bluuebunny/crossref_metadata_2025 huggingface dataset:
Community-based tourism in East Asia: A bibliometric research note
Authors: Tham Aaron , Chin Shirley Wei Lee
Published: May 2022

Community-based tourism (CBT) is part of East Asia’s tourism landscape as local communities seek to diversify their livelihoods towards tourism. However, little is known about the evolution of research surrounding CBT in the region. Through undertaking a bibliometric analysis of 401 Scopus-indexed articles, this research found that CBT practices have increasingly questioned the legitimacy and authenticity of its value to local communities. Findings also illustrated most studies centred on China, and co-authorship networks mostly occurring between research supervisors and their students. Theoretical and practical insights to advance CBT research in East Asia are proposed.
Technology-Facilitated Abuse Against Women From Culturally and Linguistically Diverse Backgrounds: A Scoping Review of the Literature
Authors: Leyton Zamora Carolina , Boddy Jennifer , O'Leary Patrick , Liang Jianqiang
Published: May 2022

Women from culturally and linguistically diverse (CALD) backgrounds are particularly vulnerable to domestic and family violence, including technology-facilitated abuse. Often CALD women depend on technology to connect with support networks in their home country. Technology-facilitated abuse can be devastating and isolating. There is limited comprehensive knowledge of how technology-facilitated abuse is experienced by CALD women. This scoping review addresses this gap by exploring and analysing the available literature on technology-facilitated abuse amongst CALD women in the context of domestic and family violence. Employing a scoping review methodology, a total of nine studies were identified from a database search and other sources (including snowball, web search, and search verification processes). Studies were included if they contained the following three elements: (1) a focus on technology-facilitated abuse, (2) the inclusion of CALD women’s experiences, and (3) a context of domestic and family violence (DFV). This review firstly maps the methodologies and characteristics of the studies. Second, the most common types of technology-facilitated abuse that disproportionally affect CALD women are identified together with culturally related help-seeking barriers. Areas for future research are discussed along with suggestions for improving practises and policies for prevention and intervention.
Extraction and Optimization of Active Metabolites From Cluster Bean: An In Vitro Biological and Phytochemical Investigation
Authors: Riaz Saima , Hussain Iqbal , Ibrahim Muhammad , Ishtiaq Muhmmad , Ali Qasim , Muazzam Ali Muhammad , Sajid Hamid Akash Muhammad
Published: May 2022

The current study aimed to explore active metabolites of locally recognized and high yielding cultivar cluster bean (BR-99) with a wide range of adaptability having antioxidant, antidiabetic, antimicrobial, and cytotoxic potential. Six solvents were used (crude methanol, n-hexane, chloroform, ethyl acetate, butanol, and aqueous) with escalating polarity for colorimetric determination of antioxidants such as total phenolic contents (TPC), total flavonoid contents (TFC), and free radical scavenging activity (FRSA) by DPPH (2, 2-diphenyl-1-picrylhydrazyl) assay. Moreover, an antidiabetic and anticancer study was conducted by α-amylase inhibition and MTT (3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-tetrazolium bromide) assay. Biological investigations were carried out against the most commonly found infectious microbial strains. The significant results (P ≤ .001) of each activity were seen among six tested solvent extracts. The ethyl acetate and methanol extract have more antioxidant potential with the highest TPC (16.38 ± .13 mg GAE/g) and TFC (8.15 ± .24 mg CE/g), respectively. Similarly, methanol extract presented the highest free radical scavenging activity (46.31 ± .91%), followed by ethyl acetate, butanol, chloroform, aqueous, and n-hexane extract. However, the maximum α-amylase inhibition (62.54 ± 1.47%) and anticancer activity against human lung cancer cells were congregated (78.31 ± 1.46%) in butanol and chloroform, respectively. A positive correlation was seen between TPC with TFC ( R2= .8356), FRSA ( R2= .8381), and anti-diabetic activity ( R2= .8082), which highlights the phenolic contents as strong anti-oxidant agents especially flavonoids. Each extract of cluster bean (BR-99) showed significant antimicrobial activities for all tested bacterial strains except B. cereus and E. coli. The profound results of maximum antibacterial activity were witnessed by chloroform extract while ethyl acetate extracts showed great antifungal potential against all tested fungal strains. The HPLC quantitative analysis results of cluster bean (BR-99) revealed the presence of active phytochemicals such as gallic acid, HB acid, vanillic acid, kaempferol, sinapic acid, ferulic acid, salicylic acid, coumarins, quercetin, rutin, p-coumaric acid, and catechin, and the variation in both phytochemical and biological spectrums envisioned the cluster bean (BR-99) used in future as a cheap, safer, and potent source of bioactive drugs.
Long non-coding RNA RMST serves as a diagnostic biomarker in patients with carotid artery stenosis and predicts the occurrence of cerebral ischemic event: A retrospective study
Authors: Wang Cui , Zhao Feng , He Yunliang , E Yajun , Li Shanfeng
Published: May 2022

Objectives

The purpose of this retrospective study is to explore the diagnostic and prognostic roles of serum RMST in carotid artery stenosis (CAS).

Methods

Serum levels of RMST were detected in CAS patients, and the relationship between degree of carotid stenosis and RMST levels was analyzed. The ROC curve was drawn to evaluate RMST value in predicting the risk of CAS. Then, all CAS patients received a 5-year follow-up. K-M curve was used to analyze the significance of RMST on prognosis of CAS patients. Multi-factor cox logistic regression analysis was conducted to evaluate independent factors for outcome of CAS patients.

Results

An increased RMST expression was certified in CAS patients when compared with healthy controls. The increase of serum RMST expression was related to high degree of carotid stenosis. In addition, serum RMST was a possible diagnosis and an independent influencing factor of prognosis in patients with CAS.

Conclusions

Raised serum RMST level was found in patients with CAS. Detecting RMST expression levels was of high value for predicting the occurrence and outcomes in CAS.
Book Review: Creative social change: Leadership for a healthy world
Authors: Bozkurt Bilgehan
Published: May 2022

In the book entitled “Creative social change: Leadership for a healthy world” which was published before the novel Coronavirus pandemic, there could be lessons that organizations have neglected. Its main argument implies that health together with effectiveness could help leadership sustain their organizations for a healthy world. Correspondingly, this actionable book review aims to provide implications that could help organizations become or stay healthy during the pandemic. A critical analysis of the book’s contents reveals that it could be reasonable to start with gender equality for women before everything else in order to have healthy organizations during the pandemic. Health could improve through gender equality, trust-based partnerships, adaptation to environment, and involving in organizational (and entrepreneurial) activities. This contribution is intriguing for three reasons. Firstly, it provides actionable recommendations during increased uncertainty. Secondly, it prioritizes a sustainable development goal. Thirdly, it is an attempt to strengthen the sustainable development goals that are under challenges. Therefore, the link among health, leadership, sustainability, and organization in the book and the above road map in the book review could be inspiring.
Resilience in the pandemic: Remote learning on the fly
Authors: Chang Isabelle
Published: May 2022

This study examined students’ learning adjustments in an introductory statistics class in response to the unexpected challenge presented by the COVID-19 pandemic. Results show significant correlations in grades, page views, and on-time assignment submissions (OTAS) suggesting that the in-person and online learning modalities were comparable. The distributions of student learning activities were narrowly clustered around the means with smaller standard deviations recorded during the online sessions. Grades were positively correlated with OTAS for the in-person classes. For online classes using synchronous screen sharing, grades were positively associated with attendance; however, they were negatively influenced by the numbers of page views in the learning management system. The relations between attendance and achievement might be influenced by the complexity of content material. Students benefited more from attending classes in technical topics such as inferential statistics compared to descriptive statistics. It appears that participating in synchronous classes was a more effective means of learning inferential statistics than merely reviewing the instructor’s notes. In contrast, no correlation between grades and attendance was observed for in-person learning sessions covering descriptive statistics. There were no differences in learning adjustments between male and female students and both showed substantial resilience in adapting to the changes. Students unanimously looked forward to returning to campus. This study suggests it is the students’ individual learning approaches and behaviors that have a greater impact on their learning outcomes than the modality in which they are taught. Course designs and assignment formats might be factors that influenced students’ attendance and OTAS.
Effects of Gehl’s urban design guidelines on walkability: A virtual reality experiment in Singaporean public housing estates
Authors: Silvennoinen Heidi , Kuliga Saskia , Herthogs Pieter , Recchia Daniela Rodrigues , Tunçer Bige
Published: May 2022

Walkability has become an important theme of urban design research and practice. Evidence suggests that environmental attractiveness can have a significant impact on the amount of walking activities that take place, but relatively little research exists on which environmental features linked to attractiveness increase walkability. Using a virtual reality experiment, the present study examined the effects on walkability of three key features, as defined by Jan Gehl, an influential urban planning practitioner and theorist: liveliness, high-quality façades and low buildings. A virtual reality simulation allowed isolating the effects of these features, while avoiding confounding factors, such as the presence of shops, which has been difficult to do in past field studies. Our study confirmed that the combination of features recommended by Gehl promoted walking activity in the study’s context. Further exploratory analyses suggested that improved façade quality was positively linked to walking activity, and that building height and liveliness had negligible effects. Our findings contribute to the existing understanding of walkability, which may benefit urban planning practice and models of walkability. Further research is necessary to confirm our results regarding the effects of specific features on walking activity in different contexts.
An optimal variant to gene distance window derived from an empirical definition of cis and trans protein QTLs
Authors: Fauman Eric B. , Hyde Craig
Published: May 2022

Background

A genome-wide association study (GWAS) correlates variation in the genotype with variation in the phenotype across a cohort, but the causal gene mediating that impact is often unclear. When the phenotype is protein abundance, a reasonable hypothesis is that the gene encoding that protein is the causal gene. However, as variants impacting protein levels can occur thousands or even millions of base pairs from the gene encoding the protein, it is unclear at what distance this simple hypothesis breaks down.

Results

By making the simple assumption that cis-pQTLs should be distance dependent while trans-pQTLs are distance independent, we arrive at a simple and empirical distance cutoff separating cis- and trans-pQTLs. Analyzing a recent large-scale pQTL study (Pietzner in Science 374:eabj1541, 2021) we arrive at an estimated distance cutoff of 944 kilobasepairs (95% confidence interval: 767–1,161) separating the cis and trans regimes.

Conclusions

We demonstrate that this simple model can be applied to other molecular GWAS traits. Since much of biology is built on molecular traits like protein, transcript and metabolite abundance, we posit that the mathematical models for cis and trans distance distributions derived here will also apply to more complex phenotypes and traits.
How effective are chest compressions when wearing mask? A randomised simulation study among first-year health care students during the COVID-19 pandemic
Authors: Bánfai Bálint , Musch János , Betlehem József , Sánta Emese , Horváth Balázs , Németh Dániel , Bánfai-Csonka Henrietta
Published: May 2022

Background

The resuscitation guidelines provided for the COVID-19 pandemic strongly recommended wearing personal protective equipment. The current study aimed to evaluate and compare the effectiveness of chest compressions and the level of fatigue while wearing two different types of mask (surgical vs. cloth).

Methods

A randomized, non-inferiority, simulation study was conducted. Participants were randomised into two groups: surgical mask group (n = 108) and cloth mask group (n = 108). The effectiveness (depth and rate) of chest compressions was measured within a 2-min continuous chest-compression-only CPR session. Data were collected through an AMBU CPR Software, a questionnaire, recording vital parameters, and using Borg-scale related to fatigue (before and after the simulation). For further analysis the 2-min session was segmented into 30-s intervals.

Results

Two hundred sixteen first-year health care students participated in our study. No significant difference was measured between the surgical mask and cloth mask groups in chest compression depth (44.49 ± 10.03 mm vs. 45.77 ± 10.77 mm), rate (113.34 ± 17.76/min vs. 111.23 ± 17.51/min), and the level of fatigue (5.72 ± 1.69 vs. 5.56 ± 1.67) (p > 0.05 in every cases). Significant decrease was found in chest compression depth between the first 30-s interval and the second, third, and fourth intervals (p < 0.01).

Conclusion

The effectiveness of chest compressions (depth and rate) was non-inferior when wearing cloth mask compared to wearing surgical mask. However, the effectiveness of chest compressions decreased significantly in both groups during the 2-min chest-compression-only CPR session and did not reach the appropriate chest compression depth range recommended by the ERC.
Application of a novel scoring system for gastric cancer opportunistic screening in hospital visits
Authors: Zhou Qingjie , Chen Yihan , Pan Jie , Zhou Leying , Lin Jiejun
Published: May 2022

Background

A novel scoring system and screening procedure for gastric cancer (GC) screening was proposed based on the national conditions of China, which state that endoscopy professionals and facilities are relatively limited compared with the large Chinese population.

Methods

A novel scoring system for gastric cancer screening was used to retrospectively analyse the patients who met the screening procedure from April 2017 to December 2019 in our hospital. We divided all of the patients into three groups: low-risk group (0–11 scores), medium-risk group (12–16 scores), and high-risk group (17–23 scores). Statistical analysis was performed on the detection rate of gastric cancer and precursors of gastric cancer among these three groups.

Results

A total of 6701 patients were enrolled in this study, including 4,352(64.95%) in the low-risk group, 1,948 patients (29.07%) in the medium-risk group, and 401 patients (5.98%) in the high-risk group. The total detection rate of gastric cancer was 2.84% (190/6,701), with a 0.94% rate (41/4,352) in the low-risk group, a 5.18% rate (101/1,948) in the medium-risk group, and a 11.97% rate (48/401) in the high-risk group. There were statistically significant differences in the detection rate of gastric cancer among these three groups (all P < 0.05). The detection rate of early gastric cancer was 46.31% (88/190) among all of the detected gastric cancers in this study. In addition, the detection rates of differentiated gastric cancer and precursors of gastric cancer in the medium-risk group and high-risk group were significantly higher than those in the low-risk group. In addition, the area under the curve (AUC) of the receiver operating characteristic curve (ROC) of the novel scoring system in differentiating GC was 0.79.

Conclusion

The screening strategy based on the novel scoring system can significantly improve the efficiency of gastric cancer opportunistic screening in hospital visits. Gastroscopy should be strongly recommended for patients in the medium-risk group and high-risk group, and detailed gastroscopy should be adopted as early as possible to improve the detection rate of early gastric cancer.
Influence of cytochrome P450 and glutathione S transferase polymorphisms on response to nilotinib therapy among chronic myeloidleukemia patients from Pakistan
Authors: Mukry Samina Naz , Shahni Aneeta , Zaidi Uzma , Sultan Shamsi Tahir
Published: May 2022

Background

Cytochrome P450 (CYP) and glutathione S transferases (GSTs) are important biotransforming enzymes responsible for detoxification of anticancer drugs and carcinogens. Polymorphisms in these enzymes may greatly influence the susceptibility to CML and overall efficacy of tyrosine kinase inhibitors. This study was aimed to estimate the possible influence of the polymorphisms of GSTs and CYP in the occurrence of CML as well as in predicting therapeutic outcome of nilotinib therapy in Pakistani CML patients.

Methods

The polymorphic variability in CYP 1A1*2C, GSTP1 (A3131G), GSTT1 and GSTM1 was assessed either by RFLP or multiplex PCR. The BCR ABL1 transcripts were quantified by qPCR to monitor response to nilotinib.

Results

The CYP1A1*2C heterozygous and GSTP1 homozygous polymorphisms seemed to be a contributing factor in developing CML. Altogether, there were 12 non-responders, 66 responders and 21 partial responders. The most frequent genotype was null GSTM1 in responders followed by CYP 1A1 and GSTP1 -wild type (p =  < 0.05). Whereas, homozygous GSTP1 and GSTT1 null genotype is significantly higher only among nilotinib non-responders.

Conclusion

Hence, it can be concluded that wild type CYP1A1, GSTP1 and null GSTM1 may be frequently linked to favorable outcome in patients treated with nilotinib as depicted by sustained deep molecular response in most CML patients.
Effects of long-acting muscarinic antagonists on promoting ciliary function in airway epithelium
Authors: Katsumata Mineo , Fujisawa Tomoyuki , Kamiya Yosuke , Tanaka Yuko , Kamiya Chiaki , Inoue Yusuke , Hozumi Hironao , Karayama Masato , Suzuki Yuzo , Furuhashi Kazuki , Enomoto Noriyuki , Nakamura Yutaro , Inui Naoki , Maekawa Masato , Setou Mitsutoshi , Watanabe Hiroshi , Ikegami Koji , Suda Takafumi
Published: May 2022

Background

Mucociliary clearance (MCC) is an essential defense mechanism in airway epithelia for removing pathogens from the respiratory tract. Impaired ciliary functions and MCC have been demonstrated in asthma and chronic obstructive pulmonary disease (COPD). Long-acting muscarinic antagonists (LAMAs) are a major class of inhaled bronchodilators, which are used for treating asthma and COPD; however, the effects of LAMAs on ciliary function remain unclear. This study aimed to identify the effects of LAMAs on airway ciliary functions.

Methods

Wild-type BALB/c mice were treated with daily intranasal administrations of glycopyrronium for 7 days, and tracheal samples were collected. Cilia-driven flow and ciliary activity, including ciliary beat frequency (CBF), ciliary beating amplitude, effective stroke velocity, recovery stroke velocity and the ratio of effective stroke velocity to recovery stroke velocity, were analyzed by imaging techniques. Using in vitro murine models, tracheal tissues were transiently cultured in media with/without LAMAs, glycopyrronium or tiotropium, for 60 min. Cilia-driven flow and ciliary activity were then analyzed. Well-differentiated normal human bronchial epithelial (NHBE) cells were treated with glycopyrronium, tiotropium, or vehicle for 60 min, and CBF was evaluated. Several mechanistic analyses were performed.

Results

Intranasal glycopyrronium administration for 7 days significantly increased cilia-driven flow and ciliary activity in murine airway epithelium. In the murine tracheal organ culture models, treatment with glycopyrronium or tiotropium for 60 min significantly increased cilia-driven flow and ciliary activity in airway epithelium. Further, we confirmed that 60-min treatment with glycopyrronium or tiotropium directly increased CBF in well-differentiated NHBE cells. In the mechanistic analyses, neither treatment with glycopyrronium nor tiotropium affected intracellular calcium ion concentrations in well-differentiated NHBE cells. Glycopyrronium did not increase protein kinase A activity in well-differentiated NHBE cells. Moreover, glycopyrronium had no effect on extracellular adenosine triphosphate concentration.

Conclusions

LAMAs exert a direct effect on airway epithelium to enhance ciliary function, which may improve impaired MCC in asthma and COPD. Further investigations are warranted to elucidate the underlying mechanisms of the effects of LAMAs on the promotion of airway ciliary function.
Perceptions towards childhood asthma and barriers to its management among patients, caregivers and healthcare providers: a qualitative study from Ethiopia
Authors: Kassa Eden , Kebede Rahel Argaw , Habte Bruck Messele
Published: May 2022

Background

The management of asthma, which is one of the major causes of childhood morbidity and mortality has been affected by non-adherence to recommended treatment regimens with severe consequences. The aim of the present study was therefore to explore the perceptions of the children with asthma, their caregivers and their healthcare providers towards asthma and barriers to long term childhood asthma management in an institutional setting in Addis Ababa, Ethiopia.

Methods

A qualitative descriptive design was followed for the present study that used individual interviews as a data collection method. The study participants were 23 pairs of children with asthma that had treatment follow-ups in two tertiary hospitals and their caregivers and eight healthcare providers who cared for these children. The data was analyzed using thematic analysis approach.

Results

The study findings revealed that the children’s reported adherence to the recommended treatment regimens was low and they along with their caregivers were facing physical, emotional and social burdens related to asthma. Some of the influencing factors affecting childhood asthma management were found to be the low-level implementation of the asthma management guidelines by the healthcare providers, limited awareness about asthma and its management by the children and their caregivers, use of traditional home remedies and religious healing on a complementary and alternative basis and inadequate education received from healthcare professionals. Further identified barriers to the adherence of especially inhaled corticosteroids appear to be the low necessity beliefs towards chronic administration of treatment regimens and concerns related with difficulty of administration, fear of side effects and general negative attitude towards it, in addition to their low availability and affordability.

Conclusions

Low awareness of the biomedical treatment regimens and use of traditional home remedies and religious healing by the children with asthma and their caregivers, the low-level implementation of the asthma management guidelines as well as low access to medications may among other things contribute to the low adherence of the children to their recommended regimens. The findings support the need for implementation of asthma management guidelines, institution of strong asthma care and education programs that are sensitive to local and individual patients’ and caregiver perceptions and experiences including emotional distress, the need to institute chronic care approach and ways to address patients’ medication access issues.
Experiences, challenges, and prospects of National Medical Licensing Examination in China
Authors: Wang Xiancheng
Published: May 2022

Since the implementation of National Medical Licensing Examination (NMLE) system in China, millions of individuals have participated in the examination and have been licensed as physicians. Over the past few decades, NMLE has played a major role in evaluating and guiding Chinese medical education and has made great progress. This commentary discusses the main experience, challenges, and prospects of NMLE in China.
Dilated cardiomyopathy caused by a pathogenic nucleotide variant in RBM20 in an Iranian family
Authors: Malakootian Mahshid , Bagheri Moghaddam Mahrokh , Kalayinia Samira , Farrashi Melody , Maleki Majid , Sadeghipour Parham , Amin Ahmad
Published: May 2022

Introduction

Dilated cardiomyopathy (DCM) is characterized by the dilation and impaired contraction of 1 or both ventricles and can be caused by a variety of disorders. Up to 50% of idiopathic DCM cases have heritable familial diseases, and the clinical screening of family members is recommended. Identifying a genetic cause that can explain the DCM risk in the family can help with better screening planning and clinical decision-making. Whole-exome sequencing (WES) has aided significantly in the detection of causative genes in many genetically heterogeneous diseases. In the present study, we applied WES to identify the causative genetic variant in a family with heritable DCM.

Methods

WES was applied to identify genetic variants on a 26-year-old man as the proband of a family with DCM. Subsequently, Sanger sequencing was performed to confirm the variant in the patient and all the available affected and unaffected family members. The pathogenicity of the variant was evaluated through co-segregation analysis in the family and employment of in silico predictive software.

Results

WES demonstrated the missense pathogenic heterozygous nucleotide variant, c.1907G > A, (p.Arg636His, rs267607004, NM_0011343), in exon 9 of the RBM20 gene in the proband. The variant was co-segregated in all the affected family members in a heterozygous form and the unaffected family members. The in silico analysis confirmed the variant as pathogenic.

Conclusion

Pathogenic RBM20 nucleotide variants are associated with arrhythmogenic DCM. We believe that our report is the first to show an RBM20 variant in Iranian descent associated with DCM.
Receptivity to malaria: meaning and measurement
Authors: Yukich Joshua O. , Lindblade Kim , Kolaczinski Jan
Published: May 2022

“Receptivity” to malaria is a construct developed during the Global Malaria Eradication Programme (GMEP) era. It has been defined in varied ways and no consistent, quantitative definition has emerged over the intervening decades. Despite the lack of consistency in defining this construct, the idea that some areas are more likely to sustain malaria transmission than others has remained important in decision-making in malaria control, planning for malaria elimination and guiding activities during the prevention of re-establishment (POR) period. This manuscript examines current advances in methods of measurement. In the context of a decades long decline in global malaria transmission and an increasing number of countries seeking to eliminate malaria, understanding and measuring malaria receptivity has acquired new relevance.
Duffy blood system and G6PD genetic variants in vivax malaria patients from Manaus, Amazonas, Brazil
Authors: Ferreira Natália S. , Mathias Jéssica Lorena S. , Albuquerque Sérgio Roberto L. , Almeida Anne Cristine G. , Dantas Ana C. , Anselmo Fernanda C. , Lima Emerson S. , Lacerda Marcus Vinicius G. , Nogueira Paulo A. , Ramasawmy Rajendranath , Gonçalves Marilda S. , Moura Neto José P.
Published: May 2022

Background

Over a third of the world’s population is at risk of Plasmodium vivax-induced malaria. The unique aspect of the parasite’s biology and interactions with the human host make it harder to control and eliminate the disease. Glucose-6-phosphate dehydrogenase (G6PD) deficiency and Duffy-negative blood groups are two red blood cell (RBC) variations that can confer protection against malaria.

Methods

Molecular genotyping of G6PD and Duffy variants was performed in 225 unrelated patients (97 with uncomplicated and 128 with severe vivax malaria) recruited at a Reference Centre for Infectious Diseases in Manaus. G6PD and Duffy variants characterizations were performed using Real Time PCR (qPCR) and PCR–RFLP, respectively.

Results

The Duffy blood group system showed a phenotypic distribution Fy(a + b−) of 70 (31.1%), Fy(a + b +) 96 (42.7%), Fy(a−b +) 56 (24.9%) and Fy(a−b−) 1 (0.44%.) The genotype FY*A/FY*B was predominant in both uncomplicated (45.3%) and severe malaria (39.2%). Only one Duffy phenotype Fy(a-b) was found and this involved uncomplicated vivax malaria. The G6PD c.202G > A variant was found in 11 (4.88%) females and 18 (8.0%) males, while c.376A > G was found in 20 females (8.88%) and 23 (10.22%) male patients. When combined GATA mutated and c.202G > A and c.376A > G mutated, was observed at a lower frequency in uncomplicated (3.7%) in comparison to severe malaria (37.9%). The phenotype Fy(a−b +) (p = 0.022) with FY*B/FY*B (p = 0.015) genotype correlated with higher parasitaemia.

Conclusions

A high prevalence of G6PD c202G > A and c.376A > G and Duffy variants is observed in Manaus, an endemic area for vivax malaria. In addition, this study reports for the first time the Duffy null phenotype Fy(a-b-) in the population of the Amazonas state. Moreover, it is understood that the relationship between G6PD and Duffy variants can modify clinical symptoms in malaria caused by P. vivax and this deserves to be further investigated and explored among this population.
Prevalence and sociodemographic correlates of physical activity and sitting time among South American adolescents: a harmonized analysis of nationally representative cross-sectional surveys
Authors: Araujo Raphael H. O. , Werneck André O. , Barboza Luciana L. , Ramírez-Vélez Robinson , Martins Clarice M. L. , Tassitano Rafael M. , Silva Ellen C. M. , de Jesus Gilmar M. , Matias Thiago S. , de Lima Luiz R. A. , Brazo-Sayavera Javier , Silva Danilo R.
Published: May 2022

Background

To identify the prevalence and sociodemographic correlates of different domains of physical activity (PA) and higher sitting time among South American adolescents.

Methods

Data from national surveys of 11 South American countries were analyzed, and comprised information on 166,901 adolescents. PA (≥ 60 min/day of moderate-vigorous PA), physical education classes (PEC) (≥ 3 classes/wk), active commuting to school (≥ 1 d/wk), and higher sitting time (≥ 3 h/d) were self-reported. Sociodemographic correlates, such as gender, age, and food security status were explored using a random effect meta-analysis for logistic parameters.

Results

Recommended PA ranged between 7.5% (Brazil) and 19.0% (Suriname). Peru (2.2%) and Guyana (43.1%) presented the lowest prevalence of PEC and active commuting to school, respectively. Higher sitting time was less prevalent in Bolivia (24.6%) and more prevalent in Argentina (55.6%). Compared to girls, boys were more prone to reach recommendations for PA [OR = 1.94(1.65;2.28)]; to reach ≥ 3 PEC [OR = 1.17(1.04;1.33)] and to be active in commuting to school [(OR = 1.14(1.06;1.23)], but less prone to higher sitting time [OR = 0.89(0.82;0.96)]. Older adolescents had less odds of reach PA guidelines [OR = 0.86(0.77; 0.97)] and accumulated higher sitting time [OR = 1.27(1.14;1.41)]. Adolescents with food insecurity reported more PEC [OR = 1.12(1.04;1.21)] and active commuting to school [OR = 1.12(1.02;1.22)] but had less higher sitting time than their food security pairs [OR = 0.89(0.81;0.98)].

Conclusions

Few adolescents reach the PA recommendation. Actions aiming the promotion of PA and the reduction of sitting time must consider girls and older adolescents as target groups, as well as the specifics of each country.
A scoping review on women’s sexual health in the postpartum period: opportunities for research and practice within low-and middle-income countries
Authors: Wood Shannon N. , Pigott Alexandria , Thomas Haley L. , Wood Chloe , Zimmerman Linnea A.
Published: May 2022

Background

Women’s sexual health is generally defined and explored solely in relation to reproductive capacity, and often omits elements of sexual function and/or dysfunction. Concerted focus is given to women’s health during pregnancy; however, women’s sexual health is largely neglected after childbirth. This scoping review explored how the sexual health of postpartum women has been defined, measured, and researched in low- and middle-income countries (LMICs).

Methods

Articles eligible for review were those that investigated women’s sexual health during the first 12 months postpartum and were conducted among women aged 15–49 in LMICs. Eligibility was further restricted to studies that were published within the last 20 years (2001–2021). The initial PubMed search identified 812 articles, but upon further eligibility review, 97 remained. At this time, the decision was made to focus this review only on articles addressing sexual function and/or dysfunction, which yielded 46 articles. Key article characteristics were described and analyzed by outcome.

Results

Of the final included articles, five studies focused on positive sexual health, 13 on negative sexual health, and the remaining 28 on both positive and negative sexual health or without specified directionality. The most common outcome examined was resumption of sex after childbirth. Most studies occurred within sub-Saharan Africa (n = 27), with geographic spread throughout the Middle East (n = 10), Asia (n = 5), North Africa (n = 3), and cross-geography (n = 1); notably, all five studies on positive sexual health were conducted in Iran. Negative sexual health outcomes included vaginismus, dyspareunia, episiotomy, perineal tears, prolapse, infection, obstetric fistula, female genital cutting, postnatal pain, uterine prolapse, coercion to resume sex, sexual violence, and loss of sexual desire/arousal. Most studies were quantitative, though eight qualitative studies elucidated the difficulties women endured in receiving information specific to sexual health and hesitance in seeking help for sexual morbidities in the postpartum period.

Conclusions

Overall, the evidence base surrounding women’s sexual health in the postpartum period within LMICs remains limited, with most studies focusing solely on the timing of resumption of sex. Integration of sexual health counseling into postnatal care and nonjudgmental service provision can help women navigate these bodily changes and ultimately improve their sexual health.
Parental communication on sexual and reproductive health issues to their adolescents and affecting factors at Asella town, Ethiopia: a community-based, cross-sectional study
Authors: Bekele Daniel , Deksisa Abdi , Abera Wondu , Megersa Getu
Published: May 2022

Background

Parents’ communication on sexual and reproductive health issues with their adolescent plays a great role in preventing morbidity and mortality associated with sexual behavior. However lack of parent to adolescent communication was a serious problem in Ethiopia resulted in teenage pregnancy, unsafe abortions, sexually transmitted infections, school problems, and other sexual risk behaviors. Parents have high responsibility on cultivating their son and daughter regarding to sexual and reproductive health issues. Therefore, the objective of this study was to determine the magnitude of parent’s communication with their adolescents and affecting factors in Ethiopia.

Methods

A community-based, cross-sectional study was conducted on 347 respondents. A systematic sampling method was used to select the study participants. Data were collected by trained interviewers using a structured questionnaire, entered into Epi-Info version 7.1.2 and exported to SPSS version 23 for analysis. Descriptive statistics, bivariate and multivariate logistic regression analyses were used. Variables at P-value < 0.05 were considered as significant associations.

Results

Slightly more than one-fifth of the parents (21.3%) had communicated with their adolescents on sexual and reproductive health issues. Associated factors like: being knowledgeable [AOR = 3.08, 95% CI: 1.89–5.39] and being having positive attitudes [AOR 3.03, 95% CI: 1.37–6.70] towards sexual reproductive health issues were significantly associated with communication.

Conclusion

Overall a low proportion of parental communication with their children was identified on sexual and reproductive health issues. This was affected by multidimensional factors to determine their discussion. Thus, promotion of parent to adolescent communication, parents training and addressing the importance of parent to young people communication along with health care providers was important.
User-centered design and spatially-distributed sequential electrical stimulation in cycling for individuals with paraplegia
Authors: S. Baptista Roberto , C. C. Moreira Marina , D. M. Pinheiro Lucas , R. Pereira Tiago , G. Carmona Gabriel , P. D. Freire Joao , A. I. Bastos Julia , Padilha Lanari Bo Antonio
Published: May 2022

Background

In this work, we share the enhancements made in our system to take part in the CYBATHLON 2020 Global Edition Functional Electrical Stimulation (FES) Bike Race. Among the main improvements, firstly an overhaul, an overhaul of the system and user interface developed with User-centered design principles with remote access to enable telerehabilitation. Secondly, the implementation and experimental comparison between the traditional single electrode stimulation (SES) and spatially distributed sequential stimulation (SDSS) applied for FES Cycling.

Methods

We report on the main aspects of the developed system. To evaluate the user perception of the system, we applied a System Usability Scale (SUS) questionnaire. In comparing SDSS and SES, we collected data from one subject in four sessions, each simulating one race in the CYBATHLON format.

Results

User perception measured with SUS indicates a positive outcome in the developed system. The SDSS trials were superior in absolute and average values to SES regarding total distance covered and velocity. We successfully competed in the CYBATHLON 2020 Global Edition, finishing in 6th position in the FES Bike Race category.

Conclusions

The CYBATHLON format induced us to put the end-user in the center of our system design principle, which was well perceived. However, further improvements are required if the intention is to progress to a commercial product. FES Cycling performance in SDSS trials was superior when compared to SES trials, indicating that this technique may enable faster and possibly longer FES cycling sessions for individuals with paraplegia. More extensive studies are required to assess these aspects.
Dealing with difficult choices: a qualitative study of experiences and consequences of moral challenges among disaster healthcare responders
Authors: Gustavsson Martina E. , Juth Niklas , Arnberg Filip K. , von Schreeb Johan
Published: May 2022

Background

Disasters are chaotic events with healthcare needs that overwhelm available capacities. Disaster healthcare responders must make difficult and swift choices, e.g., regarding who and what to prioritize. Responders dealing with such challenging choices are exposed to moral stress that might develop into moral distress and affect their wellbeing. We aimed to explore how deployed international disaster healthcare responders perceive, manage and are affected by moral challenges.

Methods

Focus groups discussions were conducted with 12 participants which were Swedish nurses and physicians with international disaster healthcare experience from three agencies. The transcribed discussions were analyzed using content analysis.

Results

We identified five interlinked themes on what influenced perceptions of moral challenges; and how these challenges were managed and affected responders’ wellbeing during and after the response. The themes were: “type of difficult situation”, “managing difficult situations”, “tools and support”, “engagement as a protective factor”, and “work environment stressors as a risk factor. Moral challenges were described as inevitable and predominant when working in disaster settings. The responders felt that their wellbeing was negatively affected depending on the type and length of their stay and further; severity, repetitiveness of encounters, and duration of the morally challenging situations. Responders had to be creative and constructive in resolving and finding their own support in such situations, as formal support was often either lacking or not considered appropriate.

Conclusion

The participating disaster healthcare responders were self-taught to cope with both moral challenges and moral distress. We found that the difficult experiences also had perceived positive effects such as personal and professional growth and a changed worldview, although at a personal cost. Support considered useful was foremost collegial support, while psychosocial support after deployment was considered useful provided that this person had knowledge of the working conditions and/or similar experiences. Our findings may be used to inform organizations’ support structures for responders before, during and after deployment.
Effect of medically assisted reproduction (MAR) and pregnancy planning on Bayley-III Screening Test subscales in preterm infants at 12 months of corrected age: a cross-sectional study
Authors: Szele Anna Szabina , Gáll József Mihály , Nagy Beáta Erika
Published: May 2022

Background

The association between medically assisted reproduction and pregnancy planning on overall developmental outcomes of infants has been studied in relatively few studies. The availability of accurate tools for the early detection of developmental delays is a major issue. The purpose of this study is describing the average neurodevelopment of preterm infants and assessing the association between medically assisted reproduction, pregnancy planning and neurodevelopmental outcomes among Hungarian preterm infants.

Methods

Cross-sectional study of preterm infants with gestational age < 37 weeks (N = 171) who underwent developmental assessment using Bayley-III Screening Test (Bayley Scales of Infant and Toddler Development Screening Test – Third Edition) in five developmental domains (cognitive, receptive and expressive language, fine and gross motor) at 12 months of corrected age. We examined the developmental pattern of infants and the potential associations between medically assisted reproduction, pregnancy planning and Bayley-III Screening Test subscales. Information on the mode of conception and pregnancy planning was obtained through parental anamnesis.

Results

Concerning the risk for developmental delay, the language and motor subscales were the most affected. Examination of the mode of conception and developmental outcomes revealed higher neurodevelopmental skills in infants who were conceived through medically assisted reproduction. Significantly lower cognitive, receptive and expressive language skills were found to be associated with unplanned pregnancies. Multi-way analysis of variance was conducted in order to assess the impact of the mode of conception and pregnancy planning on subscales.

Conclusions

We cannot unambiguously conclude that MAR and pregnancy planning had a solely positive effect on the development of preterm infants at 12 months of corrected age, but our results are vital for the design and implementation of further research.
Dirofilaria immitis antigenemia and microfilaremia in Iberian wolves and red foxes from Portugal
Authors: Gomes-de-Sá Sónia , Santos-Silva Sérgio , Moreira Alícia de Sousa , Barradas Patrícia Ferreira , Amorim Irina , Cardoso Luís , Mesquita João R.
Published: May 2022

Background

Dirofilaria immitis is a parasitic nematode endemic in the Mediterranean countries, which causes cardiopulmonary dirofilariosis in wild and domestic animals. Despite being recognized hosts of D. immitis, wild carnivores such as wolves and foxes are frequently disregarded when considering a potential role in the transmission of these zoonotic nematodes. In Portugal, studies available regarding D. immitis circulation are scarce, likely underestimating its relevance. To add knowledge on this, we sought to assess Iberian wolves (Canis lupus signatus) and red foxes (Vulpes vulpes) from northern Portugal for D. immitis antigenemia and microfilaremia.

Methods

Blood samples from 42 Iberian wolves and 19 red foxes were collected, during 2010–2012, in Peneda-Gerês National Park. Antigenemia was searched for by rapid antigen detection test kits (Uranotest Dirofilaria ®). Microfilaremia was assessed by polymerase chain reaction (PCR). Nucleic acids were extracted from blood using QIAamp® DNA Mini Kit (Qiagen), and DNA was screened for the presence of microfilaria using a conventional PCR targeting the 5.8S-internal transcribed spacer 2–28S regions, followed by bidirectional sequencing, Basic Local Alignment Search Tool analysis and phylogenetic analysis.

Results

Three red foxes had antigenemia, with an occurrence of 15.8% (95% confidence interval [CI] 3.4–39.6), while showing no evidence for the presence of microfilaremia. No wolf samples presented evidence for D. immitis antigenemia. Nevertheless, two wolves were positive for D. immitis microfilaremia (4.8%; 95% CI 0.6–16.2%) as revealed by PCR and confirmed by bidirectional sequencing.

Conclusions

Although Dirofilaria microfilaremia in wolves does not necessarily correlate to an endangerment of the infected animal's health, positive individuals can act as a reservoir for further infection if the intermediate mosquito hosts are present. To the best of our knowledge, one single study had reported that wolves were suitable Dirofilaria hosts, but microfilaremia have never been reported.

Graphical Abstract