bluuebunny/crossref_metadata_2025 huggingface dataset:
Salient deliberative norm types in comment sections on news sites
Authors: Engelmann Ines , Marzinkowski Hanna , Langmann Klara
Published: January 2022

Civil and argumentative public discussions are considered crucial for functioning democracies. Among other factors, the quality of user discussions of political issues on news sites depends on prevalent discussion norms. We integrate injunctive and descriptive norms into news comment research, assuming that the degree of salience of the respective norm influences the commenting behavior. Furthermore, we discuss how technical affordances such as default comment sorting determine the comment visibility and thus the salience of norms. Using data from a content analysis of 8162 comments on eight German news sites, we investigate how the two norm types influence deliberative forms of commenting. The results show that different types of salient injunctive and descriptive norms promote norm-compliant commenting. Furthermore, the default comment sorting can determine which comments are more or less salient. The results underline the importance of distinguishing different norm types in analyzing the quality of user comments in comment sections.
Social media literacy: A conceptual framework
Authors: Cho Hyunyi , Cannon Julie , Lopez Rachel , Li Wenbo
Published: January 2022

Concerns over the harmful effects of social media have directed public attention to media literacy as a potential remedy. Current conceptions of media literacy are frequently based on mass media, focusing on the analysis of common content and evaluation of the content using common values. This article initiates a new conceptual framework of social media literacy (SoMeLit). Moving away from the mass media-based assumptions of extant approaches, SoMeLit centers on the user’s self in social media that is in dynamic causation with their choices of messages and networks. The foci of analysis in SoMeLit, therefore, are one’s selections and values that influence and are influenced by the construction of one’s reality on social media; and the evolving characteristics of social media platforms that set the boundaries of one’s social media reality construction. Implications of the new components and dimensions of SoMeLit for future research, education, and action are discussed.
Audience size, moderator activity, gender, and content diversity: Exploring user participation and financial commitment on Twitch.tv
Authors: Wolff Grace H , Shen Cuihua
Published: January 2022

User participation has long been recognized as a cornerstone of thriving online communities. Social live-streaming service (SLSS) communities are built on a subscription-based model and rely on viewers’ participation and financial support. Using the collective effort model and heuristics of social influence, this study examines the influence of streamer and viewer behaviors on viewers’ participation and financial commitment on the SLSS, Twitch.tv. Findings from behavioral data collected over 7 weeks show larger audiences diminish individual participation and financial commitment while moderation may encourage more. Female streamers benefit from increased moderation, earning two to three times more in financial commitment compared to men, who streamed more frequently and for longer durations but attracted much smaller audiences. Viewers’ participation and financial commitment did not differ across streams with more content diversity. Our results demonstrate how group factors influence individual participation and financial commitment in newer subscription-based media.
‘We thought she was a witch’: Gender, class and whiteness in the familial ‘memory archive’
Authors: Hemmings Clare
Published: January 2022

‘We thought she was a witch’ uses my own ‘memory archive’ to give texture to the complex inheritance of gender, class and race that characterises the present. Drawing on interviews, archival data and fictionalisation, the article explores the role of gendered labour in securing dominant understandings of class progress. Starting from stories, my mother and I weave together of the history of 64 Chepstow Road, Newport (where her maternal family lived), I highlight the cost of historiography that does not pay attention to what is written out of family memory. The article draws on existing feminist memory work to flesh out an intersectional approach to the ‘memory archive’ we inherit and introduces the importance of an imaginative approach to the past.
Spectacular memory: Zombie pasts in the themed shopping malls of Dubai
Authors: O’Connor Paul
Published: January 2022

Memory invariably involves sifting and sorting historical traces and reassembling them into societal representations of the past. Usually this has been done by social groups of different kinds or the cultural institutions associated with them, and has provided materials for the construction and maintenance of group identity. In what I term “spectacular memory,” however, the sifting and sorting of memory traces is performed by commercial and media institutions within a globalized cultural framework to create spectacles for mass consumption. Spectacular memory is enabled by the progressive breakdown of Halbwach’s “social frameworks of memory”—the association of memory with face-to-face relations within social groups. In late modern societies, “memory” as a coherent body of representations which is the property of more-or-less bounded social groups has largely devolved into a globalized store of representations curated and diffused through the media, advertising, tourism and entertainment industries. This article uses the example of the history-themed shopping malls of Dubai to characterize this form of memory.
Civilizational mnemonics and the longue durée: The Bulgarian case
Authors: Nedelcheva Dafina , Levy Daniel
Published: January 2022

Constructivist assumptions have dominated the field of memory studies, producing an avalanche of case studies focusing on the instrumental and expedient factors shaping memory politics. However, this constructivist bias has also yielded new blind spots. For one, it tends to privilege “events” and “contingencies” over the longue durée of a particular memory configuration. Two, it remains caught in a binary juxtaposition with some states adopting globally circulating mnemonic scripts, signaling universal aspirations, while other states pursue nation-centric approaches. To overcome these blind spots (and binaries), we propose two interrelated conceptual moves: first, we are taking the importance of enduring memory figurations into consideration. Second, we expand the nation-state focus by introducing the notion of “civilizational mnemonics,” which does not replace national memories, but frequently underwrites them. Bulgarian memory politics, our test case, is part of a complex nexus of imperial legacies and post-colonial discourses. Bulgaria has been a middle ground, accommodating competing imperial projects—Ottoman, Russian, and Western. These intersections allow us to draw general inferences about mnemonic tropes and their enduring salience.
Knotted memories of a betrayed sacrifice: Rethinking trauma and hope in South Africa
Authors: Wale Kim
Published: January 2022

Different groups within South African society express disillusionment with the present through a discourse of betrayal in relation to the liberation movement-cum-governing-party of the African National Congress. This article focuses on a particular articulation of this discourse within two memory communities in the Western Cape (Bonteheuwel and Crossroads) who were embroiled in violence and political struggle during apartheid and continue to suffer conditions of structural violence in the post-apartheid era. It analyses the shared memory narrative of a ‘betrayed sacrifice’ to demonstrate a proposed theoretical concept of ‘knotted memories’ which describes the way in which past and present memories of suffering knot together to produce a lived affective condition of despair. It further considers what these everyday experiences of ‘knotted memories’ mean for re-thinking the nature of trauma and hope in relation to post-apartheid despair.
Trajectories of Persons with Visual Impairment: Narratives of a Woman
Authors: Panwar Preeti
Published: January 2022

This study discusses the lived-in experiences of a lady with visual impairment. The main objective of the study was to explore the trajectories of a female with visual impairment and understand life experiences from the lens of equality and justice perspectives. This study comes out with the finding that discrimination against visually impaired females is still prevalent in our society even after the enactment of acts and provision in Indian Constitution.
Effect of ramosetron, a 5-HT3 receptor antagonist on the severity of seizures and memory impairment in electrical amygdala kindled rats
Authors: Sayahi Zeynab , Komaki Alireza , Saidi Jam Masoud , Karimi Seyed Asaad , Raoufi Safoura , Mardani Parastoo , Naderishahab Marzieh , Sarihi Abdolrahman , Mirnajafi-Zadeh Javad
Published: January 2022

The entorhinal cortex (EC) plays a pivotal role in epileptogenesis and seizures. EC expresses high density of serotonergic receptors, especially 5-HT3 receptors. Cognitive impairment is common among people with epilepsy. The present study investigated the role of 5-HT3 receptor on the severity of seizures and learning and memory impairment by electrical kindling of amygdala in rats. The amygdala kindling was conducted in a chronic kindling manner in male Wistar rats. In fully kindled animals, ramosetron (as a potent and selective 5-HT3 receptor antagonist) was microinjected unilaterally (ad doses of 1, 10 or 100 µg/0.5 µl) into the EC 5 min before the novel object recognition (NOR) and Y-maze tests or kindling stimulations. Applying ramosetron at the concentration of 100 μg/0.5 µl (but not at 1 and 10 µg/0.5 µl) reduced afterdischarge (AD) duration and increased stage 4 latency in the kindled rats. Moreover, the obtained data from the NOR test showed that treatment by ramosetron (10 and 100 µg/0.5 µl) increased the discrimination index in the fully kindled animals. Microinjection of ramosetron (10 and 100 µg/0.5 µl) in fully kindled animals reversed the kindling induced changes in the percentage of spontaneous alternation in Y-maze task. The findings demonstrated an anticonvulsant role for a selective 5-HT3 receptor antagonist microinjected into the EC, therefore, suggesting an excitatory role for the EC 5-HT3 receptors in the amygdala kindling model of epilepsy. This anticonvulsive effect was accompanied with a restoring effect on cognitive behavior in NOR and Y-maze tests.
Identification of a ferroptosis-related gene pair biomarker with immune infiltration landscapes in ischemic stroke: a bioinformatics-based comprehensive study
Authors: Fan Jiaxin , Chen Mengying , Cao Shuai , Yao Qingling , Zhang Xiaodong , Du Shuang , Qu Huiyang , Cheng Yuxuan , Ma Shuyin , Zhang Meijuan , Huang Yizhou , Zhang Nan , Shi Kaili , Zhan Shuqin
Published: January 2022

Background

Ischemic stroke (IS) is a principal contributor to long-term disability in adults. A new cell death mediated by iron is ferroptosis, characterized by lethal aggregation of lipid peroxidation. However, a paucity of ferroptosis-related biomarkers early identify IS until now. This study investigated potential ferroptosis-related gene pair biomarkers in IS and explored their roles in immune infiltration.

Results

In total, we identified 6 differentially expressed ferroptosis-related genes (DEFRGs) in the metadata cohort. Of these genes, 4 DEFRGs were incorporated into the competitive endogenous RNA (ceRNA) network, including 78 lncRNA-miRNA and 16 miRNA-mRNA interactions. Based on relative expression values of DEFRGs, we constructed gene pairs. An integrated scheme consisting of machine learning algorithms, ceRNA network, and gene pair was proposed to screen the key DEFRG biomarkers. The receiver operating characteristic (ROC) curve witnessed that the diagnostic performance of DEFRG pair CDKN1A/JUN was superior to that of single gene. Moreover, the CIBERSORT algorithm exhibited immune infiltration landscapes: plasma cells, resting NK cells, and resting mast cells infiltrated less in IS samples than controls. Spearman correlation analysis confirmed a significant correlation between plasma cells and CDKN1A/JUN (CDKN1A: r = − 0.503, P < 0.001, JUN: r = − 0.330, P = 0.025).

Conclusions

Our findings suggested that CDKN1A/JUN could be a robust and promising gene-pair diagnostic biomarker for IS, regulating ferroptosis during IS progression via C9orf106/C9orf139-miR-22-3p-CDKN1A and GAS5-miR-139-5p/miR-429-JUN axes. Meanwhile, plasma cells might exert a vital interplay in IS immune microenvironment, providing an innovative insight for IS therapeutic target.
Left-censored recurrent event analysis in epidemiological studies: a proposal for when the number of previous episodes is unknown
Authors: Hernández-Herrera Gilma , Moriña David , Navarro Albert
Published: January 2022

Background

When dealing with recurrent events in observational studies it is common to include subjects who became at risk before follow-up. This phenomenon is known as left censoring, and simply ignoring these prior episodes can lead to biased and inefficient estimates. We aimed to propose a statistical method that performs well in this setting.

Methods

Our proposal was based on the use of models with specific baseline hazards. In this, the number of prior episodes were imputed when unknown and stratified according to whether the subject had been at risk of presenting the event before t = 0. A frailty term was also used. Two formulations were used for this “Specific Hazard Frailty Model Imputed” based on the “counting process” and “gap time.” Performance was then examined in different scenarios through a comprehensive simulation study.

Results

The proposed method performed well even when the percentage of subjects at risk before follow-up was very high. Biases were often below 10% and coverages were around 95%, being somewhat conservative. The gap time approach performed better with constant baseline hazards, whereas the counting process performed better with non-constant baseline hazards.

Conclusions

The use of common baseline methods is not advised when knowledge of prior episodes experienced by a participant is lacking. The approach in this study performed acceptably in most scenarios in which it was evaluated and should be considered an alternative in this context. It has been made freely available to interested researchers as R packagemiRecSurv.
Reporting methodological issues of the mendelian randomization studies in health and medical research: a systematic review
Authors: Islam Shabab Noor , Ahammed Tanvir , Anjum Aniqua , Albalawi Olayan , Uddin Md. Jamal
Published: January 2022

Background

Mendelian randomization (MR) studies using Genetic risk scores (GRS) as an instrumental variable (IV) have increasingly been used to control for unmeasured confounding in observational healthcare databases. However, proper reporting of methodological issues is sparse in these studies. We aimed to review published papers related to MR studies and identify reporting problems.

Methods

We conducted a systematic review using the clinical articles published between 2009 and 2019. We searched PubMed, Scopus, and Embase databases. We retrieved information from every MR study, including the tests performed to evaluate assumptions and the modelling approach used for estimation. Using our inclusion/exclusion criteria, finally, we identified 97 studies to conduct the review according to the PRISMA statement.

Results

Only 66 (68%) of the studies empirically verified the first assumption (Relevance assumption), and 40 (41.2%) studies reported the appropriate tests (e.g., R2, F-test) to investigate the association. A total of 35.1% clearly stated and discussed theoretical justifications for the second and third assumptions. 30.9% of the studies used a two-stage least square, and 11.3% used the Wald estimator method for estimating IV. Also, 44.3% of the studies conducted a sensitivity analysis to illuminate the robustness of estimates for violations of the untestable assumptions.

Conclusions

We found that incompleteness of the justification of the assumptions for the instrumental variable in MR studies was a common problem in our selected studies. This may misdirect the findings of the studies.
A blinded evaluation of privacy preserving record linkage with Bloom filters
Authors: Randall Sean , Wichmann Helen , Brown Adrian , Boyd James , Eitelhuber Tom , Merchant Alexandra , Ferrante Anna
Published: January 2022

Background

Privacy preserving record linkage (PPRL) methods using Bloom filters have shown promise for use in operational linkage settings. However real-world evaluations are required to confirm their suitability in practice.

Methods

An extract of records from the Western Australian (WA) Hospital Morbidity Data Collection 2011–2015 and WA Death Registrations 2011–2015 were encoded to Bloom filters, and then linked using privacy-preserving methods. Results were compared to a traditional, un-encoded linkage of the same datasets using the same blocking criteria to enable direct investigation of the comparison step. The encoded linkage was carried out in a blinded setting, where there was no access to un-encoded data or a ‘truth set’.

Results

The PPRL method using Bloom filters provided similar linkage quality to the traditional un-encoded linkage, with 99.3% of ‘groupings’ identical between privacy preserving and clear-text linkage.

Conclusion

The Bloom filter method appears suitable for use in situations where clear-text identifiers cannot be provided for linkage.
Four different frailty models predict health outcomes in older patients with stable chronic obstructive pulmonary disease
Authors: Zhang Dai , Tang Wen , Dou Li-Yang , Luo Jia , Sun Ying
Published: January 2022

Background

Frail patients with chronic obstructive pulmonary disease (COPD) face a higher risk of adverse outcomes, but there is no clear consensus on which frailty measures are most suitable for COPD patients. Herein we evaluated the ability of frailty measurements in predicting 1-year acute exacerbation, hospitalization, and mortality in older patients with COPD.

Methods

A total of 302 patients [median age: 86 years (IQR: 80–90), 22.2% female] were admitted to the Department of Geriatric Medicine were prospectively enrolled in this study. Frailty status was assessed using the Fried Frailty Phenotype (FFP), Clinical Frailty Scale (CFS), Frailty Index of Accumulative Deficits (FI-CD), and Short Physical Performance Battery (SPPB). Cox proportional hazard regression and Poisson regression were used to evaluating the association of the adverse outcomes with frailty as assessed using the four instruments. The discrimination accuracy of these tools in predicting the 1-year all-cause mortality was also compared.

Results

Prevalence of frailty ranged from 51% (using FFP) to 64.2% (using CFS). The four frail instruments were associated with 1-year mortality. After an average follow-up time of 2.18 years (IQR: 1.56–2.62 years), frailty as defined by four instruments (except for FI-CD), was associated with death [FFP: Hazard ratio (HR) = 3.11, 95% confidence interval (CI) 1.30–7.44; CFS: HR = 3.68, 95% CI 1.03–13.16; SPPB: HR = 3.74, 95% CI 1.39–10.06). Frailty was also associated with acute exacerbation (using FFP) and hospitalization (using FFP, CFS, and FI-CD). Frail showed a moderate predictive ability [area under the curve ranging (AUC) 0.70–0.80] and a high negative predictive value (0.98–0.99) for 1-year mortality.

Conclusions

With the four different frailty assessment tools, frailty was associated with poor prognosis in older patients with stable COPD. The FFP, CFS, FI-CD, and SPPB instruments showed similar performance in predicting 1-year mortality.
Caregivers of people with dementia and mental health during COVID-19: findings from a cross-sectional study
Authors: Messina Anna , Lattanzi Martina , Albanese Emiliano , Fiordelli Maddalena
Published: January 2022

Background

There is sparse evidence on the impact on vulnerable populations of the COVID-19 pandemic. The aim of our study was to explore burden and mental wellbeing (including depressive, anxiety, and stress symptoms) in caregivers of people with dementia during the first wave of the pandemic in Italy and southern Switzerland, two bordering regions severely hit by the COVID-19 pandemic.

Methods

We conducted an online cross-sectional survey with family carers of people with dementia between May and June 2020. We registered socio-demographic characteristics, and information about the relationship with the care recipient, dementia subtype, care inputs from others, and the need of care of the person with dementia. We measured caregiver burden with the Zarit Burden Interview (ZBI), psychological distress with the Depression, Anxiety and Stress Scale (DASS-21), and perceived isolation with the 3-item UCLA Loneliness Scale (UCLALS3).

Results

Caregivers (N =571) reported moderate to severe care-related burden (mean=54.30; SD=18.33), moderate anxiety symptoms (mean=10.04; SD=6.93), mild depressive symptoms (mean=11.79; SD=6.12) and mild stress (mean=12.95; SD=5.53), and 72.3% of participants reported to feel lonely. All scores were significantly more severe in Swiss compared to Italian caregivers (all p values<0.001).

Conclusions

We found that caregivers’ burden, anxiety symptoms, depression and perceived loneliness were marked during the first wave of the COVID-19 pandemic, in two severely hit bordering countries. Regional differences in the impact of the epidemic on caregivers could be due to contextual, societal, and cultural circumstances. As the pandemic endures, support to caregivers of people with dementia should be proportionate and tailored to needs and adapted to contextual factors.
Seroprevalence of anti-SARS-CoV-2 antibodies among staff at primary healthcare institutions in Prishtina
Authors: Halili Rrezart , Bunjaku Jeta , Gashi Bujar , Hoxha Teuta , Kamberi Agron , Hoti Nexhmedin , Agahi Riaz , Basha Vlora , Berisha Visar , Hoxha Ilir
Published: January 2022

Background

Many studies examined the spread of SARS-CoV-2 within populations using seroprevalence. Healthcare workers are a high-risk population due to patient contact, and studies are needed to examine seroprevalence of SARS-CoV-2 antibodies among healthcare workers. Our study investigates the seroprevalence of anti-SARS-CoV-2 antibodies among staff at primary healthcare institutions in Prishtina, and factors associated with seroprevalence.

Methods

We carried out a cross-sectional survey including SARS-CoV-2 serological testing and questionnaires with primary healthcare workers from primary healthcare facilities in the Prishtina, the capital city of Kosovo. We calculated prevalence of anti-SARS-CoV-2 antibodies, and of self-reported positive PCR test among primary healthcare workers, as well as crude and adjusted ORs for explanatory factors.

Results

Eighty-three of the healthcare workers (17.47%) tested positive for SARS-CoV-2 antibodies IgG or IgM, while 231 (48.63%) either had antibodies or a previous positive PCR test. Odds of seropositivity were affected by male gender (OR 2.08, 95% CI 1.20, 3.61), and infected family members (OR 3.61, 95% CI 2.25, 5.79) of healthcare workers. Higher education, being part of larger families and having infected family members gave higher odds of positive PCR test and seropositivity. Other healthcare workers had lower odds of positive PCR test and seropositivity than physicians.

Conclusion

Over 17% of healthcare workers were seropositive for SARS-CoV-2 antibodies and close to half of them were either seropositive or PCR self-reported positive test. Several factors are associated with decreased and increased odds for such outcomes. These findings should be explored further and addressed to Kosovo policy makers, and assist them to intensify vaccination efforts, and maintain control measures until we achieve herd immunity.
Prediction of chronic kidney disease after orthotopic liver transplantation: development and validation of a nomogram model
Authors: Guo Dandan , Wang Huifang , Liu Jun , Liu Hang , Zhang Ming , Fu Zixuan , Liu Xuemei
Published: January 2022

Background

We aimed to develop and validate a nomogram model for predicting CKD after orthotopic liver transplantation (OLT).

Methods

The retrospective data of 399 patients who underwent transplantation and were followed in our centre were collected. They were randomly assigned to the training set (n = 293) and validation set (n = 106). Multivariable Cox regression analysis was performed in the training set to identify predictors of CKD. According to the Cox regression analysis results, a nomogram model was developed and validated. The renal function of recipients was monitored, and the long-term survival prognosis was assessed.

Results

The incidence of CKD at 5 years after OLT was 25.6%. Cox regression analysis identified several predictors of post-OLT CKD, including recipient age at surgery (HR 1.036, 95% CI 1.006-1.068; p = 0.018), female sex (HR 2.867, 95% CI 1.709-4.810; p < 0.001), preoperative hypertension (HR 1.670, 95% CI 0.962-2.898; p = 0.068), preoperative eGFR (HR 0.996, 95% CI 0.991-1.001; p = 0.143), uric acid at 3 months (HR 1.002, 95% CI 1.001-1.004; p = 0.028), haemoglobin at 3 months (HR 0.970, 95% CI 0.956-0.983; p < 0.001), and average concentration of cyclosporine A at 3 months (HR 1.002, 95% CI 1.001-1.003; p < 0.001). According to these parameters, a nomogram model for predicting CKD after OLT was constructed and validated. The C-indices were 0.75 and 0.80 in the training and validation sets. The calibration curve of the nomogram showed that the CKD probabilities predicted by the nomogram agreed with the observed probabilities at 1, 3, and 5 years after OLT (p > 0.05). Renal function declined slowly year by year, and there were significant differences between patients divided by these predictors. Kaplan-Meier survival analysis showed that the survival prognosis of recipients decreased significantly with the progression of renal function.

Conclusions

With excellent predictive abilities, the nomogram may be a simple and reliable tool to identify patients at high risk for CKD and poor long-term prognosis after OLT.
Left ventricular mass regression, all-cause and cardiovascular mortality in chronic kidney disease: a meta-analysis
Authors: Maki Kevin C. , Wilcox Meredith L. , Dicklin Mary R. , Kakkar Rahul , Davidson Michael H.
Published: January 2022

Background

Cardiovascular disease is an important driver of the increased mortality associated with chronic kidney disease (CKD). Higher left ventricular mass (LVM) predicts increased risk of adverse cardiovascular outcomes and total mortality, but previous reviews have shown no clear association between intervention-induced LVM change and all-cause or cardiovascular mortality in CKD.

Methods

The primary objective of this meta-analysis was to investigate whether treatment-induced reductions in LVM over periods ≥12 months were associated with all-cause mortality in patients with CKD. Cardiovascular mortality was investigated as a secondary outcome. Measures of association in the form of relative risks (RRs) with associated variability and precision (95% confidence intervals [CIs]) were extracted directly from each study, when reported, or were calculated based on the published data, if possible, and pooled RR estimates were determined.

Results

The meta-analysis included 42 trials with duration ≥12 months: 6 of erythropoietin stimulating agents treating to higher vs. lower hemoglobin targets, 10 of renin-angiotensin-aldosterone system inhibitors vs. placebo or another blood pressure lowering agent, 14 of modified hemodialysis regimens, and 12 of other types of interventions. All-cause mortality was reported in 121/2584 (4.86%) subjects in intervention groups and 168/2606 (6.45%) subjects in control groups. The pooled RR estimate of the 27 trials ≥12 months with ≥1 event in ≥1 group was 0.72 (95% CI 0.57 to 0.90, p = 0.005), with little heterogeneity across studies. Directionalities of the associations in intervention subgroups were the same. Sensitivity analyses of ≥6 months (34 trials), ≥9 months (29 trials), and >12 months (10 trials), and including studies with no events in either group, demonstrated similar risk reductions to the primary analysis. The point estimate for cardiovascular mortality was similar to all-cause mortality, but not statistically significant: RR 0.67, 95% CI 0.39 to 1.16.

Conclusions

These results suggest that LVM regression may be a useful surrogate marker for benefits of interventions intended to reduce mortality risk in patients with CKD.
Heart work: Indigenous doulas responding to challenges of western systems and revitalizing Indigenous birthing care in Canada
Authors: Doenmez Caroline Fidan Tyler , Cidro Jaime , Sinclair Stephanie , Hayward Ashley , Wodtke Larissa , Nychuk Alexandra
Published: January 2022

Background

In Canada, there has been a significant increase in the training of Indigenous doulas, who provide continuous, culturally appropriate support to Indigenous birthing people during pregnancy, birth, and the postpartum period. The purpose of our project was to interview Indigenous doulas across Canada in order to document how they worked through the logistics of providing doula care and to discern their main challenges and innovations.

Population/setting

Our paper analyzes interviews conducted with members of five Indigenous doula collectives across Canada, from the provinces of British Columbia, Manitoba, Ontario, Quebec and Nova Scotia.

Methods

Semi-structured interviews were conducted with members of the five Indigenous doula collectives across Canada in 2020 as part of the project, “She Walks With Me: Supporting Urban Indigenous Expectant Mothers Through Culturally Based Doulas.” Interview transcripts were approved by participants and subsequently coded by the entire research team to identify key themes.

Results

Our paper examines two themes that emerged in interviews: the main challenges Indigenous doulas describe confronting when working within western systems, and how they navigate and overcome these obstacles. Specifically, interview participants described tensions with the biomedical approach to maternal healthcare and conflicts with the practice of Indigenous infant apprehension. In response to these challenges, Indigenous doulas are working to develop Indigenous-specific doula training curricula, engaging in collective problem-solving, and advocating for the reformation of a grant program in order to fund more Indigenous doulas.

Conclusions

Both the biomedical model of maternal healthcare and the crisis of Indigenous infant apprehension renders Canadian hospitals unsafe and uncomfortable spaces for many Indigenous birthing people and their families. Indigenous doulas are continually navigating these challenges and creatively and concertedly working towards the revitalization of Indigenous birthing care. Indigenous doula care is critical to counter systemic, colonial barriers and issues that disproportionately impact Indigenous families, as well as recentering birth as the foundation of Indigenous sovereignty and community health.
Prevalence of depressive symptoms and correlated factors among pregnant women during their second and third trimesters in northwest rural China: a cross-sectional study
Authors: Chang Fang , Fan Xin , Zhang Yi , Tang Bin , Jia Xiyuan
Published: January 2022

Background

The depression mood during their second and third trimesters has a negative impact on both the mother and her child. Compared with pregnant women in urban areas, rural pregnant women who are in more disadvantaged situation may have more serious psychological problems. Particular, many rural pregnant women had internal migrant work experience during pregnancy in rural China. It is thus necessary to study the prevalence of depressive symptoms and correlated factors among Chinese northwest rural pregnant women.

Methods

This study was conducted from October 2017 to April 2018 and surveyed 1053 pregnant women in the middle and late stages of pregnancy who were registered in rural areas, gave informed consent and did not suffer from cognitive impairment or severe mental illness. Depressive symptoms were evaluated by the Chinese Version of the Short Depression Anxiety and Stress Scale (DASS-C21). Demographic characteristics, pregnancy characteristics and family factors were obtained through structured questionnaires. This study employed multiple factor logistic regression to analyze the relationship between depressive symptoms and their correlates.

Results

The prevalence of depressive symptoms among pregnant women during their second and third trimesters was 16.14% (95%CI 13.92%-18.36%). Higher education levels (OR = 0.50; 95%CI 0.29–0.85) and taking folic acid (OR = 0.59; 95%CI 0.39–0.89) reduced the risk of depression symptoms. The family receiving rural welfare (OR = 1.69; 95%CI 1.04–2.75), migration for work (OR = 1.95; 95%CI 1.03–3.71) and living with both parents and parents-in-law (OR = 2.55; 95%CI 1.09–5.96) increased the risk of depressive symptoms.

Conclusions

The prevalence of depressive symptoms among pregnant women during their second and third trimesters in Northwest rural China was 16.14% that was nearly 4 percentage points higher than the average survey result of the pregnant women in developed countries and was higher than the findings in Chinese urban areas. To prevent depression symptoms, it’s essential to early screen and provide folic acid for free when antenatal examination. Moreover, maternal examination files should be established so that wo pay attention to the psychological status of pregnant women who were with low education levels, poor family economic situations, excessive parental burden and who had been migrant workers.
Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia
Authors: Fekadu Binyam , Ali Ismael , Tafesse Zergu , Segni Hailemariam
Published: January 2022

Background

Essential newborn care (ENC) is a package of interventions which should be provided for every newborn baby regardless of body size or place of delivery immediately after birth and should be continued for at least the seven days that follows. Even though Ethiopia has endorsed the implementation of ENC, as other many counties, it has been challenged. This study was conducted to measure the level of essential newborn care practice and identify health facility level attributes for consistent delivery of ENC services by health care providers.

Methods

This study employed a retrospective cross-sectional study design in 425 facilities. Descriptive statistics were formulated and presented in tables. Binary logistic regression was employed to assess the statistical association between the outcome variable and the independent variables. All variables with p < 0.2 in the bivariate analysis were identified as candidate variables. Then, multiple logistic regression analysis was performed using candidate variables to determine statistically significant predictors of the consistent delivery of ENC by adjusting for possible confounders.

Results

A total of 273, (64.2%), of facilities demonstrated consistent delivery of ENC. Five factors—availability of essential obstetrics drugs in delivery rooms, high community score card (CSC) performances, availability of maternity waiting homes, consistent partograph use, and availability of women-friendly delivery services were included in the model. The strongest predictor of consistent delivery of essential newborn care (CD-ENC) was consistent partograph use, recording an odds ratio of 2.66 (AOR = 2.66, 95%CI: 1.71, 4.13). Similarly, providing women-friendly services was strongly associated with increased likelihood of exhibiting CD-ENC. Furthermore, facilities with essential obstetric drugs had 1.88 (AOR = 1.88, 95%CI: 1.15, 3.08) times higher odds of exhibiting consistent delivery of ENC.

Conclusion

The delivery of essential newborn care depends on both health provider and facility manager actions and availability of platforms to streamline relationships between the clients and health facility management.
Using deep learning to predict the outcome of live birth from more than 10,000 embryo data
Authors: Huang Bo , Zheng Shunyuan , Ma Bingxin , Yang Yongle , Zhang Shengping , Jin Lei
Published: January 2022

Background

Recently, the combination of deep learning and time-lapse imaging provides an objective, standard and scientific solution for embryo selection. However, the reported studies were based on blastocyst formation or clinical pregnancy as the end point. To the best of our knowledge, there is no predictive model that uses the outcome of live birth as the predictive end point. Can a deep learning model predict the probability of live birth from time-lapse system?

Methods

This study retrospectively analyzed the time-lapse data and live birth outcomes of embryos samples from January 2018 to November 2019. We used the SGD optimizer with an initial learning rate of 0.025 and cosine learning rate reduction strategy. The network is randomly initialized and trained for 200 epochs from scratch. The model is quantitively evaluated over a hold-out test and a 5-fold cross-validation by the average area under the curve (AUC) of the receiver operating characteristic (ROC) curve.

Results

The deep learning model was able to predict live birth outcomes from time-lapse images with an AUC of 0.968 in 5-fold stratified cross-validation.

Conclusions

This research reported a deep learning model that predicts the live birth outcome of a single blastocyst transfer. This efficient model for predicting the outcome of live births can automatically analyze the time-lapse images of the patient’s embryos without the need for manual embryo annotation and evaluation, and then give a live birth prediction score for each embryo, and sort the embryos by the predicted value.
Strategies to improve the quality of midwifery care and developing midwife-centered care in Iran: analyzing the attitudes of midwifery experts
Authors: Khosravi Shahla , Babaey Farah , Abedi Parvin , Kalahroodi Zohreh Mazaheri , Hajimirzaie Saeideh Sadat
Published: January 2022

Background

In recent years, extensive studies have been designed and performed in the context of providing midwifery care in developed countries, which has been unfortunately neglected in some low resources and upper middle-income countries such as Iran. This study was conducted to identify the best strategies for improving the quality of midwifery care and developing midwife-centered care in Iran.

Methods

This was a qualitative study using focus group discussion and content analysis method. Data were collected from 121 participants including midwifery board members, gynecologists, heads of midwifery departments, midwifery students, in charge midwives in hospitals, and midwives in the private sector. Focused-group discussions were used for data collection, and data were analyzed using content analysis method.

Results

The main themes extracted from the participants’ statements regarding improving the quality of midwifery care were as follows: Promotion and development of education, Manpower management, Rules, and regulations and standards for midwifery services, and Policy making.

Conclusion

This study showed that to improve midwifery care, health policy makers should take into account both the quality and quantity of midwifery education, and promote midwifery human resources through employment. Furthermore, insurance support, encouragement, supporting and motivating midwives, enhancing and improving the facilities, providing hospitals and maternity wards with cutting-edge equipment, promoting and reinforcing the position of midwives in the family doctor program, and using a referral system were the strategies proposed by participants for improving midwifery care. Finally, establishing an efficient and powerful monitoring system to control the practice of gynecologists and midwives, promoting the collaborative practice of midwives and gynecologists, and encouraging team-work with respect to midwifery care were other strategies to improve the midwifery services in Iran. Authorities and policymakers may set the stage for developing high quality and affordable midwifery care by relying on the strategies presented in this study.
Comparison of surgical outcomes and prognosis between wedge resection and simple Segmentectomy for GGO diameter between 2 cm and 3 cm in non-small cell lung cancer: a multicenter and propensity score matching analysis
Authors: Zhou Yaodong , Yu Tao , Zhang Yixin , Qian Liqiang , Xia Qing
Published: January 2022

Background

As segmentectomy had become commonly used for Non-Small Cell Lung Cancer (NSCLC) treatment, which had the advantages of radical operation, however, it remains controversial owing to procedural complexity and risk of increased complications compared with wedge resection. We evaluated operative and postoperative outcomes of simple segmentectomy compared to wedge resection in ground-glass opacity (GGO) diameter between 2 cm and 3 cm NSCLC.

Methods

We retrospectively reviewed 1600 clinical GGO diameter between 2 cm and 3 cm NSCLC patients who received simple segmentectomy and wedge resection between Jan 2011 and Jan 2015. Participants were matched 1:1 on their propensity score for two groups. Clinic-pathologic, operative, and postoperative results of two groups were compared.

Results

After using propensity score methods to create a matched cohort of participants with simple segmentectomy group similar to that wedge resection, there were no significant differences detected in tumor size, margin distance, histology, age, sex, preoperative comorbidities and preoperative pulmonary function. Overall complications in simple segmentectomy group were more than wedge resection group (21% vs 3%, p = 0.03). Median operative time (110.6 vs. 71.2 min; p = 0.01) and prolonged air leakage (12% vs. 3%; p = 0.02) was significantly longer in the simple segmentectomy group. There was no difference in recurrence free survival (RFS) and overall survival (OS) of 5-years between simple segmentectomy group and wedge resection group. Postoperative pulmonary function in simple segmentectomy group recovered more slowly than wedge resection group.

Conclusion

Wedge resection may have comparable efficacy as simple segmentectomy for GGO diameter between 2 cm and 3 cm NSCLC, but lead to less complications, less surgical procedure and faster recovery of pulmonary function.
Women’s health behaviour change after receiving breast cancer risk estimates with tailored screening and prevention recommendations
Authors: Rainey Linda , van der Waal Daniëlle , Donnelly Louise S. , Southworth Jake , French David P. , Evans D. Gareth , Broeders Mireille J. M.
Published: January 2022

Background

The Predicting Risk of Cancer at Screening (PROCAS) study provided women who were eligible for breast cancer screening in Greater Manchester (United Kingdom) with their 10-year risk of breast cancer, i.e., low (≤1.5%), average (1.5–4.99%), moderate (5.-7.99%) or high (≥8%). The aim of this study is to explore which factors were associated with women’s uptake of screening and prevention recommendations. Additionally, we evaluated women’s organisational preferences regarding tailored screening.

Methods

A total of 325 women with a self-reported low (n = 60), average (n = 125), moderate (n = 80), or high (n = 60) risk completed a two-part web-based survey. The first part contained questions about personal characteristics. For the second part women were asked about uptake of early detection and preventive behaviours after breast cancer risk communication. Additional questions were posed to explore preferences regarding the organisation of risk-stratified screening and prevention. We performed exploratory univariable and multivariable regression analyses to assess which factors were associated with uptake of primary and secondary breast cancer preventive behaviours, stratified by breast cancer risk. Organisational preferences are presented using descriptive statistics.

Results

Self-reported breast cancer risk predicted uptake of (a) supplemental screening and breast self-examination, (b) risk-reducing medication and (c) preventive lifestyle behaviours. Further predictors were (a) having a first degree relative with breast cancer, (b) higher age, and (c) higher body mass index (BMI). Women’s organisational preferences for tailored screening emphasised a desire for more intensive screening for women at increased risk by further shortening the screening interval and moving the starting age forward.

Conclusions

Breast cancer risk communication predicts the uptake of key tailored primary and secondary preventive behaviours. Effective communication of breast cancer risk information is essential to optimise the population-wide impact of tailored screening.
An estimate of rate of deviation from NCCN guideline recommendations for central nervous system imaging in trials forming basis for drug approval in first line advanced non-small cell lung cancer (NSCLC)
Authors: Sharp John , Prasad Vinay
Published: January 2022

Importance

It is unknown whether and to what degree trials submitted to the US FDA to support drug approval adhere to NCCN guideline-recommended care in their baseline and surveillance CNS imaging protocols.

Objective

We sought to characterize the frequency with which the trials cited in US FDA drug approvals for first line advanced NSCLC between 2015 and 2020 deviated from NCCN guideline-recommended care for baseline and surveillance CNS imaging.

Design, setting, and participants

Retrospective observational analysis using publicly available data of (1) list of trials cited by the FDA in drug approvals for first line advanced NSCLC from 2015 to 2020 (2) individual trial protocols (3) published trial data and supplementary appendices (4) archived versions of the NCCN guidelines for NSCLC from 2009 to 2018 (the years during which the trials were enrolling).

Main outcomes and measures

Estimated percentage of trials for first line advanced NSCLC leading to FDA approval which deviated from NCCN guideline-recommended care with regards to CNS baseline and surveillance imaging.

Results

A total of 14 studies that had been cited in FDA drug approvals for first line advanced NSCLC met our inclusion criteria between January 1, 2015 and September 30, 2020. Of these trials, 8 (57.1%) deviated from NCCN guidelines in their baseline CNS imaging requirement. The frequency of re-assessment of CNS disease was variable amongst trials as well, with 9 (64.3%) deviating from NCCN recommendations.

Conclusions and relevance

The trials supporting US FDA drug approvals in first line advanced NSCLC often have CNS imaging requirements that do not adhere to NCCN guidelines. Many trials permit alternative, substandard methods and the proportion of patients undergoing each modality is uniformly not reported. Nonstandard CNS surveillance protocols are common. To best serve patients with advanced NSCLC in the US, drug approvals by the FDA must be based on trials that mirror clinical practice and have imaging requirements consistent with current US standard of care.