by ACE‐R and MoCA tools. Moreover, NAA/Cr alterations at 4th week of RT and 1‐month post‐RT were significantly negatively correlated with the mean dose received by the corpus callosum, as well as the corpus callosum 40 Gy dose volume, i.e., the volume of the corpus callosum receiving a dose greater than 40 Gy. Conclusion. MRS‐based biomarkers may be more sensitive than the state‐of‐the‐art cognitive tests in the prediction of postradiation cognitive impairments. They would be utilized in treatment planning and dose sparing protocols, with a specific focus on the corpus callosum in the radiation therapy of LGG patients.
Missense Variant of Endoplasmic Reticulum Region of WFS1 Gene Causes Autosomal Dominant Hearing Loss without Syndromic Phenotype
Authors: Li Jinying , Xu Hongen , Sun Jianfeng , Tian Yongan , Liu Danhua , Qin Yaping , Liu Huanfei , Li Ruijun , Neng Lingling , Deng Xiaohua , Xue Binbin , Yu Changyun , Tang Wenxue
Published: March 2021

Objective. Genetic variants in the WFS1 gene can cause Wolfram syndrome (WS) or autosomal dominant nonsyndromic low‐frequency hearing loss (HL). This study is aimed at investigating the molecular basis of HL in an affected Chinese family and the genotype‐phenotype correlation of WFS1 variants. Methods. The clinical phenotype of the five‐generation Chinese family was characterized using audiological examinations and pedigree analysis. Target exome sequencing of 129 known deafness genes and bioinformatics analysis were performed among six patients and four normal subjects to screen suspected pathogenic variants. We built a complete WFS1 protein model to assess the potential effects of the variant on protein structure. Results. A novel heterozygous pathogenic variant NM_006005.3 c.2020G>T (p.Gly674Trp) was identified in the WFS1 gene, located in the C‐terminal domain of the wolframin protein. We further showed that HL‐related WFS1 missense variants were mainly concentrated in the endoplasmic reticulum (ER) domain. In contrast, WS‐related missense variants are randomly distributed throughout the protein. Conclusions. In this family, we identified a novel variant p.Gly674Trp of WFS1 as the primary pathogenic variant causing the low‐frequency sensorineural HL, enriching the mutational spectrum of the WFS1 gene.
Branchial Chamber and Gastrointestinal Tracts Parasites of Fish Species in Benue and Niger Rivers, North Central, Nigeria
Authors: Onoja-Abutu Agatha Eleojo , Okpanachi Martin Abdubala , Alkazmi Luay , Yaro Clement Ameh , Batiha Gaber El-Saber
Published: March 2021

Freshwater fish species are posing health challenges by either serving as host of parasites that are harmful to man and animals. This study was conducted to determine the parasitic profile of the branchial and gastrointestinal tracts of freshwater fish species from Niger and Benue rivers at Lokoja. These fish species are Tilapia zillii, Oreochromis niloticus, Clarias species, Synodontis schall, and Megalops atlanticus. Fish samples were collected within a period of 12 months, and the species and sex of the fish were identified. The two opercula of each fish were removed and examined for parasites; parasites recovered were preserved in 0.7% physiological saline. Gastrointestinal tracts were removed from each fish, placed in physiological saline, and examined microscopically for parasites. Prevalence of parasites was calculated. The chi-square test was used to compare prevalence of parasites according to sexes, body parts examined, fish species, and parasites species, while the t-test was used to compare between gills and intestines of each fish species. The chi-square test was used to determine if any significant difference exists in prevalence between the sexes, body parts, fish species, and parasites species, while the t-test was used to determine if any significant difference exists in prevalence between the gills and intestines of each fish species. A total of seven parasites species were harboured in branchial chamber and gastrointestinal tracts of fish species from rivers Niger and Benue: Clinostomum sp. (trematode), Camallanus sp. (nematode), Capillaria sp., Rhabdochona congolensis (nematode), Contracaecum sp. (nematode), Proteocephalus sp. (cestode), and Spinitectus guntheri. T. zillii (81 (95.3%)) had the highest prevalence, while O. niloticus, Clarias sp., S. schall, and M. atlanticus had prevalence of 87 (89.7%), 96 (80.0%), 48 (70.6%), and 27 (38.6%), respectively. Out of the total fish samples examined, females (191 (80.3%)) were observed to harbour more parasites than males (148 (73.3%)). The gastrointestinal tracts (287 (65.2%)) significantly harboured more parasites than branchial chamber (52 (11.8%)). Fish species in rivers Niger and Benue are highly infected with parasites. Fish consumers should subject the fish to proper processing before consumption, as some of these parasites are of zoonotic importance.
The Efficacy of Percutaneous Patent Foramen Ovale Closure on Migraine: a Meta‐Analysis of Randomized Controlled Trials and Observational Studies
Authors: Zhang Quan-Quan , Lu Jia-Jie , Yan Man-Yun , Hu Xiao-Wei , Qin Yi-Ren , Wang Da-Peng , Jiang Jian-Hua , Fang Qi , Zhao Hong-Ru
Published: March 2021

Objectives. Whether patent foramen ovale (PFO) closure is effective on migraine is controversial. This article was aimed at assessing the efficacy of PFO closure on migraine based on randomized controlled trials (RCTs) and observational studies. Methods. We searched PubMed, Embase, and Cochrane databases up to October 2020 evaluating PFO closure versus control in patients with migraine, then conducted a meta‐analysis of all RCTs and observational studies, respectively. The main outcomes were (1) respond rate: complete cessation of migraine; (2) reduction in the frequency of migraine attacks per month; and (3) reduction in migraine days per month. Results. Seven studies (3 RCTs and 4 observational studies), containing 887 migraine patients, were identified. (1) The respond rate of PFO closure on migraine was significantly higher than control group both in RCT subgroup and observational studies subgroup (OR 3.86, 95% CI 1.35‐11.04, P = 0.01 in RCTs; OR 8.28, 95% CI 2.31‐29.67, P = 0.001 in observational studies). (2) Reduction in frequency of migraine attacks was higher in PFO closure group compared with control group in the RCT subgroup analysis (mean difference (MD) = 0.57, 95% CI 0.23‐0.90, P = 0.0009). (3) Reduction in migraine days was also higher in PFO closure group compared with control group in the RCT subgroup analysis (MD = 1.33, 95% CI 0.35‐2.31, P = 0.008). Conclusions. PFO closure might be suitable for migraine patients, especially for migraine with aura, by cessation of migraine headaches or reducing migraine attacks and migraine days.