bluuebunny/crossref_metadata_2025 huggingface dataset:
Cryopreserving Jewish Motherhood: Egg Freezing in Israel and the United States
Authors: Birenbaum‐Carmeli Daphna , Inhorn Marcia C. , Vale Mira D. , Patrizio Pasquale
Published: April 2021

Oocyte cryopreservation (i.e., egg freezing) is one of the newest forms of assisted reproduction and is increasingly being used primarily by two groups of women: (1) young cancer patients at risk of losing their fertility through cytotoxic chemotherapy (i.e., medical egg freezing); and (2) single professionals in their late 30s who are facing age‐related fertility decline in the absence of reproductive partners (i.e., elective egg freezing). Based on a binational ethnographic study, this article examines the significance of egg freezing among Jewish women in Israel and the United States. As they face the Jewish maternal imperative, these women are turning to egg freezing to relieve both medical and marital uncertainties. In both secular and religious Jewish contexts, egg freezing is now becoming naturalized as acceptable and desirable precisely because it cryopreserves Jewish motherhood, keeping reproductive options open for Jewish women, and serving as a protective self‐preservation technology within their pronatalist social environments.
The Role of Issues in Negotiation: Framing, Linking, and Ordering
Authors: Druckman Daniel , Wagner Lynn
Published: April 2021

Three aspects of negotiation issues are framing (types of issues), linking (relationships among the issues), and ordering (procedures for discussing them). In this essay, we review the relevant experimental and case study literatures on each of these aspects and consider interactions among them. Framing includes distinctions among abstract and concrete issues, values and interests, and broad formulas and the details needed to implement them. Linking can be either substantive or tactical, involves adding or subtracting issues, and includes issues imported from other domains or those previously discussed separately within a negotiation. Ordering refers to the distinction between sequential (one issue at a time) and simultaneous (building packages of issues) strategies. These distinctions are choices that may influence the course of negotiation depending on various contingencies within and outside of the negotiation. They are also understood in terms of interactions in a more dynamic conception of negotiating issues. The review concludes with an organizing framework and suggestions for further research in each of the areas covered.
Diagnostic accuracy of the Parr vision test, single crowded Lea symbols and Spot vision screener for vision screening of preschool children aged 4–5 years in Aotearoa/New Zealand
Authors: Findlay Rebecca , Black Joanna , Goodman Lucy , Chelimo Carol , Grant Cameron C , Anstice Nicola
Published: April 2021

Purpose

Preschool children in New Zealand undergo vision screening to detect amblyopia at 4–5 years of age. The current test, the Parr vision test, does not meet international visual acuity chart guidelines and has not been validated against other commonly used paediatric vision tests. New Zealand vision screening protocols are also not targeted for detecting other eye conditions such as uncorrected refractive error, which may affect school performance. We compared the Parr vision test with the single crowded Lea symbols and the Spot vision screener for detecting ocular pathology, refractive error and amblyopic risk factors in preschool children.

Methods

A cross‐sectional diagnostic accuracy study recruited children aged 4–5 years via convenience sampling from the University of Auckland Optometry Clinic and through primary schools in Auckland, New Zealand. Participants received vision screening with the three different instruments administered by a lay screener. Comprehensive eye examinations were completed by a paediatric optometrist to determine the presence of vision disorders.

Results

Of 197 children who received a comprehensive eye examination, 14 (7.1%) had amblyopic risk factors and 43 (21.8%) had significant refractive error (15.7% with astigmatism, 9.1% with hyperopia). The sensitivity for detecting any ocular condition did not differ significantly between the tests (50.0% for Parr, 43.5% for Lea, 42.5% for Spot). Specificity was significantly lower for the Parr vision test (80.8%) than for the Lea symbols (93.4%) and Spot vision screener (98.0%). Adding the Spot vision screener to measurements of visual acuity significantly improved sensitivity in detecting any ocular condition with the Parr vision test (67.5% for Parr/Spot vs 50% for Parr alone), but not with the Lea symbols (52.5% for Lea/Spot vs 43.5% for Lea alone).

Conclusion

The sensitivity of the Parr vision test for detecting ocular conditions in preschool children does not vary significantly from that achieved by the Lea symbols or the Spot vision screener. However, current New Zealand vision screening protocols could be improved by expanding the target conditions to include significant refractive error and incorporating the use of the Spot vision screener to increase the accuracy with which children with refractive error are identified. Future research should include longitudinal studies to determine the effect of preschool vision screening on later ocular and academic outcomes.
Short‐term intensive gastrointestinal endoscopy training program
Authors: Morita Atsushi , Kudo Takahiro , Horiuchi Akira , Kajiyama Masashi , Tanaka Naoki , Takada Hidetoshi
Published: April 2021

Background

In Japan there are limited opportunities for pediatric gastrointestinal (GI) trainees to learn GI endoscopy. This study investigated whether a short‐term intensive training for 3 months in an adult GI unit enabled pediatric GI trainees to acquire the required number of cases and the technical competence to perform pediatric GI endoscopic procedures.

Methods

This was a retrospective case series of pediatric GI trainees who underwent 3 months of intensive endoscopy training, which also included direct observation and a questionnaire. The numbers of esophagogastroduodenoscopies (EGD), ileocolonoscopies, and snare polypectomies each trainee performed as well as cecal intubation rates were collected with the goal of meeting the standards of overseas educational guidelines. The trainees were also asked about continuing experience with pediatric endoscopic procedures after the intensive training.

Results

There were 10 enrolled trainees, 9 men, average age, 34 (range, 29–41). The average number (range) of EGD and ileocolonoscopies that the 10 trainees had done before this training period was 52 (0–200) and 15 (0–20), respectively. The average number (range) of EGD, ileocolonoscopies and snare polypectomies per each trainee was 651.7 (485–814), 159.2 (130–195) and 25.8 (10–55), respectively, over 3 months: all trainees thus fulfilled all of the criteria of the minimal training requirements. All trainees also reached the required threshold in the cecal intubation rate (>90%). In addition, all trainees were able to perform pediatric endoscopic procedures alone after the intensive training period.

Conclusions

Short‐term intensive training for 3 months in an adult GI setting enabled pediatric GI trainees to acquire technical competence for pediatric endoscopic procedures.
Considerations for utilizing medullary sponge kidney allografts in pediatric patients
Authors: Mahajan Ruchi G. , Chang Jae‐Hyung , Runge Brian , Carpenter Christina , Sandoval Pedro R. , Ratner Lloyd E. , Uy Natalie S. , Jain Namrata G.
Published: April 2021

Background

Medullary sponge kidney (MSK) disease predisposes patients to recurrent nephrolithiasis, which affects one in every 5000 people in the United States.

Methods

We report a rare case of a pediatric recipient of a living donor MSK transplant and discuss considerations when discussing risks and benefits of accepting MSK allografts for this population.

Results

The recipient was admitted due to concerns for nephrolithiasis, hydronephrosis, and urinary tract infection at 1‐month post‐transplant. The hydronephrosis was resolved by surgical removal of an encrusted ureteral stent; this was followed by supplementation with oral medications to prevent future episodes of nephrolithiasis. The recipient did not have any further episodes after this as seen at a 1‐year follow‐up. The donor has remained well through this period.

Conclusions

With increasing organ shortages, the use of variety of donors may need to be considered to enlarge the organ pool.
COVID‐19 infection in a pediatric kidney transplant population: A single‐center experience
Authors: Singer Pamela S. , Sethna Christine , Molmenti Ernesto , Fahmy Ahmed , Grodstein Elliot , Castellanos‐Reyes Laura , Fassano Jessica , Teperman Lewis
Published: April 2021

Background

The clinical course of SARS‐CoV‐2 in the pediatric kidney transplant population is not well described.

Methods

We performed a retrospective cohort study of a pediatric kidney transplant population at a New York transplant center. Baseline characteristics and clinical course of patients with SARS‐CoV‐2 positivity (Ab or PCR) were described, and comparison between COVID‐positive and COVID‐negative transplant patients was performed.

Results

Twenty‐two patients had COVID‐19 IgG testing performed, eight of whom also had PCR testing. 23% of our cohort had evidence of COVID‐19 infection. Four patients had positive IgG only, and one patient had a positive PCR. All five patients with a positive COVID test were female. Two patients had COVID‐19 symptoms, which were mild. Of the symptomatic patients, one had a positive PCR at time of symptoms, while the other had a negative PCR during symptoms but subsequently had positive IgG. As compared to patients with COVID‐19 negative results, those with COVID‐19 positivity were significantly more likely to have a known COVID‐19 exposure, and were also more likely to be female. There was no significant difference in time from transplant between the groups. Those in the COVID‐positive group had higher baseline antimetabolite dose and CNI troughs, although these did not reach statistical significance.

Conclusions

Pediatric kidney transplant recipients are at risk for development of COVID‐19 infection. While this population may be more at risk for SARS‐CoV‐2 infection due to their immunosuppressed status, their clinical course appears mild and similar to a healthy pediatric population.
Three novel HLA alleles detected in individuals from Russia: HLA‐A*26:209, ‐DRB1*03:01:33, and ‐DQB1*03:447
Authors: Loginova Maria , Smirnova Daria , Kutyavina Svetlana , Kashin Konstantin , Paramonov Igor
Published: April 2021

Three new alleles were identified during routine next generation sequencing.
Impact of poverty reduction on access to water and sanitation in low‐ and lower‐middle‐income countries: country‐specific Bayesian projections to 2030
Authors: Swe Khin Thet , Rahman Md. Mizanur , Rahman Md. Shafiur , Teng Yvonne , Abe Sarah Krull , Hashizume Masahiro , Shibuya Kenji
Published: April 2021

Background

In 2017, 785 million people globally lacked access to basic services of drinking water and 2 billion people lived without basic sanitation services. Most of these people live in low‐ and lower‐middle‐income countries in South Asia, Southeast Asia and sub‐Saharan Africa. To monitor the progress towards universal access to water and sanitation, this study aimed to predict the coverage of access to basic drinking water supply and sanitation (WSS) services as well as the reduction in the practice of open defecation by 2030, under two assumptions: following the current trends and accelerated poverty reduction.

Methods and findings

Households reporting access to basic WSS services and those practising open defecation were extracted from 210 nationally representative Demographic Health Surveys and Multiple Cluster Indicator Surveys (1994–2016) from 51 countries. A Bayesian hierarchical mixed effect linear regression model was developed to predict the indicators in 2030 at national, urban–rural and wealth‐specific levels. A Bayesian regression model with accelerated reduction in poverty by 2030 was applied to assess the impact of poverty reduction on these indicators. Out of 51 countries, only nine (Bangladesh, Bhutan, Ghana, India, Nepal, Pakistan, The Philippines, Togo and Vietnam) were predicted to reach over 90% coverage in access to basic services of drinking water by 2030. However, none of the countries were projected to achieve equivalent coverage for access to basic sanitation services. By 2030, 21 countries were projected to achieve the target of less than 10% households practising open defecation. Urban–rural and wealth‐derived disparities in access to basic WSS services, especially sanitation, were more pronounced in sub‐Saharan Africa than South Asia and Southeast Asia. Access to basic sanitation services was projected to benefit more from poverty reduction than access to basic drinking water services. Households residing in rural settings were predicted to receive greater benefit from poverty reduction than urban populations in access to both basic WSS services.

Conclusion

Achieving poverty eradication targets may have a substantial positive impact on access to basic water supply and sanitation services. However, many low‐ and lower‐middle‐income countries will struggle to achieve the goal of universal access to basic services, especially in the sanitation sector.
Integration of municipal state, society and university efforts for sanitary risk prevention associated withAedes aegyptimosquito in the metropolitan area of Buenos Aires, Argentina
Authors: Ruggerio Carlos Alberto , Querejeta Giselle Andrea , Conicelli Katherine Belen , Lombardo Rubén Jorge
Published: April 2021

The sanitary problem ofAedes aegyptimosquito acquires relevance around the world because it is the vector of dengue, zika, chikungunya and yellow fever. The vector is adapting to southern regions faster, and the propagation of these diseases in urban areas is a complex problem for society. We aimed to contribute to the risk prevention of disease transmission in the Metropolitan Area of Buenos Aires, through monitoringAedes aegyptipopulation levels and developing education campaigns with government agencies and society participation. Monitoring activities aimed to diagnose the presence of the vector and its ecology behaviour, and to generate education and prevention politics to avoid its propagation. The results show that (1) the mosquito is in the territory and it is spreading, (2) prevention activities of the municipalities are insufficient to generate an effective sanitary response and (3) it is necessary to improve the education programmes to the population about the life cycle of the vector. The integration of university, government and society improved the work of the team because it combined knowledge about vector ecology, diseases and territory characteristics.
A comparison study between the results of the Siemens ADVIA 120 analyzer and the manual method for differential leukocyte counts in sheep
Authors: Oikonomidis Ioannis L. , Brozos Christos , Kiossis Evangelos , Tsouloufi Theodora K. , Kritsepi‐Konstantinou Maria
Published: April 2021

Background

The ADVIA 120 is a widely used hematology analyzer, which has not been previously validated for determining differential leukocyte counts in sheep.

Objectives

We aimed to compare differential leukocyte counts on the ADVIA 120 (A‐Diff) with counts obtained using the manual method (M‐Diff) in sheep.

Methods

Ethylenediaminetetraacetic acid‐anticoagulated blood samples analyzed within 4 hours of collection were used. Samples with inappropriately filled tubes, detectable clots, overtly erroneous ADVIA peroxidase cytograms, and poor‐quality blood smears were excluded from the study. Two independent observers compared the results of the A‐Diff with those of the M‐Diff. The M‐diff was performed by counting 200 leukocytes on a blood smear.

Results

Overall, 88 samples (44 rams and 44 ewes) were included. The correlation between the A‐Diff and M‐Diff was high for neutrophils (r = .873, P < .001), lymphocytes (r = .863, P < .001), and eosinophils (r = .750, P < .001), and low for monocytes (r = .212, P = .048). The Passing‐Bablok regression analyses revealed constant error for eosinophils [1.17%; 95% confidence interval (CI): 0.67%, 1.55%] and proportional error for lymphocytes (0.84; 95% CI: 0.74, 0.95) and eosinophils (0.85; 95% CI: 0.74, 0.96). The Bland‐Altman analyses revealed negative biases of 2.4% and 3.0% for neutrophils and lymphocytes, respectively, and positive biases of 3.2% and 0.8% for monocytes and eosinophils, respectively. The extremely low basophil percentages precluded a meaningful method comparison for this leukocyte type.

Conclusions

The ADVIA 120 appears to perform well for determining neutrophil, lymphocyte, and eosinophil percentages in sheep as compared with the manual method. However, blood smear examinations are recommended for the confirmation of abnormal differential leukocyte count results.
Allocating transmissivities from constant head tests for the development of DFN models
Authors: Howroyd M. , Novakowski K.S
Published: April 2021

Constant head tests are commonly used for field measurements of fracture transmissivity. As a bulk transmissivity is measured for each test section, it is frequently unclear how this transmissivity relates to the hydraulic properties of individual fractures. The goal of this study is to determine if constant head tests conducted at scales larger than the average fracture spacing can be used to generate discrete fracture network (DFN) models that describe transport. The methodology involved generating DFNs using measurements from constant head tests conducted at lengths both above and below the average fracture spacing at a site in Ontario, Canada. Transport predictions from DFNs produced from different scales of hydraulic tests were compared to determine if a method for proportioning larger-scale test results to obtain a DFN representative of the smaller-scale tests could be established. The results of this study indicate that the choice of method used to apportion bulk transmissivities has a significant impact on transport simulations, with a difference in mass arrival of over a factor of two at travel distances less than 50 m. While the most appropriate method is case specific, the error resulting from the choice needs to be considered when using DFN models.
Metric-affine bumblebee gravity: classical aspects
Authors: Delhom Adrià , Nascimento J. R. , Olmo Gonzalo J. , Petrov A. Yu. , Porfírio Paulo J.
Published: April 2021

We consider the metric-affine formulation of bumblebee gravity, derive the field equations, and show that the connection can be written as Levi-Civita of a disformally related metric in which the bumblebee field determines the disformal part. As a consequence, the bumblebee field gets coupled to all the other matter fields present in the theory, potentially leading to nontrivial phenomenological effects. To explore this issue we compute the post-Minkowskian, weak-field limit and study the resulting effective theory. In this scenario, we couple scalar and spinorial matter to the effective metric, and then we explore the physical properties of the VEV of the bumblebee field, focusing mainly on the dispersion relations and the stability of the resulting effective theory.
NATO-EU Cooperation in Cybersecurity and Cyber Defence Offers Unrivalled Advantages
Authors: Poptchev Peter
Published: April 2021

The article identifies the trends as well as documented instances of adversarial cyberattacks and hybrid warfare against NATO and EU Member States. It illustrates how these adversarial activities impact on the broader aspects of national security and defence, the socio-economic stability and the democratic order of the states affected, including on the cohesion of their respective societies. Cyberattacks by foreign actors—state and non-state—including state-sponsored attacks against democratic institutions, critical infrastructure and other governmental, military, economic, academic, social and corporate systems of both EU and NATO Member States have noticeably multiplied and have become more sophisticated, more destructive, more expensive and often indiscriminate. The cyber and hybrid threats are increasingly seen as a strategic challenge. The article presents some salient topics such as the nexus between cyberattacks and hybrid operations; the game-changing artificial intelligence dimension of the cyber threat; and the viability of public attributions in cases of cyberattacks. On the basis of analysis of the conceptual thinking and policy guide-lines of NATO, the European Union and of the U.S., the author makes the case that a resolute Trans-Atlantic cooperation in the cyber domain is good for the security of the countries involved and essential for the stability of today’s cyber-reliant world.
Standardization in the Field of Cybersecurity and Cyber Protection in Ukraine
Authors: Pleskach Mariia , Pleskach Valentyna , Semenchenko Andrii , Myalkovsky Danylo , Stanislavsky Taras
Published: April 2021

This article demonstrates the similarity of approaches to standardization in the field of cybersecurity carried out by international standardization organizations (ISO, ITU, ETSI), leading regional organizations and selected countries. The authors consider necessary that Ukrainian committees of standardization report on the effectiveness of adopted cybersecurity standards. The harmonization of national with the international standards is essential for saving financial resources and time, and ensuring cross-border cooperation. The article considers a number of standardization organizations and approaches and a list of priority international standards of highest priority for improving the Ukrainian system of regulatory and technical documents on cybersecurity.
Labour Relations and the Information Security of the State during the Covid-19 Pandemics
Authors: Zapara Svitlana , Melnyk Yaroslav , Melnyk Mariya , Kuznetsova Maryna , Bondar Natalia
Published: April 2021

The technological changes directly influence human values, way of life, communication, education, new digital competencies, economic productivity, social rights, privacy, access to information, and more. Understanding and describing these effects is key for understanding the new digital social reality and determining possibilities, challenges, and threats of the fourth industrial revolution. The prerequisites of this study are the objective monitoring of the state of social and labour relations in Ukraine and other countries, the analysis of urgent issues of alternative employment, the global crisis and crisis of the human rights mechanism of social and labour relations, changes in the legal status and powers of trade union organizations. These institutions are intended to protect the interests of employees, to facilitate the ‘individualization’ of labour relations, and new forms to protect employees’ rights and interests.
https://isij.eu/article/assessing-variety-expected-losses-upon-materialisation-threats-banking-information-systems
Authors: Izmailova Olha , Krasovska Hanna , Krasovska Kateryna , Zaslavskyi Volodymyr
Published: April 2021

The article addresses the problem of estimating the expected losses of a bank when information security threats to functioning computer systems materialize. A scenario approach to solving the problem is developed based on multi-criteria decision-making methods, taking into account quantitative and qualitative indicators and expert assessment, and applying the analytic hierarchy process for comprehensive assessment of expected losses in probabilistic terms. That allows to take into account different levels of the hierarchy of criteria and the weight of their impact on the calculated results. The process of estimating the probability of materialization of various threats under accepted standards and situational conditions, the actions of the attacker and the consequences on the bank’s functioning is formalized. Expert assessments are grouped with control over the sufficiency of the degree of logic and dispersion of opinions of each expert, compliance with the established requirements for the degree of consistency of opinions of the group of experts, assessment and formalized consideration of the degree of their competence. The process of assessing expected losses is presented as a daily business process of the functioning of the bank’s security system.
Psychological Consequences of the Delay in the Silent Mentor Programme During the COVID-19 Pandemic: Perspectives From Family Members of Silent Mentors
Authors: Wong Li Ping , Tan Sik Loo , Alias Haridah , Sia Thiam Eng , Saw Aik
Published: April 2021

The COVID-19 pandemic has put a hold on the Silent Mentor Programme (SMP); this pause has not only caused unprecedented challenges for the delivery of medical education but has forced changes in the programme ceremony sessions. We aimed to describe the psychological impact and experiences of family members of silent mentors during the COVID-19 pandemic using qualitative interviews. Many expressed feelings of remorse and unrest about the unprecedented delay of the SMP. The delay increased negative emotions particularly among some elderly family members; however, there was no prominent negative effect on their functional health and well-being. Several participants relayed the belief that the soul cannot rest until the body receives a proper burial while some worried about the deterioration of the physical condition of the mentors. In conclusion, findings provide insights into the importance of not overlooking the mental health implications of delaying the SMP in future outbreaks or crises.
“Do Not Protect Us, Train Us.”—Swiss Healthcare Students’ Attitudes Toward Caring for Terminally Ill Patients
Authors: Juvet Typhaine Maïko , Bornet Marc-Antoine , Desbiens Jean-François , Tapp Diane , Roos Pauline
Published: April 2021

Positive attitudes and a sense of competence toward end-of-life care are the key to adequately support terminally ill patients. This qualitative study aims to explore healthcare students’ attitudes toward caring for terminally ill patients. Eleven students from the University of Applied Health Sciences in Switzerland participated in focus groups. Attitudes were overall positive. Most participants felt that supporting dying patients was a way to achieve professional fulfillment. However, most students felt not competent in palliative care and lacking experience. They wanted to receive better training, more specifically in good practices and appropriate behaviors. Our study fills a knowledge gap regarding the opinions and pedagogical needs of healthcare students, and highlights the importance of experiencing end-of-life care during the educational process. We recommend early exposure to terminally ill patients and appropriate attitudes toward death and dying as part of the bachelor’s curriculum, accompanied by benevolent guidance from teachers and health professionals.
A Group Therapy Program for Parentally Bereaved Young Adults With Grief Complications: Rationale, Method and Case Examples
Authors: Larsen Lene Holm , Guldberg Anitta , Kring Villy
Published: April 2021

Considerable effort has gone into studying bereavement in children, adults and the elderly, but few studies have investigated the effects of bereavement or grief interventions in young adults. Even fewer studies have reported on the effect of interventions for young adults with grief complications. The present study seeks to help fill this gap by describing a Danish treatment program specially developed for young adults with complicated grief reactions. The dual process model of coping with bereavement, psychodynamic theory, and a narrative approach provide the foundation for the treatment. In addition, it utilizes an eclectic use of techniques and a group treatment modality that involves providing individual therapy within a group context. The core elements of the treatment are discussed and then exemplified in two case studies.
School Connectedness, Academic Self-Efficacy, and Academic Performance: Mediating Role of Hope
Authors: Zeinalipour Hossien
Published: April 2021

The present study explored the effects of school connectedness and academic self-efficacy beliefs on academic performance among male and female high school students. It was hypothesized that hope would mediate the effects of school connectedness and academic self-efficacy beliefs on academic performance. The statistical population of the study included all high school students in a city of Iran, from whom 500 individuals were selected as the study sample using multistage random sampling. To collect the required data, three questionnaires – i.e., academic self-efficacy subscale from the Patterns of Adaptive Learning Scale by Midgley et al., Children’s Hope Scale by Snyder et al., and Brown and Evans’ School Connectedness Scale – were used. Structural equation modeling (SEM) was also applied to evaluate the proposed model, and the results indicated the statistical significance of all the path coefficients between the variables. The model showed the positive and significant relation of school connectedness, academic self-efficacy beliefs, and hope with academic performance and the relation of school connectedness and academic self-efficacy beliefs with hope. The fit indices showed that the model was well-fitted. Furthermore, the significance of all the indirect relationships was also confirmed. We concluded that, the high levels of school connectedness and academic self-efficacy are associated with high academic performance and hope seems to be an important mediator of these relationships.
Climatic zoning for the building thermal design in China's rural areas
Authors: Chen Yao , Wang Zhiwei , Wei Peng
Published: April 2021

Building climatic zoning is a prerequisite for implementing building energy efficiency technology, which can help code makers and architects have an accurate understanding of the local climatic conditions. It takes the extreme monthly average temperature as the zoning index in the existing climatic zoning of rural areas in China. There will be unreasonable design phenomena of insufficient or excessive thermal insulation for a building envelope in rural areas. Aiming at the above problems, this paper modifies the current zoning. This research established the cooling and heating degree-day indexes HDD14 and CDD30 based on the thermal comfort characteristics of rural occupants and used the threshold method to subdivide rural areas into eight sub-zones. The results show that the problem of insufficient or excessive thermal insulation in rural areas can be effectively solved by replacing the extreme monthly average temperature index with the degree day index and the annual cumulative building load can be reduced by 6.4% on average without increasing the insulation cost. After more detailed zoning, the variance within the group is reduced and it accurately describes climate diversity, which is conducive to implementing climate-responsive energy-saving design in each subzone.

Practical application: The major purpose of this paper is to solve the problem of unreasonable climate zone boundaries specified in the existing Design Standard for Energy Efficiency of Rural Residential Buildings. The existing zoning has led to conflicts between the actual heating demand and the building envelope thermal parameter limits specified in the standard. This work redefines the boundaries of the existing map using more up-to-date weather data to provide the right guidance for architectural designers.
Isolated reversal of flow in the vertebral artery – A missed entity
Authors: Kannan Koushik , Ravishankar Ramanish , Muralidharan Srinivasan
Published: April 2021

Isolated reversal of flow in the vertebral artery is a rare phenomenon occurring in the general population and is due to intrinsic anatomical defects. The most common cause is subclavian stenosis; however, reversal of flow in the vertebral artery can occur regardless of any detection of anatomic deterioration. In this series, we report three asymptomatic cases where the extracranial Doppler scan preceding off-pump coronary arterial bypass grafting showed isolated reversal of flow in the vertebral artery. No signs of subclavian stenosis or steal syndrome were elicited. However, all patients subsequently suffered from a posterior circulation stroke following off-pump coronary arterial bypass grafting but recovered fully with medical management. We conclude that a detailed pre-operative neurological investigation can mitigate this risk and improve neurological outcomes following off-pump coronary arterial bypass grafting.
Do Health-Seeking Populations Know the Link Between Human Papillomavirus and Oropharyngeal Cancer? A Cross-Sectional Study in a Nigerian Population
Authors: Adesina Ayodele , Olufemi Erinoso , Oluwatosin Odukoya , Kayode Obigbesan , Babatunde Alli , Babalola Castano , Michael Gbotolorun
Published: April 2021

Background

The human papillomavirus (HPV) has been causally linked to oropharyngeal cancers. The extent to which the population is aware of this link has not been explored in Nigeria. We aim to investigate the knowledge of the link between HPV and oropharyngeal cancers in a health-seeking population in Nigeria. Methodology: We used a cross-sectional study design, with a multi-stage sampling method comprising a cluster of four health facilities and first-time adult patients attending the general outpatient clinics of the selected health facilities. An interviewer-administered questionnaire was be used to obtain demographic information, social history, HPV awareness, HPV vaccination and the link between HPV and oropharyngeal cancer.

Results

A total of 1,000 respondents completed the survey from four health facilities in Lagos, Nigeria. Majority of respondents were below 40 years (61.5%), and female (53.4%). About 13.4% of the study population were aware of HPV, and 7.9% of HPV vaccines. The most common source of HPV information for respondents who were aware of HPV was the internet (65.4%). Only 7.7% of respondents knew the link between HPV and oropharyngeal cancer. Significant predictors of knowledge of the link between HPV and oropharyngeal cancer were higher education [ p: 0.012], higher overall knowledge of HPV risk factors and complications [ p: 0.000]; and awareness of HPV vaccine [ p: 0.020].

Conclusions

Our findings suggest a lack of public knowledge of the link between HPV and oropharyngeal cancer. These findings could inform health promotion measures for oropharyngeal cancer, particularly for groups where knowledge is lowest.
A randomised crossover study to compare the user seal check and quantitative fit test between two types of duckbill N95 particulate respirator masks: The Halyard Fluidshield® N95 and the BSN Medical ProShield® N-95 particulate respirator masks
Authors: Williams Daryl L , Kave Benjamin , Lee Keat , Segal Reny , Krieser Roni B , Mezzavia Paul M , Ng Irene
Published: April 2021

N95 particulate respirator masks are currently recommended for all healthcare workers who care for patients with suspected or confirmed coronavirus disease (COVID-19) when performing aerosol-generating procedures. The protection provided by N95 particulate respirator masks is dependent on the filter’s efficiency and seal quality. In this prospective randomised crossover study, we conducted the user seal check and the quantitative fit test on two readily available duckbill models of N95 masks, the Halyard Fluidshield® N95 (Halyard, Alpharetta, GA, USA) and the BSN Medical ProShield® N-95 (BSN Medical, Mount Waverley, Victoria) particulate respirator masks. We recruited a total of 96 anaesthetic staff, of whom 26% were of South-East Asian ethnicity. We found that both types of masks provided reasonably high fit test pass rates among our participants and there was no significant difference between the two brands (77% for the Fluidshield and 65% for the ProShield, P = 0.916). Ninety-two percent of the participants could find at least one well-fitted mask among these two types of masks. We also demonstrated that the user seal check had low accuracy and low concordance (kappa coefficient of 0.16 for the Fluidshield and 0.08 for the ProShield) when compared to the quantitative fit test, and hence was not a reliable method to test seal quality.
Exploring the Efficacy of Comprehensive Management of Breast Abscesses in Restoring Milk Volume
Authors: Haifeng Gao , Yi Zhang , Ying Chen , Xin Li , Yan Li , Songtao Ding , Yajun Gao , Xiangping He , Si Chen , Xingxing Liu
Published: April 2021

Background

Approximately 54.8% of patients with breast abscesses discontinue breastfeeding due to the lack of adequate breastfeeding support.

Research aims

We aimed to (1) examine the difference in milk volume produced by healthy breasts and breasts with abscesses; and (2) to explore the changes in milk volume before and after comprehensive management.

Method

A prospective, consecutive series study was designed. Lactating patients ( N = 50) with breast abscesses were selected from March 2017 to November 2018. The volume and frequency of milk expression of the affected and the unaffected breast were recorded every 24 hr before and after comprehensive management. The difference in the milk volume produced by healthy breasts (control) and breasts with abscesses, as well as the milk volume produced by each breast before and after comprehensive management, was determined.

Results

There was a significant difference in the milk volume produced by healthy breasts and breasts with abscess before ( t = 3.016; p = .004) and after ( t = 4.336; p < .001) comprehensive management. The frequency of milk expression was significantly higher after comprehensive management than before it ( z = −6.145; p < .001); the milk volume produced by each side significantly increased after comprehensive management (healthy breasts: t = −4.789; p < .001; breasts with abscess: t = 2.555; p = .014).

Conclusion

The total milk volume produced by breasts with abscesses can be less than that produced by healthy breasts. The management of abscesses by increasing the frequency of milk expression and degree of emptying can help mothers increase their milk volume.
Understanding Dermatologic Concerns Among Persons Experiencing Homelessness: A Scoping Review and Discussion for Improved Delivery of Care
Authors: Adly Merna , Woo Taylor Evart , Traboulsi Danya , Klassen David , Hardin Jori
Published: April 2021

There is a paucity of information surrounding dermatologic care for persons experiencing homelessness (PEH). This scoping review aims to map existing literature and provide a summary of the most common cutaneous manifestations among PEH, risk factors for dermatologic disease, describe any reported interventions, as well as identify research gaps for future studies. Search strategies developed for MEDLINE and hand searching yielded 486 articles. Out of the 486 articles screened, 93 articles met the inclusion criteria. The majority were cohort studies, cross-sectional studies, and case-control studies concentrated in North America and Europe. Excluding the pediatric population, the prevalence of dermatologic conditions ranged from 16.6% to 53.5%. Common skin conditions described in PEH were: acne, psoriasis, seborrheic dermatitis, atopic dermatitis, and lichen simplex chronicus. There were no studies comparing the extent or severity of these cutaneous diseases in PEH and the general population. PEH have a higher prevalence of skin infections and non-melanoma skin cancers. This scoping review has direct implications on public health interventions for PEH and highlights the need for evidence-based interventions to provide optimum and safe dermatologic healthcare for PEH. We propose several recommendations for improved care delivery, including addressing upstream factors and comorbidities impacting skin health, providing trauma informed care, reducing barriers to care, preventing and managing skin conditions, as well as including PEH in the planning and implementation of any proposed intervention.
Rutin: A Potential Antiviral for Repurposing as a SARS-CoV-2 Main Protease (Mpro) Inhibitor
Authors: Agrawal Pawan K. , Agrawal Chandan , Blunden Gerald
Published: April 2021

Various computational studies, including in silico ones, have identified several existing compounds that could serve as effective inhibitors of the SARS-CoV-2 main protease (Mpro), and thus preventing replication of the virus. Among these, rutin has been identified as a potential hit, having prominent binding affinity to the virus. Moreover, its presence in several traditional antiviral medicines prescribed in China to infected patients with mild to moderate symptoms of COVID-19 justify its promise as a repurposed bioactive secondary metabolite against SARS-CoV-2.
COVID-19-Induced Anosmia and Ageusia Are Associated With Younger Age and Lower Blood Eosinophil Counts
Authors: Sehanobish Esha , Barbi Mali , Fong Valerie , Kravitz Meryl , Sanchez Tejera Denise , Asad Mohammad , Matsumura Cynthia , Ferastraoaru Denisa , O’Neill Meaghan , Karagic Merhunisa , Akbar Nadeem , Bottalico Danielle M. , Patel Viraj , Peshansky Alexandre , Rangareddy Mahendra , Hudes Golda , Kim Mimi , Eisenberg Ruth , Nath Avindra , Smith Bryan R. , Ow Thomas J. , Jerschow Elina
Published: April 2021

Background

Anosmia and ageusia are symptoms commonly associated with COVID-19, but the relationship with disease severity, onset and recovery are unclear.

Objective

To examine factors associated with anosmia and ageusia and the recovery from these symptoms in an ethnically diverse cohort.

Methods

Individuals tested for SARS-CoV-2 between March and April 2020 were eligible for the study. Randomly selected participants answered a telephone questionnaire on COVID-19 symptoms with a focus on anosmia and ageusia. Additionally, relevant past medical history and data on the COVID-19 clinical course were obtained from electronic medical records. 486 patients were in the COVID-19 group and 103 were COVID-19-negative.

Results

Patients who were younger were more likely to report anosmia and/or ageusia (odds ratio (OR) for anosmia per 1-year increase in age: 0·98, 95%CI:0–97-0·99, p = 0·003; for ageusia: 0·98, 95%CI:0·97-0·99, p = 0·005) as were patients with lower eosinophil counts (OR for anosmia per 0.1-K/μL increase in eosinophils: 0·02, 95%CI:0·001-0·46, p = 0·01, for ageusia 0·10, 95%CI:0·01-0·97, p = 0·047). Male gender was independently associated with a lower probability of ageusia (OR:0·56, 95%CI:0·38-0·82, p = 0·003) and earlier sense of taste recovery (HR:1·44, 95%CI:1·05-1·98, p = 0·02). Latinos showed earlier sense of taste recovery than white patients (HR:1·82, 95%CI:1·05-3·18, p = 0·03).

Conclusion

Anosmia and ageusia were more common among younger patients and those with lower blood eosinophil counts. Ageusia was less commonly reported among men, and time to taste recovery was earlier among both men and Latinos.
Changes in working memory-related cortical responses following pediatric mild traumatic brain injury: A longitudinal fMRI study
Authors: Stein Athena , Iyer Kartik K , Khetani Aneesh M , Barlow Karen M
Published: April 2021

Persistent post-concussion symptoms (PPCS) lasting longer than 4 weeks affect 25% of children with mild traumatic brain injury (mTBI) or concussion. Working memory (WM) problems are a common complaint in children with PPCS. Despite normal function on traditional neuropsychological tests, these children exhibit aberrant cortical responses within the dorsolateral prefrontal cortex (dlPFC) and default mode network (DMN) regions – both of which are implicated in WM. Using a prospective, longitudinal cohort study design, we investigated changes in cortical fMRI responses within the dlPFC and DMN during an nback WM task at two timepoints: one and two months post-injury. Across these timepoints, the primary outcome was change in cortical activations (increase in BOLD) and deactivations (decrease in BOLD) of both dlPFC and DMN. Twenty-nine children (mean age 15.49 ± 2.15; 48.3% male) with fMRI scans at both timepoints were included, following data quality control. Student’s t-tests were used to examine cortical activations across time and task difficulty. ANCOVA F-tests examined cortical responses after removal of baseline across time, task difficulty and recovery. Volumes of interest (5 mm sphere) were placed in peak voxel regions of the DMN and dlPFC to compare cortical responses between recovered and unrecovered participants over time (one-way ANOVA). Between one and two months post-injury, we found significant increases in dlPFC activations and significant activations and deactivations in the DMN with increasing task difficulty, alongside improved task performance. Cortical responses of the DMN and bilateral dlPFC displayed increased intensity in recovered participants, together with improved attention and behavioural symptoms. Overall, our findings suggest evidence of neural compensation and ongoing cognitive recovery from pediatric TBI over time between one and two months post injury in children with PPCS. These results highlight the wider and persisting implications of mTBI in children, whose maturing brains are particularly vulnerable to TBI.
Parents’ experiences of caring for a young child with type 1 diabetes: a systematic review and synthesis of qualitative evidence
Authors: Kimbell B. , Lawton J. , Boughton C. , Hovorka R. , Rankin D.
Published: April 2021

Aims

To synthesise the qualitative evidence on parents’ experiences of caring for a child aged ≤8 years with type 1 diabetes to identify: the challenges they encounter; their views about support received; ways in which support could be improved; and, directions for future research.

Methods

We searched Medline, EMBASE, CINAHL, PsycINFO and Web of Science databases to identify qualitative studies reporting parents’ views and experiences of caring for a child with type 1 diabetes aged ≤8 years. Key analytical themes were identified using thematic synthesis.

Results

Fourteen studies were included. The synthesis resulted in the generation of two overarching themes. Monopolisation of life describes the all-encompassing impact diabetes could have on parents due to the constant worry they experienced and the perceived need for vigilance. It describes how parents’ caring responsibilities could affect their wellbeing, relationships and finances, and how a lack of trusted sources of childcare and a desire to enable a ‘normal’ childhood constrained personal choices and activities. However, use of diabetes technologies could lessen some of these burdens. Experiences of professional and informal support describes how encounters with healthcare professionals, while generally perceived as helpful, could lead to frustration and anxiety, and how connecting with other parents caring for a child with type 1 diabetes provided valued emotional and practical support.

Conclusions

This synthesis outlines the challenges parents encounter, their views about support received and ways in which support might be improved. It also highlights significant limitations in the current literature and points to important areas for future research, including how sociodemographic factors and use of newer diabetes technologies influence parents’ diabetes management practices and experiences.

PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019128710