bluuebunny/crossref_metadata_2025 huggingface dataset:
The Promise and Pitfalls of Conflict Prediction: Evidence from Colombia and Indonesia
Authors: Bazzi Samuel , Blair Robert A. , Blattman Christopher , Dube Oeindrila , Gudgeon Matthew , Peck Richard
Published: February 2021

How feasible is violence early-warning prediction? Colombia and Indonesia have unusually fine-grained data. We assemble two decades of local violent events alongside hundreds of annual risk factors. We attempt to predict violence one year ahead with a range of machine learning techniques. Our models reliably identify persistent, high-violence hot spots. Violence is not simply autoregressive, as detailed histories of disaggregated violence perform best, but socioeconomic data substitute well for these histories. Even with unusually rich data, however, our models poorly predict new outbreaks or escalations of violence. These “best-case” scenarios with annual data fall short of workable early-warning systems.
Psychosocial Impacts of the Coronavirus Disease (COVID-19) Pandemic in Zimbabwe: Citizens’ Perspective
Authors: Mbulayi Shingirai P. , Makuyana Abigail , Kang’ethe Simon M.
Published: February 2021

The outbreak of the ongoing coronavirus pandemic altered the social, economic, and public health landscape across the world, and unleashed a plethora of negative psychosocial impacts on society. This qualitative study used an online based case study design to explore the psychosocial impacts of COVID-19 among a few selected citizens of Zimbabwe. The study was conceptualized around an orienting question stated as: What are the psychosocial impacts of the COVID-19 pandemic in Zimbabwe? Participants for the study were purposively selected, and data was collected through in-depth interviews, which were hosted online. The study returned findings that the COVID-19 pandemic in Zimbabwe was concomitant with a range of psychosocial impacts including inter alia, exposure of people to mental health problems such as severe distress, phobias, anxiety, development of psychosomatic symptoms, as well as increase in social ills such as poverty, and domestic and sexual violence perpetrated against women and children.
From the “Pink Tide” to “Soft Coup d’État” in Latin America: the Case of Bolivia
Authors: Chew Sánchez Martha I.
Published: February 2021

This article addresses the impact of settler colonialism by the Spanish and United States in the American continent in forming the base, development, and power of capitalism in the West. It provides a general overview of the United States’ unequal economic relationships with Latin American countries since the end of the nineteenth century to the present. It highlights the role evangelist groups have in changing the way coup d’états have been taking place in the region, in particular, to countries that had democratically elected presidents who were part of the “Pink Tide” and had a program to counterbalance neoliberal policies that were contributing to unprecedented economic inequality in their societies. One of the central questions in this work is the role of coloniality within Latin American countries and between the US and Latin America in the coup d’état against Evo Morales in Bolivia on November 10, 2019.
The Lonchaeidae of Vanuatu (Diptera: Schizophora)
Authors: MACGOWAN IAIN
Published: February 2021

Seven new species of Lonchaeidae in three genera are described from the Pacific island group of Vanuatu namely, Lamprolonchaea vila MacGowan sp. nov., Lonchaea efate MacGowan sp. nov., Lonchaea malekula MacGowan sp. nov., Lonchaea pentecosti MacGowan sp. nov., Lonchaea tanna MacGowan sp. nov., Silba erromango MacGowan sp. nov. and Silba hebridensis MacGowan sp. nov. The lonchaeid fauna of Vanuatu now totals 13 species in three genera. A key to species with illustrations of the male genitalia is provided.
New leaf-mining Nepticulidae (Lepidoptera): potential pests of aromatic Lamiaceae plants from equatorial Andes
Authors: STONIS JONAS R. , DIŠKUS ARŪNAS , FERNÁNDEZ-ALONSO JOSÉ L. , REMEIKIS ANDRIUS , SOLIS M. ALMA
Published: February 2021

Members of the Lamiaceae, or mint family, are used worldwide for medicinal, culinary and/or magical-religious purposes, as well as in pesticides and as ornamental plants. Very little is known about nepticulids, or pygmy moths, as leaf miners of Lamiaceae, but they may be an important component of South American diversity and potential pests of economically-important species of the mint family. In this paper, four new species of leaf-mining Nepticulidae are described from the equatorial Andes of Ecuador: S. mentholica Diškus & Stonis, sp. nov., Stigmella aromatica Diškus & Stonis, sp. nov., S. odora Diškus & Stonis, sp. nov., feeding on Minthostachys mollis (Benth.) Griseb., and S. tomentosella Diškus & Stonis, sp. nov., feeding on Clinopodium tomentosum (Kunth) Govaerts. It is hypothesized that host-plant distribution ranges can provide clues to potential distribution ranges of these newly discovered, trophically specialized leaf miners. The leaf mines, adults, and the genitalia of the new species are illustrated with photographs.
Entomophilic nematodes, Diploscapter coronatus and Oscheius tipulae from Afghanistan
Authors: FALAHZADAH MOHAMMAD HUSSAIN , SHOKOOHI EBRAHIM , MORAVEJ GHOLAM HOSSEIN , MASHELA PHATU WILLIAM , MADADI ABDUL KHALID , KARIMI JAVAD
Published: February 2021

Several soil samples from different habitats in Badakhshan province of Afghanistan were collected to isolate and characterize bacteria feeding nematodes. The Galleria mellonella-baiting method was used for the isolation of the Afghan insect-associated nematodes. The nematodes were studied using morphological and morphometric data. The Oscheius specimen was characterized by a longer body (630–820 µm) and shorter pharynx (125–145 µm), whereas other morphological characters were not unusual. The Diploscapter specimen had an annulated cuticle, with lip region width 1.5 times shorter than the stoma, and had separated pharyngeal corpus from the isthmus and vulva located in the middle of the body. The molecular data were derived using three loci; 18S, 28S (D2/D3 segment), and ITS rRNA region, which were utilized to measure the genetic distance. The phylogenetic analysis was conducted to reconstruct the relationship tree. Both morphological and molecular approaches confirmed the identity of nematode isolates as Oscheius tipulae and Diploscapter coronatus. This is the first report of insect-associated nematodes from the soil of Afghanistan. Both species were capable of infecting and killing G. mellonella larvae in less than 96 h.
Reconstructing an Interdecadal Pacific Oscillation Index from a Pacific Basin–Wide Collection of Ice Core Records
Authors: Porter Stacy E. , Mosley-Thompson Ellen , Thompson Lonnie G. , Wilson Aaron B.
Published: February 2021

Using an assemblage of four ice cores collected around the Pacific basin, one of the first basinwide histories of Pacific climate variability has been created. This ice core–derived index of the interdecadal Pacific oscillation (IPO) incorporates ice core records from South America, the Himalayas, the Antarctic Peninsula, and northwestern North America. The reconstructed IPO is annually resolved and dates to 1450 CE. The IPO index compares well with observations during the instrumental period and with paleo-proxy assimilated datasets throughout the entire record, which indicates a robust and temporally stationary IPO signal for the last ~550 years. Paleoclimate reconstructions from the tropical Pacific region vary greatly during the Little Ice Age (LIA), although the reconstructed IPO index in this study suggests that the LIA was primarily defined by a weak, negative IPO phase and hence more La Niña–like conditions. Although the mean state of the tropical Pacific Ocean during the LIA remains uncertain, the reconstructed IPO reveals some interesting dynamical relationships with the intertropical convergence zone (ITCZ). In the current warm period, a positive (negative) IPO coincides with an expansion (contraction) of the seasonal latitudinal range of the ITCZ. This relationship is not stationary, however, and is virtually absent throughout the LIA, suggesting that external forcing, such as that from volcanoes and/or reduced solar irradiance, could be driving either the ITCZ shifts or the climate dominating the ice core sites used in the IPO reconstruction.
Pooling Data Improves Multimodel IDF Estimates over Median-Based IDF Estimates: Analysis over the Susquehanna and Florida
Authors: Srivastava Abhishekh Kumar , Grotjahn Richard , Ullrich Paul Aaron , Sadegh Mojtaba
Published: February 2021

Traditional multimodel methods for estimating future changes in precipitation intensity, duration, and frequency (IDF) curves rely on mean or median of models’ IDF estimates. Such multimodel estimates are impaired by large estimation uncertainty, shadowing their efficacy in planning efforts. Here, assuming that each climate model is one representation of the underlying data generating process, i.e., the Earth system, we propose a novel extension of current methods through pooling model data: (i) evaluate performance of climate models in simulating the spatial and temporal variability of the observed annual maximum precipitation (AMP), (ii) bias-correct and pool historical and future AMP data of reasonably performing models, and (iii) compute IDF estimates in a nonstationary framework from pooled historical and future model data. Pooling enhances fitting of the extreme value distribution to the data and assumes that data from reasonably performing models represent samples from the “true” underlying data generating distribution. Through Monte Carlo simulations with synthetic data, we show that return periods derived from pooled data have smaller biases and lesser uncertainty than those derived from ensembles of individual model data. We apply this method to NA-CORDEX models to estimate changes in 24-h precipitation intensity–frequency (PIF) estimates over the Susquehanna watershed and Florida peninsula. Our approach identifies significant future changes at more stations compared to median-based PIF estimates. The analysis suggests that almost all stations over the Susquehanna and at least two-thirds of the stations over the Florida peninsula will observe significant increases in 24-h precipitation for 2–100-yr return periods.
Significant Impacts of Rainfall Redistribution through the Roof of Buildings on Urban Hydrology
Authors: Cao Xuejian , Qi Youcun , Ni Guangheng
Published: February 2021

Microtopography on a building roof will direct rainfall from roofs to the ground through downspouts and transform the rainfall spatial distribution from plane to points. However, the issues on whether and how the building-induced rainfall redistribution (BIRR) influences hydrologic responses are still not well understood despite the numerous downspouts in the urban area. Hence, this study brings the roof layer into a grid-based urban hydrologic model (gUHM) to quantitatively evaluate the impacts of BIRR, aiming to enhance the understanding of building effects in urban hydrology and subsequently to identify the necessity of incorporating BIRR into flood forecasting. Nine land development strategies and 27 rainfall conditions are considered herein to characterize the changing circumstance. Results indicate that the impacts of BIRR depend on multiple circumstance factors and are nonnegligible in urban hydrology. The BIRR causes not only bidirectional impacts on the hydrologic characteristic values (e.g., peak flow and runoff volume) but also an obvious alteration of the hydrograph. Overall, the BIRR tends to increase the peak flow, and more importantly, the impact will be aggravated by the increase of rainfall intensity with the maximum relative error of peak flow approaching 10%. This study contributes to a better understanding of building effects on urban hydrology and a step forward to reduce the uncertainty in urban flood warnings.
Bridewealth, Women’s Subordination and Agency in Marriage: An ethnographic critique of gender activism in rural north-western Ghana
Authors: Akurugu Constance Awinpoka , Domapielle Maximillian Kolbe , Jatoe Mathias Mwinlabagna
Published: February 2021

This article examines current discourses on the role of the bridewealth in subordinating women and the implications of gender justice advocacy that privilege the undoing of this practice. In northern Ghana, to liberate women from oppression, some women’s rights activists advocate the abolition of the marriage payment. Drawing on ethnographic data gathered in north-western Ghana, we argue that dismantling the institution of the bridewealth risks worsening women’s subordination. Gender activism needs to be sensitive to contextual norms and respectful of the ‘oppressed’ subjects of ‘liberation’. We propose a return to the traditional court as a site for negotiating women’s emancipation.
Mandate or Donors? Explaining the UNHCR’s Country-Level Expenditures from 1967 to 2016
Authors: Thorvaldsdottir Svanhildur , Patz Ronny , Goetz Klaus H
Published: February 2021

In recent decades, many international organizations have become almost entirely funded by voluntary contributions. Much existing literature suggests that major donors use their funding to refocus international organizations’ attention away from their core mandate and toward serving donors’ geostrategic interests. We investigate this claim in the context of the United Nations High Commissioner for Refugees (UNHCR), examining whether donor influence negatively impacts mandate delivery and leads the organization to direct expenditures more toward recipient countries that are politically, economically, or geographically salient to major donors. Analyzing a new dataset of UNHCR finances (1967–2016), we find that UNHCR served its global mandate with considerable consistency. Applying flexible measures of collective donor influence, so-called “influence-weighted interest scores,” our findings suggest that donor influence matters for the expenditure allocation of the agency, but that mandate-undermining effects of such influence are limited and most pronounced during salient refugee situations within Europe.
Interpersonal Relationship Experiences in Adults Born With Cleft Lip and/or Palate: A Whole of Life Survey in the United Kingdom
Authors: Ardouin Kenny , Hotton Matt , Stock Nicola Marie
Published: February 2021

Objectives:

Previous research has suggested that adults with a cleft lip and/or palate (CL/P) may find their familial, friend, collegial, and/or romantic relationships impacted by their condition. Building on this prior work, this study examined the self-reported interpersonal experiences of a national sample of adults born with CL/P.

Design:

An online survey was designed by the Cleft Lip and Palate Association in collaboration with the Centre for Appearance Research. Data from 181 participants were included in the present study, collected between July and October 2018. Qualitative data were analyzed using inductive content analysis, while quantitative data were analyzed using descriptive statistics and independent t tests.

Results:

Most participants reported having good relationships with family members and existing friends with similar patterns of marriage as the general population. However, some experienced difficulties initiating new friendships and romantic relationships. Participants described bullying and discrimination in adulthood, most often in public settings and the workplace. Participants reported lower satisfaction with intimate relationships and less secure attachment compared to the general population. Concerns regarding the heritability of CL/P and its impact on the decision to have a family were also reported.

Conclusions:

Individuals with CL/P are at risk of negative social experiences, which if not appropriately addressed may impact psychological well-being in adulthood. The findings illustrate the importance of routine psychosocial support from childhood onward to help individuals with CL/P build social skills, self-esteem, and social confidence and to develop mutually fulfilling friendships and intimate relationships. Additionally, societal campaigns to raise awareness and target discrimination may be helpful.
Identifying Associations between Quality Initiatives and Quality Measures among Home Health Agencies: Findings from a National Study
Authors: Zinn Jacqueline S , Ladd Heather , Nuccio Eugene , Ettner Susan L , Sorkin Dara H , Mukamel Dana B
Published: February 2021

Home health performance gained visibility with the publication of Home Health Compare and the Home Health Value-Based Payment demonstration. Both provide incentives for home health agencies (HHA) to invest in quality improvements. The objective of this study is to identify the association between quality initiatives adopted by HHAs and improved performance. A 2018 national survey of 7459 HHAs, yielding a sample of 1192 eligible HHAs, provided information about 23 quality initiatives, which was linked to 5 composite Super Quality Measures (SQMs): ADL/pain, self-treatment, timely care, hospitalizations, and patient experience. Exclusions for missing data and outliers yielded a final analytical sample of 903 HHAs. Regression models estimated associations between quality initiatives and SQMs. The relationships between sixteen of the SQM/quality initiative pairs were positively associated with improvement and 7 were negatively associated. Web-based technologies for staff and care-givers improved performance but deteriorated patient experience. Web support-groups for staff and review of HHC rankings reduced hospitalization rates. While this study offers insights for quality improvement, a limitation may be a lack of sensitivity to the nuances of quality improvement implementation. Therefore, this study should be viewed as hypothesis-generating concerning initiatives likely to have the greatest potential meriting further investigation.
HRD Interventions that Offer a Solution to Work-Life Conflict
Authors: Hammer Emily
Published: February 2021

The Problem

Balancing work and life can be difficult. In a new world of work amidst COVID-19, balancing work and life has become even more challenging. Employees are struggling to adjust their work-life obligations while maintaining performance expectations. Providing employee support to reduce stress and minimize adverse effects on performance outcomes requires employer action.

The Solution

HRD interventions are recommended as organizational support mechanisms. These interventions are designed to reduce stress produced by work life conflict, particularly during stressful organizational events. Through organizational support, employees are offered the opportunity to increase individual performance.

The Stakeholders

HRD and HRM professionals, scholars, organizational planners, organizational leaders and managers, and all others who have a vested interest in employee well-being.
von Willebrand factor antigen levels are associated with burden of rare nonsynonymous variants in the VWF gene
Authors: Sadler Brooke , Christopherson Pamela A. , Haller Gabe , Montgomery Robert R. , Di Paola Jorge
Published: February 2021

Approximately 35% of patients with type 1 von Willebrand disease (VWD) do not have a known pathogenic variant in the von Willebrand factor (VWF) gene. We aimed to understand the impact of VWF coding variants on VWD risk and VWF antigen (VWF:Ag) levels, studying 527 patients with low VWF and VWD and 210 healthy controls. VWF sequencing was performed and VWF:Ag levels assayed. A combined annotation-dependent depletion (CADD) score >20 was used as a predicted pathogenicity measure. The number of rare nonsynonymous VWF variants significantly predicted VWF:Ag levels (P = 1.62 × 10−21). There was an association between average number of rare nonsynonymous VWF variants with VWD type 1 (P = 2.4 × 10−13) and low VWF (P = 1.6 × 10−27) compared with healthy subjects: type 1 subjects possessed on average >2 times as many rare variants as those with low VWF and 8 times as many as healthy subjects. The number of rare nonsynonymous variants significantly predicts VWF:Ag levels even after controlling for presence of a variant with a CADD score >20 or a known pathogenic variant in VWF (P = 2.7 × 10−14). The number of rare nonsynonymous variants in VWF as well as the presence of a variant with CADD >20 are both significantly associated with VWF levels. The association with rare nonsynonymous variants holds even when controlling for known pathogenic variants, suggesting that additional variants, in VWF or elsewhere, are associated with VWF:Ag levels. Patients with higher VWF:Ag levels with fewer rare nonsynonymous VWF gene variants could benefit from next-generation sequencing to find the cause of their bleeding.
Identification of novel genes involved in neutral lipid storage by quantitative trait loci analysis of Saccharomyces cerevisiae
Authors: Pačnik Klavdija , Ogrizović Mojca , Diepold Matthias , Eisenberg Tobias , Žganjar Mia , Žun Gašper , Kužnik Beti , Gostinčar Cene , Curk Tomaž , Petrovič Uroš , Natter Klaus
Published: February 2021

Background

The accumulation of intracellular fat depots is a polygenic trait. Therefore, the extent of lipid storage in the individuals of a species covers a broad range and is determined by many genetic factors. Quantitative trait loci analysis can be used to identify those genetic differences between two strains of the same species that are responsible for the differences in a given phenotype. We used this method and complementary approaches to identify genes in the yeastSaccharomyces cerevisiaethat are involved in neutral lipid storage.

Results

We selected two yeast strains, the laboratory strain BY4741 and the wine yeast AWRI1631, with a more than two-fold difference in neutral lipid content. After crossing, sporulation and germination, we used fluorescence activated cell sorting to isolate a subpopulation of cells with the highest neutral lipid content from the pool of segregants. Whole genome sequencing of this subpopulation and of the unsorted pool of segregants implicated several loci that are involved in lipid accumulation. Three of the identified genes,PIG1,PHO23andRML2, were investigated in more detail. Deletions of these genes and the exchange of the alleles between the two parental strains confirmed that the encoded proteins contribute to neutral lipid storage inS. cerevisiaeand thatPIG1,PHO23andRML2are the major causative genes. Backcrossing of one of the segregants with the parental strains for seven generations revealed additional regions in the genomes of both strains with potential causative genes for the high lipid accumulation phenotype.

Conclusions

We identified several genes that contribute to the phenotype of lipid accumulation in an allele-specific manner. Surprisingly, no allelic variations of genes with known functions in lipid metabolism were found, indicating that the level of storage lipid accumulation is determined by many cellular processes that are not directly related to lipid metabolism.
Genome-wide identification of PbrbHLH family genes, and expression analysis in response to drought and cold stresses in pear (Pyrus bretschneideri)
Authors: Dong Huizhen , Chen Qiming , Dai Yuqin , Hu Wenjie , Zhang Shaoling , Huang Xiaosan
Published: February 2021

Background

The basic helix-loop-helix (bHLH) transcription factors play important roles in many processes in plant growth, metabolism and responses to abiotic stresses. Although, the sequence of Chinese white pear genome (cv. ‘Dangshansuli’) has already been reported, there is still a lack of clarity regarding the bHLH family genes and their evolutionary history.

Results

In this work, a genome-wide identification of the bHLH genes in Chinese white pear was performed, and we characterized the functional roles of these PbrbHLH genes in response to abiotic stresses. Based on the phylogenetic analysis and structural characteristics, 197 identified bHLH genes could be well classified into 21 groups. Expansion of PbrbHLH gene family was mainly driven by WGD and dispersed duplication with the purifying selection from the recent WGD. The functional annotation enrichment showed that the majority of PbrbHLHs were enriched in the GO terms and KEGG pathways involved in responds to stress conditions as TFs. Transcriptomic profiles and qRT-PCR revealed that PbrbHLH7, PbrbHLH8, PbrbHLH128, PbrbHLH160, PbrbHLH161 and PbrbHLH195 were significantly up-regulated under cold and drought treatments. In addition, PbrbHLH195-silenced pear seedlings display significant reduced cold tolerance, exhibiting reduced chlorophyll content, as well as increased electrolyte leakage and concentrations of malondialdehyde and H2O2.

Conclusion

For the first time, a comprehensive analysis identified the bHLH genes in Chinese white pear and demonstrated that PbrbHLH195 is involved in the production of ROS in response to cold stress, suggesting that members of the PbrbHLH family play an essential role in the stress tolerance of pear.
Prevalence of biliary acid malabsorption in patients with chronic diarrhoea of functional characteristics: a prospective study
Authors: Flores Virginia , Martínez-Lozano Helena , Bighelli Federico , Orcajo Javier , García-Lledó Javier , Alonso-Farto Juan Carlos , Menchén Luis
Published: February 2021

Background

Bile acid malabsorption occurs in up to one third of patients with chronic diarrhoea of functional characteristics. The gold standard test for its diagnosis is the 75Selenium homocholic acid taurine (75SeHCAT) test. The aim of this work is to confirm previous data suggesting that bile acid malabsorption, diagnosed by 75Se-HCAT test, is the underlying cause of diarrhoea in a significant proportion of patients previously diagnosed with a functional disorder. In addition, we have analysed the clinical response of bile acid sequestrants in those patients with a bile acid diarrhoea diagnosis.

Methods

This is a prospective, single-centre study including consecutive adult patients diagnosed with chronic diarrhoea of unknown origin and with functional characteristics; systematic rule out of common causes of chronic diarrhoea was performed before bile acid malabsorption evaluation by 75SeHCAT scanning. A retention percentage less than 10% was considered positive. Clinical response to cholestyramine was further evaluated in those patients with a positive diagnosis of bile acid diarrhoea

Results

38 patients (20 male, mean age 37.5 years) were finally included. Twenty (52.6%) patients included had a positive 75SeHCAT test. Median body mass index was significantly higher in those patients. We did not find significant differences in other clinical or biochemical variables 75SeHCAT-positive and 75SeHCAT-negative groups. Only 6 of 17 (35.3%) patients responded to cholestyramine treatment; 10 patients did not have response or withdraw the drug due to adverse events. Logistic regression analysis showed that none of the included variables was a predictor of clinical response to cholestyramine.

Conclusions

Bile acid malabsorption occurs in a high proportion of patients suffering from chronic diarrhoea with functional characteristics. Systematic investigation of bile acid malabsorption should be included in the diagnostic algorithms of patients with chronic watery diarrhoea in the routine clinical practice. Absence of response to cholestyramine does not rule out bile acid diarrhoea.
Clinical impact of respiratory syncytial virus infection on children hospitalized for pertussis
Authors: Zhang Ruimu , Deng Jikui
Published: February 2021

Background

Although Respiratory syncytial virus (RSV) is one of the common pathogens in children with pertussis and viral coinfection, the clinical impact of RSV infection on pertussis remains unclear. We compared clinical characteristics and sought differences between infants with single Bordetella pertussis (B. pertussis) infection and those with RSV coinfection.

Methods

We enrolled 80 patients with pertussis who were hospitalized in Shenzhen Children’s Hospital from January 2017 to December 2019. Respiratory tract samples were tested for B. pertussis with real-time polymerase chain reaction and respiratory viruses with immunofluorescence assay. Clinical data were obtained from hospital records and collected using a structured questionnaire.

Results

Thirty-seven of 80 patients had B. pertussis infection alone (pertussis group) and 43 had RSV-pertussis coinfection (coinfection group). No significant differences were found with regard to sex, body weight, preterm birth history, pertussis vaccination, symptoms, presence of pneumonia, or lymphocyte count between the 2 groups. Univariate analysis showed patients with RSV coinfection were older (median, 4.57 months vs 4.03 months, p = 0.048); more commonly treated with β-lactam antibiotics (21% vs 5%, p = 0.044); had higher rates of wheezes (40% vs 14%, p = 0.009) and rales (35% vs 14%, p = 0.028) on chest auscultation, a higher rate of readmission (40% vs 11%, p = 0.004), and a longer hospital stay (median, 10 days vs 7 days, p = 0.002). In the further binary logistic regression analysis, patients with RSV coinfection had higher rates of wheezes (OR = 3.802; 95% CI: 1.106 to 13.072; p = 0.034) and readmission (OR = 5.835; 95% CI: 1.280 to 26.610; p = 0.023).

Conclusions

RSV coinfection increases readmission rate in children hospitalized for pertussis. RSV infection should be suspected when wheezes are present on auscultation of the chest in these patients. Early detection of RSV may avoid unnecessary antibiotic use.
COVID-19 lung CT image segmentation using deep learning methods: U-Net versus SegNet
Authors: Saood Adnan , Hatem Iyad
Published: February 2021

Background

Currently, there is an urgent need for efficient tools to assess the diagnosis of COVID-19 patients. In this paper, we present feasible solutions for detecting and labeling infected tissues on CT lung images of such patients. Two structurally-different deep learning techniques, and , are investigated for semantically segmenting infected tissue regions in CT lung images.

Methods

We propose to use two known deep learning networks, and , for image tissue classification. is characterized as a scene segmentation network and as a medical segmentation tool. Both networks were exploited as binary segmentors to discriminate between infected and healthy lung tissue, also as multi-class segmentors to learn the infection type on the lung. Each network is trained using seventy-two data images, validated on ten images, and tested against the left eighteen images. Several statistical scores are calculated for the results and tabulated accordingly.

Results

The results show the superior ability of in classifying infected/non-infected tissues compared to the other methods (with 0.95 mean accuracy), while the shows better results as a multi-class segmentor (with 0.91 mean accuracy).

Conclusion

Semantically segmenting CT scan images of COVID-19 patients is a crucial goal because it would not only assist in disease diagnosis, also help in quantifying the severity of the illness, and hence, prioritize the population treatment accordingly. We propose computer-based techniques that prove to be reliable as detectors for infected tissue in lung CT scans. The availability of such a method in today’s pandemic would help automate, prioritize, fasten, and broaden the treatment of COVID-19 patients globally.
“The kind of support that matters to exclusive breastfeeding” a qualitative study
Authors: Theodorah Dasheka Zukiswa , Mc’Deline Rala Ntombana
Published: February 2021

Background

Worldwide, only 41 % of infants are exclusively breastfed for the first six months while South Africa has an alarming figure of only 12 %. First-time mothers are inexperienced in the initiation and maintenance of exclusive breastfeeding, hence a need for support. Data on forms and quality of exclusive breastfeeding support as experienced by first-time mothers is minimal. The study explored the exclusive breastfeeding support available to first-time mothers in the Buffalo City Metro, South Africa.

Methods

A qualitative explorative, descriptive and contextual study, and a non-probability, purposive sampling was used with 10 first-time mothers within the first six months postpartum. The in-depth face-to-face semi-structured individual interviews for data collection and Creswell’s steps of thematic analysis were used.

Results

Two themes emerged; challenges, empowerment, support and resilience during initiation of exclusive breastfeeding, and diverse support and resilience during maintenance of exclusive breastfeeding. First-time mothers received practical support majorly from nurses and other mothers during the initiation; social support was from family members, friends, and community members for the maintenance of exclusive breastfeeding. Sometimes there was a disjuncture between practical support from nurses and that from family members and the community. There were instances where the support was needed but not given or not supportive of exclusive breastfeeding.

Conclusions

These findings illustrate that professional, practical and social support for first-time mothers is crucial in the initiation and maintenance of exclusive breastfeeding for the first six months. Timing and the kind of support given to these mothers is crucial for successful exclusive breastfeeding.
Longitudinal study on steroid hormone variations during the second trimester of gestation: a useful tool to confirm adequate foetal development
Authors: Alonso Silvia , Caceres Sara , Vélez Daniel , Sanz Luis , Silvan Gema , Illera Maria Jose , Illera Juan Carlos
Published: February 2021

Background

The interaction of hormonal factors are crucial for good foetal development. During the second trimester of gestation, most of the main physiological processes of foetal development occur. Therefore, the aim of this study was to determine the variations in the physiological levels of cortisol, estriol, estrone sulphate, and progesterone during the second trimester (weeks 12–26) in order to establish normal ranges that can serve as indicators of foetal well-being and good functioning of the foetal-placental unit.

Methods

Saliva samples from 106 pregnant women were collected weekly (from week 12 to week 26 of gestation), and hormonal measurements were assayed by an enzyme immunoassay. The technique used for hormone measurements was highly sensitive and served as a non-invasive method for sample collection.

Results

The results revealed a statistically significant (p<0.05) difference between cortisol, progesterone, and oestrogens throughout the second trimester, with a more substantial relationship between oestrogens and progesterone [P4-E3 (r=0.427); P4-E1SO4 (r=0.419)]. By analysing these hormone concentrations, statistically significant (p<0.05) elevations in progesterone, cortisol, and estriol levels were found at the 16th[(P4 (0.78±0.088), C(1.99±0.116), E3(2.513±0.114)]; 18th [(P4 (1.116±0.144), C(3.409±0.137), E3(3.043±0.123)] and 23rd week of gestation [(P4(1.36±0.153), C(1.936±0.11), E3(2.657±0.07)]. Estrone sulphate levels appeared to increase progressively throughout the second trimester [from 1.103±0.03 to 2.244±0.09].

Conclusion

The 18th week of gestation seems to constitute a very important week during foetal adrenal development, and the analysis of the main hormones involved in foetal development, provided more precise information regarding the proper functioning of the foetal unit and foetal development.
Effect of treatment center volume on outcomes in gastroenteropancreatic neuroendocrine tumor patients
Authors: Baeg Kiwoon , Harris Cynthia , Naparst Monica S. , Ahn Eugene , Thapi Sahityasri , Martin Jacob , Rustgi Sheila , Mhango Grace , Wisnivesky Juan , Kim Michelle Kang
Published: February 2021

Background

Medical centers with varying levels of expertise treat gastroenteropancreatic neuroendocrine tumors (GEP-NETs), which are relatively rare tumors. This study assesses the impact of center volume on GEP-NET treatment outcomes.

Methods

We used the Surveillance, Epidemiology, and End Results (SEER) registry linked to Medicare claims data. The data includes patients diagnosed between 1995 and 2010 who had no health maintenance organization (HMO) coverage, participated in Medicare parts A and B, were older than 65 at diagnosis, had tumor differentiation information, and had no secondary cancer. We identified medical centers at which patients received GEP-NET treatment (surgery, chemotherapy, somatostatin analogues, or radiation therapy) using Medicare claims data. Center volume was divided into 3 tiers – low, medium, and high – based on the number of unique GEP-NET patients treated by a medical center over 2 years. We used Kaplan-Meier curves and Cox regression to assess the association between volume and disease-specific survival.

Results

We identified 899 GEP-NET patients, of whom 37, 45, and 18% received treatment at low, medium volume, and high-volume centers, respectively. Median disease-specific survival for patients at low and medium tiers were 1.4 years and 5.3 years, respectively, but was not reached for patients at high volume centers. Results showed that patients treated at high volume centers had better survival than those treated in low volume centers (HR: 0.63, 95% CI: 0.4–0.9), but showed no difference in outcomes between medium and high-volume centers.

Conclusions

Our results suggest that for these increasingly common tumors, referral to a tertiary care center may be indicated. Physicians caring for GEP-NET patients should consider early referral to high volume centers.
Targeting hippocampal hyperactivity with real-time fMRI neurofeedback: protocol of a single-blind randomized controlled trial in mild cognitive impairment
Authors: Klink Katharina , Jaun Urs , Federspiel Andrea , Wunderlin Marina , Teunissen Charlotte E. , Kiefer Claus , Wiest Roland , Scharnowski Frank , Sladky Ronald , Haugg Amelie , Hellrung Lydia , Peter Jessica
Published: February 2021

Background

Several fMRI studies found hyperactivity in the hippocampus during pattern separation tasks in patients with Mild Cognitive Impairment (MCI; a prodromal stage of Alzheimer’s disease). This was associated with memory deficits, subsequent cognitive decline, and faster clinical progression. A reduction of hippocampal hyperactivity with an antiepileptic drug improved memory performance. Pharmacological interventions, however, entail the risk of side effects. An alternative approach may be real-time fMRI neurofeedback, during which individuals learn to control region-specific brain activity. In the current project we aim to test the potential of neurofeedback to reduce hippocampal hyperactivity and thereby improve memory performance.

Methods

In a single-blind parallel-group study, we will randomize n = 84 individuals (n = 42 patients with MCI, n = 42 healthy elderly volunteers) to one of two groups receiving feedback from either the hippocampus or a functionally independent region. Percent signal change of the hemodynamic response within the respective target region will be displayed to the participant with a thermometer icon. We hypothesize that only feedback from the hippocampus will decrease hippocampal hyperactivity during pattern separation and thereby improve memory performance.

Discussion

Results of this study will reveal whether real-time fMRI neurofeedback is able to reduce hippocampal hyperactivity and thereby improve memory performance. In addition, the results of this study may identify predictors of successful neurofeedback as well as the most successful regulation strategies.

Trial registration

The study has been registered with clinicaltrials.gov on the 16th of July 2019 (trial identifier: NCT04020744).
Age- and sex-specific profiles of temporal fasting plasma glucose variability in a population undergoing routine health screening
Authors: Lartey Agyei Helena , Li Xiaona , Li Zhongqi , Zhang Qun , Wang Jianming
Published: February 2021

Background

Fasting plasma glucose (FPG) variability is a significant predictor of mortality, especially in patients with poor glycemic control. This study aimed to explore the temporal age- and sex-specific profiles of temporal FPG variability in a Chinese population undergoing routine health screening and to guide the development of targeted public health interventions for the prevention and control of diabetes.

Methods

In this cross-sectional study, we used a general linear model to compare differences in temporal FPG values between sexes and across age groups in 101,886 Nanjing residents who underwent a routine physical health examination at the Health Management Center, the First Affiliated Hospital of Nanjing Medical University, in 2018. The variability of FPG as a function of time, age, and sex, independently and in combination, was analyzed.

Results

The participants included 57,455 (56.4%) males and 44,431 (43.6%) females, with a mean ± SD age of 42.8 ± 15.0 years. The average ± SD FPG level was 5.5 ± 1.1 mmol/L. The monthly variation contributed to 22% of the overall FPG variability. A significant main effect for the age group was observed (F = 7.39, P < 0.05), with an excellent fitting effect (Eta-squared =0.15). The variability of FPG showed sex differences in the percentage difference of the coefficient of variation, which was 34.1% higher in males than females. There were significant interaction effects for month*age*sex and day*age*sex.

Conclusions

Temporal variability in FPG is evident in the general Chinese population and is affected by both age and sex. To avoid complications associated with FPG variability, interventions should be directed at females and males at specific ages for optimal control of FPG variability and to reduce the risk of diabetes and cardiovascular events.
Psychological characteristics of suicide attempters among undergraduate college students in China: a cross-sectional study
Authors: Lew Bob , Osman Augustine , Chan Caryn Mei Hsien , Chen Won Sun , Ibrahim Norhayati , Jia Cun-Xian , Siau Ching Sin
Published: February 2021

Background

There is a need to understand the psychological characteristics of suicide attempters to prevent future suicide attempts. This study aims to examine potential differences between individuals who have attempted suicide and those who have not done so, on several risk and protective measures.

Method

Participants were 11,806 undergraduate students from seven provinces in China, of which 237 reported a non-fatal suicide attempt. We used the random numbers generator function within the SPSS to randomly select a control subset of 1185 participants to be used as the comparison group based on a 1:5 case-control ratio. Scores on three commonly used risk measures (depression, hopelessness, and psychache) and three protective measures (social support, self-esteem, and purpose in life) for suicidality were adopted to compare the responses of the two groups.

Results

Suicide attempters had indicated higher Median scores for all three risk factor measurements. Suicide attempters also reported significantly lower Median scores for all three protective factor measurements compared to non-suicide attempters. The results suggest that the suicide attempters’ group had higher risks of suicidality compared to the non-attempter group.

Conclusions

Suicide attempters continued to report higher scores of risk factors and lower scores of protective factors, indicating that they may continue to be at a higher likelihood of a suicide attempt. Key protective factors should be identified for each individual in order to deliver appropriate clinical interventions to reduce their risk of reattempting.
Correction to: Renal dysfunction reduces the diagnostic and prognostic value of serum CC16 for acute respiratory distress syndrome in intensive care patients
Authors: Lin Jinle , Tao Wuyuan , Wei Jian , Wu Jian , Zhang Wenwu , Ye Jianbing , Fu Xuan , Zeng Shiyong , Dou Qingli , Wang Lijun , Tian Fang
Published: February 2021

An amendment to this paper has been published and can be accessed via the original article.
Two cases of angular pregnancy with incomplete abortion treated with hysteroscopy: a case report and review of literature
Authors: Meichen Yin , Jing Fei , Lingyun Zhai , Jianwei Zhou
Published: February 2021

Background

Angular pregnancy is characterized as implant medial to the uterotubal junction in lateral angular of uterine. It was a rare obstetric complication with severe complications like uterine rupture and retained placenta.

Case presentation

We report a case of 2 incomplete aborted angular pregnancy that was diagnosed and treated with hysteroscopy. In this case, both of patient were performed operative hysteroscopy for incomplete abortion, and with the assistance of hysteroscopy, the angular pregnancy was detected.

Conclusions

Hysteroscopy can more intuitively display the conditions inside the uterine cavity, reduce the intraoperative and postoperative complications, and shorten the hospitalization time of patients. During hysteroscopy, angular pregnancy can be visualized in the upper lateral side of the uterine cavity. Based on the investigation results of clinical cases, this is the first case report of hysteroscopy in the treatment of incomplete aborted angular pregnancy.
Soft tissue facial changes among adult females during alignment stage of orthodontic treatment: a 3D geometric morphometric study
Authors: Hou Si Yu , Zhou Wenwen , Dai Hongwei , Wong Hai Ming , Wen Yi Feng , Zhou Jianping
Published: February 2021

Background

To investigate changes in facial morphology during the first six months of orthodontic treatment among adult females receiving orthodontic treatment.

Methods

43 adult females receiving orthodontic treatment were randomly recruited. 3D facial images were taken at baseline (T0), three months (T1), and six months (T2) after treatment initiation. Spatially dense facial landmarks were digitized to allow for sufficient details in characterization of facial features. 3D geometric morphometrics and multivariate statistics were used to investigate changes in mean and variance of facial shape and facial form associated with treatment.

Results

We observed statistically significant changes in facial shape across the three treatment stages (p = 0.0022). Pairwise comparisons suggested significant changes from T0 to T1 (p = 0.0045) and from T0 to T2 (p = 0.0072). Heatmap visualization indicated that the buccal and temporal region were invaginated while the labial region became protruded with treatment. The magnitude of shape change was 0.009, 0.004, and 0.010 from T0 to T1, T1 to T2, and T0 to T2, respectively, in unit of Procrustes distance. The average magnitude of change per-landmark was 1.32 mm, 0.21 mm, and 1.34 mm, respectively. Changes in mean facial form were not statistically significant (p = 0.1143). No changes in variance of facial shape were observed across treatment stages (p > 0.05).

Conclusion

Rate of facial changes was twice as fast during the first three months as that during fourth to sixth month. Buccal and temporal region became invaginated while labial region became protruded with treatment.