bluuebunny/crossref_metadata_2025 huggingface dataset:
A meta-ethnographic synthesis of lived experience of spouse caregivers in chronic illness
Authors: Warrier Manjusha G , Sadasivan Arun , Balasubramaian Bhuvaneshwari , Nair Meera G , Nashi Saraswati , Vengalil Seena , Nalini A , Thomas Priya Treesa
Published: March 2021

Social workers routinely work with chronically ill, providing support for long term care. Several qualitative studies describe the experiences of the person and carer in a chronic illness. There is a limited synthesis of these experiences to aid practice. The current review aims to present a synthesis of the experiences of the spouses of chronically ill persons reported in the literature. A comprehensive search of electronic databases was done, and the studies were selected using PRISMA guidelines. The selected studies were subjected to quality check using CASP guidelines and a score was assigned to each of those studies. Later, qualitative synthesis of the results of the selected studies was done using the principles of meta-ethnography. 2407 studies published between 1999–2019 were identified and 22 studies were included in the final synthesis. The number of participants in the studies reviewed was 309, with more representation of females. The reciprocal synthesis of these studies identified loss, change, caregiving and exhaustion, barriers in providing care, illness experience, coping, socio-cultural norms and support as common themes from the accounts of the participants. ‘Continuity of change’ was identified as the core concept in the lived experience of the spouses of chronically ill persons. ‘Illness, loss and Lived experience’ is proposed as a model of the lived experience of the spouses. Through this synthesis, the factors influencing the lived experience of spouse caregivers is understood, which can help social work professionals in the health sector in planning interventions for the spouses of chronically ill persons.
Kambô-Induced Systemic Inflammatory Response: A Case Report of Acute Disease Progression of Cholangiocarcinoma
Authors: Peleg Hasson Shira , Shachar Eliya , Kessner Rivka , Shpigel Shulim , Wolf Ido
Published: March 2021

Kambô is a cleansing ritual involving the application of a toxin produced by the giant leaf frog ( Phyllomedusa bicolor). The Kambô ritual has increasingly been adopted among cancer patients in Europe. Accumulating data indicate various adverse effects. We report another severe adverse reaction to Kambô, a systemic inflammatory response syndrome mimicking disease progression in a patient with cholangiocarcinoma. We describe a systemic reaction to Kambô, manifested as tachycardia, tachypnea, impaired liver cholestatic enzymes, and enlargement of lymphadenopathy mimicking disease progression. The clinical features and onset of symptoms, the rapid reaction, and the lack of other identified causes make the diagnosis of Kambô-induced SIRS highly probable. This case report calls for future studies examining standard oncological care such as chemotherapy, radiotherapy, and immunotherapy in conjunction with alternative therapy. Additionally, greater awareness and physician education should be promoted, encouraging inquiry of oncology patients’ administration of alternative, complementary, and integrative medicine.
Severe and critical COVID-19 in pregnancy: A case series from Montreal
Authors: Trahan Marie-Julie , Malhamé Isabelle , Mitric Cristina , Simard Camille , Lipes Jed , Abenhaim Haim A
Published: March 2021

Background

Optimal obstetric management for women with coronavirus disease (COVID-19) is not known. We describe the management of six pregnant women requiring in-hospital care for severe COVID-19.

Methods

A retrospective chart review was conducted to identify pregnant women who tested positive for Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) between 15 March and 30 June 2020. A subset of women meeting criteria for severe COVID-19 was included.

Results

Four women required non-invasive supplemental oxygen therapy and two required mechanical ventilation. Four women were discharged from hospital undelivered and two required preterm delivery. One woman had a pulmonary embolism, and two required re-admission for worsening symptoms.

Conclusion

Management of pregnant women with severe COVID-19 is complex and should involve multidisciplinary expertise. Avoiding early delivery may be a safe option. We recommend an individualized approach to care, including careful consideration of the expected risks and benefits of expectant obstetric management versus delivery.
Primary sclerosing cholangitis: A rare cause of liver dysfunction in pregnancy
Authors: Slade Laura , McKendrick Linda , Grivell Rosalie
Published: March 2021

Primary sclerosing cholangitis is an uncommon condition with few cases reported in pregnancy. We present the case and outcome of a 28-year-old female presenting in her second pregnancy with new onset liver dysfunction, eventually diagnosed with primary sclerosing cholangitis. She went into spontaneous preterm labour and delivered a healthy infant but has subsequently continued to deteriorate and underwent a liver transplant 11 months post-delivery.
Does Customer Experience Always Benefit Company? Examining Customers’ Epistemic Motivation and Interaction With Service Contexts
Authors: Mai Chi Vu Thi , Paramita Widya , Ha Minh Quan Tran
Published: March 2021

The main purpose of this study is explaining how and when customer experience benefits the company. Built upon social identity theory, we propose that customer experience leads to customer engagement behavior, via two routes: customer-company and customer-employee identification. Furthermore, we advance that customers’ epistemic motivation negatively moderates the mediated effect of customer experience on customer engagement behavior. We ran two studies to validate the measurement of customer experience and to test our hypotheses. For the two studies, we employed a survey method by recruiting consumers of beauty salons in Vietnam. The results demonstrated that EXQ as a measurement for customer experience is applicable to the context of the study and provided empirical support for the hypotheses. Such as, this research found that customer experience positively influences customer engagement behavior as mediated by customer-company and customer-employee identification. Furthermore, this research revealed that customer epistemic motivation negatively moderates the mediated effect of customer experience on customer engagement behavior via customer-employee identification. However, the moderating role of customer epistemic motivation is insignificant for the mediated relationship via customer-company identification. Finally, this research offers theoretical and practical contributions that are elaborated and further discussed.
“Reach the right people”: The politics of “interests” in Facebook’s classification system for ad targeting
Authors: Cotter Kelley , Medeiros Mel , Pak Chankyung , Thorson Kjerstin
Published: March 2021

Political campaigns increasingly rely on Facebook for reaching their constituents, particularly through ad targeting. Facebook’s business model is premised on a promise to connect advertisers with the “right” users: those likely to click, download, engage, purchase. The company pursues this promise (in part) by algorithmically inferring users’ interests from their data and providing advertisers with a means of targeting users by their inferred interests. In this study, we explore for whom this interest classification system works in order to build on conversations in critical data studies about the ways such systems produce knowledge about the world rooted in power structures. We critically analyze the classification system from a variety of empirical vantage points—via user data; Facebook documentation, training, and patents; and Facebook’s tools for advertisers—and through theoretical concepts from a variety of domains. In this, we focus on the ways the classification system shapes possibilities for political representation and voice, particularly for people of color, women, and LGBTQ+ people. We argue that this “big data-driven” classification system should be read as political: it articulates a stance not only on what issues are or are not important in the U.S. public sphere, but also on who is considered a significant enough public to be adequately accounted for.
Encouraging Employee Engagement With Cybersecurity: How to Tackle Cyber Fatigue
Authors: Reeves A. , Delfabbro P. , Calic D.
Published: March 2021

Cybersecurity fatigue is a form of work disengagement specific to cybersecurity. It manifests as a weariness or aversion to cybersecurity-related workplace behaviors or advice and occurs as a result of prior overexposure to cybersecurity-related work demands or training. While some previous theoretical conceptualizations of cybersecurity fatigue are available, this article is the first to capture all dimensions of the phenomenon in a four-component model. The model holds that cybersecurity fatigue can result from overexposure to workplace cybersecurity advice (e.g., training) or cybersecurity actions (e.g., forced password updates). Similarly, we argue that there can be two types of cybersecurity fatigue: attitudinal (e.g., a belief that cybersecurity is not important) and cognitive (e.g., habituated bad behaviors). We present a multidisciplinary review, which draws on research from management, psychology, and information systems. Practitioners can use the four-component model to identify the type of cybersecurity fatigue that may be occurring in employees and adapt workplace processes accordingly to improve behavior. In addition, we present three illustrative case studies, adapted from employee experiences, to demonstrate the application of the four-component model to an organizational context. The review presents a framework for coordinating the existing approaches to cybersecurity fatigue in the current literature.
L-Shaped Arthroscopic Posterior Capsular Release in Frozen Shoulder
Authors: Morsy Mohamed Gamal , Waly Ahmed Hassan , Ashraf Galal Mostafa , Ayman El Hussein Mohamed , Gawish Hisham Mohamed
Published: March 2021

Background:

The inadequate arthroscopic release of the tight posterior capsule in frozen shoulder may result in limited postoperative shoulder internal rotation.

Indication:

The purpose of this article is to describe an L-shaped arthroscopic posterior capsular release to overcome the limited internal rotation that may be encountered following the standard longitudinal technique. Operative intervention is indicated in patients with refractory shoulder stiffness with limitation of internal rotation of grade 0, +2, +4 (according to the Constant-Murley Score), after failure of conservative measures for 3 to 6 months. The technique is contraindicated if less than 3 months of physical therapy, shoulder stiffness due to osseous deformity, infection, or cuff tear arthropathy.

Technique:

After performing a standard anterior capsular release, the scope is shifted to the anterior portal to perform posterior capsular release by introducing the radiofrequency ablation device through the posterior portal. Posterior release begins from the glenoid level down to the 6 o’clock position until the back fibers of the infraspinatus muscle appear. Then the hook-tip part of the radiofrequency ablation device is used to perform a transverse release in the posterior capsule, starting from the beginning of the longitudinal limb. The transverse limb is performed in a stepwise manner going step-by-step laterally but ending before reaching the rotator cuff to avoid any damage of the cuff. After that, the shoulder was manipulated according to Codman technique.

Results:

A comparative study was performed on 43 patients with primary frozen shoulder to compare the standard longitudinal (22 patients) and L-shaped (21 patients) posterior capsular release. At the final follow-up, there was a statistically significant improvement in the internal rotation range of motion in the L-shaped group ( P < .001). There was no loss of function over time. Moreover, there were no infections, instability, or axillary nerve injury in either group.

Discussion/Conclusion:

Restriction of internal rotation in frozen shoulder has been attributed to posterior capsular tightness. The L-shaped arthroscopic posterior capsular release in patients with primary frozen shoulder significantly improves the postoperative internal rotation range of motion.
Post-COVID-19 travel behaviour patterns: impact on the willingness to pay of users of public transport and shared mobility services in Spain
Authors: Awad-Núñez Samir , Julio Raky , Gomez Juan , Moya-Gómez Borja , González Julián Sastre
Published: March 2021

Background

The COVID-19 crisis has meant a significant change in the lifestyle of millions of people worldwide. With a lockdown that lasted almost three months and an impulse to new normality, transport demand has suffered a considerable impact in the Spanish case. It is mandatory to explore the effect of the pandemic on changes in travel behaviour in post-COVID-19 times.

Methodology

A nationwide survey was carried out during the lockdown in Spring 2020 to overview the recent changes. The survey collected both stated preferences (socio-demographic characteristics and mobility-related attributes), and revealed preferences (individuals’ habits, especially in the frequency of the trips according to the trip purpose, and opinions regarding the willingness and acceptability of these changes, and which actors would have to drive them, and how) of individuals. This paper aims to study and understand the willingness to adopt a set of measures to improve the safety conditions of public transport and shared mobility services against possible contagion from COVID-19 and the willingness to pay for them.

Results

The results obtained show that some measures, such as the increase of supply and vehicle disinfection, result in a greater willingness to use public transport in post-COVID-19 times. Similarly, the provision of covers for handlebars and steering wheels also significantly increases individuals’ willingness to use sharing services. However, respondents expect that these measures and improvements would be implemented but maintaining the same pre-COVID-19 prices. The results of this research might help operators deploy strategies to adopt their services and retain users.
Can reference points explain wage rigidity? Experimental evidence
Authors: Koch Christian
Published: March 2021

I examine whether reference points can provide an explanation for rigid wages in recessions. Even though a recession provides a good reason to adjust wages downward, workers’ perception of a “fair wage” may depend on their previous wage, their reference point. Using a laboratory experiment, I test this idea by varying whether initially concluded contracts—and their stipulated wages—can serve as reference points. My experimental results show that with initial contracts workers punish wage cuts even in recessions, leading to considerable more rigid wages. Surprisingly, this is even true without an “objective” justification to feel entitled to initial contracts.
Integrative genomic expression analysis reveals stable differences between lung cancer and systemic sclerosis
Authors: Li Heng , Ding Liping , Hong Xiaoping , Chen Yulan , Liao Rui , Wang Tingting , Meng Shuhui , Jiang Zhenyou , Liu Dongzhou
Published: March 2021

Background

The incidence and mortality of lung cancer are the highest among all cancers. Patients with systemic sclerosis show a four-fold greater risk of lung cancer than the general population. However, the underlying mechanism remains poorly understood.

Methods

The expression profiles of 355 peripheral blood samples were integratedly analyzed, including 70 cases of lung cancer, 61 cases of systemic sclerosis, and 224 healthy controls. After data normalization and cleaning, differentially expressed genes (DEGs) between disease and control were obtained and deeply analyzed by bioinformatics methods. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed online by DAVID and KOBAS. The protein–protein interaction (PPI) networks were constructed from the STRING database.

Results

From a total of 14,191 human genes, 299 and 1644 genes were identified as DEGs in systemic sclerosis and lung cancer, respectively. Among them, 64 DEGs were overlapping, including 36 co-upregulated, 10 co-downregulated, and 18 counter-regulated DEGs. Functional and enrichment analysis showed that the two diseases had common changes in immune-related genes. The expression of innate immune response and response to virus-related genes increased significantly, while the expression of negative regulation of cell cycle-related genes decreased notably. In contrast, the expression of mitophagy regulation, chromatin binding and fatty acid metabolism-related genes showed distinct trends.

Conclusions

Stable differences and similarities between systemic sclerosis and lung cancer were revealed. In peripheral blood, enhanced innate immunity and weakened negative regulation of cell cycle may be the common mechanisms of the two diseases, which may be associated with the high risk of lung cancer in systemic sclerosis patients. On the other hand, the counter-regulated DEGs can be used as novelbiomarkers of pulmonary diseases. In addition, fat metabolism-related DEGs were consideredto be associated with clinical blood lipid data.
The resilience scale: factorial structure, reliability, validity, and parenting-related factors among disaster-exposed adolescents
Authors: Shi Xuliang , Wang Shuo , Wang Zhen , Fan Fang
Published: March 2021

Background

In this study, we examined psychometric properties of the Chinese version of the Resilience Scale (RS) and parenting-related factors associated with resilience among disaster-exposed adolescents.

Methods

Eighteen months after the earthquake, a total of 1266 adolescents (43.4% male, mean age = 15.98; SD = 1.28) were assessed using the RS, the Post-traumatic Stress Disorder Self-Rating Scale, the Depression Self-rating Scale for Children, the Screen for Child Anxiety Related Emotional Disorders, and Parental Bonding Instrument.

Results

Through exploratory factor analyses (EFAs) and parallel analysis, responses were characterized into a 3-factor structure: personal competence, meaningfulness, and acceptance of self and life. Cronbach’s alpha coefficient for the RS was 0.89 and the test-retest reliability coefficient was 0.72. In terms of predictive validity, resilience was found to be a significant predictor for PTSD, depression, and anxiety. Multiple regression analysis showed that maternal parenting styles were significant predictors of resilience after adjusting for gender, age, sibling number, and earthquake experiences.

Conclusions

The Chinese version of RS is a reliable and valid tool for assessing resilience among adolescent survivors after disasters. The implications for research and resilience-oriented interventions were also discussed.
Correction to: The design and implementation of a longitudinal social medicine curriculum at the University of Vermont’s Larner College of Medicine
Authors: Goyal Raghav K. , Dawson Christina A. , Epstein Samuel B. , Brach Richard J. , Finnie Sheridan M. , Lounsbury Karen M. , Lahey Timothy , Eldakar-Hein Shaden T.
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Genetic diversity and antifungal susceptibility of Candida albicans isolates from Iranian HIV-infected patients with oral candidiasis
Authors: Tamai Iradj Ashrafi , Pakbin Babak , Fasaei Bahar Nayeri
Published: March 2021

Objective

The objectives of this study were to investigate the antifungal susceptibility and genetic diversity ofCandida albicansisolated from HIV+patients with oropharyngeal candidiasis. A total of 50C. albicansisolates were cultured on Sabouraud glucose agar containing chloramophenicol. The antifungal susceptibility of the isolates against fluconazole, clotrimazole, nystatin, amphotericin B, ketoconazole and flucytosine was assessed using disc diffusion method. The genetic diversity ofC. albicansisolates was determined using random amplified polymorphic DNA marker.

Results

The inhibition zones ranged from 4 ± 1.8 to 40 ± 3.8 mm for fluconazole, 7 ± 1.0 to 37 ± 1.8 mm for ketoconazole, 14 ± 0.8 to24 ± 0.8 mm for amphotericin B, 25 ± 0.0 to 33 ± 0.0 mm for nystatin and 7 ± 4.2 to 40 ± 0.0 mm for clotrimazole. At 90% similarity, three distinct groups were observed. The smallest cluster composed of 3 isolates, whereas the largest one composed of 17 isolates. 32% (16/50), 28% (14/50) and 14% (7/50) were resistant to fluconazole, ketoconazole and clotrimazole, respectively.
Migration of pre-induced human peripheral blood mononuclear cells from the transplanted to contralateral eye in mice
Authors: Huang Jianfa , Xian Bikun , Peng Yuting , Zeng Baozhu , Li Weihua , Li Zhiquan , Xie Yaojue , Zhao Minglei , Zhang Hening , Zhou Minyi , Yu Huan , Wu Peixin , Liu Xing , Huang Bing
Published: March 2021

Background

Retina diseases may lead to blindness as they often afflict both eyes. Stem cell transplantation into the affected eye(s) is a promising therapeutic strategy for certain retinal diseases. Human peripheral blood mononuclear cells (hPBMCs) are a good source of stem cells, but it is unclear whether pre-induced hPBMCs can migrate from the injected eye to the contralateral eye for bilateral treatment. We examine the possibility of bilateral cell transplantation from unilateral cell injection.

Methods

One hundred and sixty-one 3-month-old retinal degeneration 1 (rd1) mice were divided randomly into 3 groups: an untreated group (n = 45), a control group receiving serum-free Dulbecco’s modified Eagle’s medium (DMEM) injection into the right subretina (n = 45), and a treatment group receiving injection of pre-induced hPBMCs into the right subretina (n = 71). Both eyes were examined by full-field electroretinogram (ERG), immunofluorescence, flow cytometry, and quantitative real-time polymerase chain reaction (qRT-PCR) at 1 and 3 months post-injection.

Results

At both 1 and 3 months post-injection, labeled pre-induced hPBMCs were observed in the retinal inner nuclear layer of the contralateral (left untreated) eye as well as the treated eye as evidenced by immunofluorescence staining for a human antigen. Flow cytometry of fluorescently label cells and qRT-PCR of hPBMCs genes confirmed that transplanted hPBMCs migrated from the treated to the contralateral untreated eye and remained viable for up to 3 months. Further, full-field ERG showed clear light-evoked a and b waves in both treated and untreated eyes at 3 months post-transplantation. Labeled pre-induced hPBMCs were also observed in the contralateral optic nerve but not in the blood circulation, suggesting migration via the optic chiasm.

Conclusion

It may be possible to treat binocular eye diseases by unilateral stem cell injection.

Graphical abstract
mTOR inhibitor INK128 promotes wound healing by regulating MDSCs
Authors: Li Yi , Xu Yujun , Liu Xinghan , Yan Xin , Lin Yue , Tan Qian , Hou Yayi
Published: March 2021

Background

Skin wounds in diabetic patients hardly recover. Accumulating evidence has shown that mammalian target of rapamycin (mTOR) pathway and myeloid-derived suppressor cells (MDSCs) are involved in inflammatory-related response. INK128 is a novel mTOR kinase inhibitor in clinical development. However, the exact roles of MDSCs and INK128 in healing wound of diabetic patients are unclear.

Methods

Mice models of normal, diabetic, and diabetic+INK128 were constructed. Bone marrow (BM)-derived macrophages and RAW264.7 cell line co-cultured with MDSCs, which were induced at different conditions. Flow cytometry, western blot, quantitative real-time PCR, and immunohistochemical analysis were performed.

Results

Diabetic mice (DM) had a slower recovery rate, thinner epidermis and dermis, and less blood vessels than those of normal mice. MDSCs were abnormally accumulated in DM, mTOR was activated in MDSCs of DM, and the cells were treated with high glucose. Moreover, mTOR signaling inhibitor INK128 could promote wound healing through reducing the MDSCs. MDSC function was disordered in DM and high-glucose environments, while INK128 could help retrieve their function. Furthermore, high glucose and other factors in DM could promote M-MDSC differentiation to M1 pro-inflammatory macrophage cells, thus inhibiting wound healing. The differentiation, which was dependent on mTOR signaling, could be reversed by INK128.

Conclusion

INK128 is potential to be developed as a clinical strategy to promote wound healing of diabetic patients.
Sex differences in fetal Doppler parameters during gestation
Authors: Jagota Dakshita , George Hannah , Walker Melissa , Ravi Chandran Anjana , Milligan Natasha , Shinar Shiri , Whitehead Clare L. , Hobson Sebastian R. , Serghides Lena , Parks W. Tony , Baschat Ahmet A. , Macgowan Christopher K. , Sled John G. , Kingdom John C. , Cahill Lindsay S.
Published: March 2021

Background

Fetal sex is known to affect pregnancy outcomes. In current clinical practice, monitoring of fetal well-being is based on Doppler ultrasound measurements of major placental and fetal vessels. The objective of this study was to investigate the effect of fetal sex on Doppler parameters throughout gestation in healthy pregnancy.

Methods

A prospective study was conducted in 240 pregnant women with ultrasound examinations at a 4-weekly interval between 12 and 38 weeks of gestation. Pulsed Doppler spectra were collected for the umbilical arteries (UAs), middle cerebral artery (MCA), descending abdominal aorta (DAo), and ductus venosus (DV). Linear mixed effects models were used to determine if the pulsatility indices (PIs) of these vessels depended on gestational age and fetal sex.

Results

While there were no differences in the MCA PI and DV PIV over gestation between female and male fetuses, the trajectory of the UA and DAo PIs differed by fetal sex (p = 0.02 and p = 0.01, respectively).

Conclusions

Doppler ultrasound parameters were found to be dependent on fetal sex for some vessels and not for others in healthy pregnancies. Further investigations are needed to understand the physiological mechanisms for these sex differences and the relevance for disease processes in pregnancy.
The complex relationship between estrogen and migraines: a scoping review
Authors: Reddy Nihaal , Desai Miraj N. , Schoenbrunner Anna , Schneeberger Steven , Janis Jeffrey E.
Published: March 2021

Background

Migraines are a chronic disease for millions worldwide and have been hypothesized to be hormonally mediated due to their higher prevalence in females and menstrual associations. Estrogen has been commonly implicated in migraine pathogenesis, yet its exact role in the pathophysiology of migraines has yet to be fully understood.

Method

We conducted a scoping review of the literature regarding estrogen’s role in migraine pathogenesis and included 19 studies out of an initial 202 in the final review. Two independent reviewers screened and extracted data from included studies based on predetermined inclusions and exclusion criteria.

Results

The estrogen withdrawal hypothesis, discussed by 12 of the reviewed studies, is the most discussed theory about estrogen’s role in migraine physiology and describes the association of migraine onset with natural declines in estrogen levels, particularly when estrogen levels fall below 45–50 pg/mL after an extended period of priming. Additional findings suggest that women with a history of migraine have an increased sensitivity to physiologic fluctuations in estradiol levels. Several studies suggest that migraines are associated with menstruation.

Conclusion

It appears that estrogen is very likely to play a key role in migraine pathogenesis, but seems to affect patients in different ways depending on their past medical history, age, and use of hormonal therapy. Further research is warranted to isolate the effects of estrogen in each unique patient population, and we believe that studies comparing menstruating women to postmenopausal women could help shed light in this area.
Psychosocial rehabilitation experiences of women victims of armed conflict in Montes de María, Colombia
Authors: Sarmiento-Marulanda Laura Camila , Aguilera-Char Amira Ayleen , González-Gil Catalina , López-López Wilson
Published: March 2021

Background

After 9 years of the ground-breaking social policy Law 1448 of 2011 -Victims Law- and its extension until 2030, the Colombian State and other stakeholders have made several efforts towards granting the right of integral reparation for more than 9 million victims that are recognized in the Colombian transitional context. Psychosocial rehabilitation is a Victims Law’s reparation measure whose objective is to re-establish the psychosocial, physical and mental health welfare in the individual, familiar and community levels. This study aims to understand the experiences of psychosocial rehabilitation of women victims of armed conflict in Montes de Maria and the underlying social intervention paradigms that guide the Law’s implementation.

Methods

Based on a qualitative design with a phenomenological approach, narrative tools and thematic network analysis permitted to give voice to the women participants. Individual narrative interviews were conducted with 12 women victims and a focus group with eight of them was used as a triangulation strategy.

Results

Although the Victims Law is oriented by a sociopolitical intervention paradigm, the stories of the women’s victims of Montes de María mainly evidenced non-sociopolitical interventions with humanitarian assistance towards revictimization and State abandonment. As a coping mechanism towards the State negligence encountered, women strive to overcome psychosocial trauma by developing agency and community resources for the resignification of the traumatic experiences and peacebuilding.

Conclusions

For the Victims Law to achieve its integrality aim, the psychosocial approach should be implemented through all its measures but remains absent in Montes de Maria. The diversity of victim’s individual and collective initiatives that were found, can contribute towards transformative and participatory psychosocial intervention with community’s resources. Women victims can perform as advisors and collaborators in the implementation of individual and collective reparation, which remains as an opportunity for psychosocial rehabilitation and peacebuilding. Further monitoring and evaluation of the law with a territorial and differential perspective is required to respond to the victim’s needs.
Characteristics and diversity of mutations in regulatory genes of resistance-nodulation-cell division efflux pumps in association with drug-resistant clinical isolates of Acinetobacter baumannii
Authors: Salehi Bahare , Ghalavand Zohreh , Yadegar Abbas , Eslami Gita
Published: March 2021

Background

This study was aimed to characterize the genetic diversity and expression of three putative resistance-nodulation-cell division (RND)-type efflux systems and their contribution to multidrug efflux in clinical isolates ofAcinetobacter baumannii.

Methods

Antimicrobial susceptibility testing of 95A. baumanniiisolates was determined by Kirby-Bauer disk diffusion for 18 antibiotics and minimum inhibitory concentration (MIC) of colistin was determined by the broth microdilution method. Moreover, the MIC of five classes of antibiotics was assessed using E-test strips in the presence and absence of phenylalanine-arginine beta-naphthylamide (PAβN). Regulatory genes of the RND efflux pumps (adeRS,adeL,adeNandbaeSR) were subjected to sequencing. The relative expression ofadeB,adeGandadeJgenes was determined by quantitative real-time PCR (qRT-PCR).

Results

Overall, the majority of isolates (94%) were extensively drug-resistant (XDR). In the phenotypic assay, efflux pump activity was observed in 40% of the isolates against multiple antibiotics mainly tigecycline. However, we found no efflux activity against imipenem. Several amino acid substitutions were detected in the products of regulatory genes; except in AdeN. Of note, G186V mutation in AdeS was found to be associated with overexpression of its efflux pump. No insertion sequences were detected.

Conclusions

Our findings outlined the role of RND efflux pumps in resistance ofA. baumanniito multiple antibiotics particularly tigecycline, and pointed out the importance of a variety of single mutations in the corresponding regulatory systems. Further studies are required to decipher the precise role of RND efflux pumps in multidrug-resistant clinical isolates ofA. baumannii.
Characterisitcs of Saccharomyces boulardii for reducing ammonia emission from livestock manure
Authors: Kim Sun Il , Heo Wan , Lee So Jung , Han Bok Kyung , Lee Hong Gu , Kim Young Jun
Published: March 2021

Ammonia from livestock manure acts as a precursor to produce particulate matter (PM) by reacting with atmospheric chemical components volatilized from various sources. Ammonia itself acts as a toxic substance to human health, and thus has direct or indirect adverse effects on human health. This study aimed to verify the effectiveness and mechanism of action of Saccharomyces boulardii (SB) in reducing the ammonia emission from livestock manure. The specific ability of SB was confirmed through comparative verification with S. cerevisiae (SC) belonging to the same genus. SB and SC could use 50% of ammonia–nitrogen as inorganic nitrogen source in minimal medium. In the control group, the pH level of manure was significantly increased compared to the pH level at 0 h, and the DNA concentration of Proteus mirabilis, which increase the manure pH through ammonia production, was found to increase by 2.7-fold. Significant decrease in pH and proliferation of P. mirabilis was found in SB group compared to control (p < 0.05). The SB group also reduced the amount of ammonia emitted from manure by 25% for 35 days. These results suggested that SB contributed to reducing ammonia emission from manure by reducing pH and inhibiting HAB as well as removing ammonia–nitrogen. Accordingly, SB as a microbiological agent is expected to contribute not only to reduce ammonia emission but also to improve manure quality as a fertilizer.
Multi-source financing for tuberculosis treatment in China: key issues and challenges
Authors: Long Qian , Jiang Wei-Xi , Zhang Hui , Cheng Jun , Tang Sheng-Lan , Wang Wei-Bing
Published: March 2021

Background

The End Tuberculosis (TB) Strategy of the World Health Organization highlights the need for patient-centered care and social protection measures that alleviate the financial hardships faced by many TB patients. In China, TB treatments are paid for by earmarked government funds, social health insurance, medical assistance for the poor, and out-of-pocket payments from patients. As part of Phase III of the China-Gates TB project, this paper introduces multi-source financing of TB treatment in the three provinces of China and analyzes the challenges of moving towards universal coverage and its implications of multi-sectoral engagement for TB care.

Main text

The new financing policies for TB treatment in the three provinces include increased reimbursement for TB outpatient care, linkage of TB treatment with local poverty alleviation programs, and use of local government funds to cover some costs to reduce out-of-pocket expenses. However, there are several challenges in reducing the financial burdens faced by TB patients. First, medical costs must be contained by reducing the profit-maximizing behaviors of hospitals. Second, treatment for TB and multi-drug resistant TB (MDR-TB) is only available at county hospitals and city or provincial hospitals, respectively, and these hospitals have low reimbursement rates and high co-payments. Third, many patients with TB and MDR-TB are at the edge of poverty, and therefore ineligible for medical assistance, which targets extremely poor individuals. In addition, the local governments of less developed provinces often face fiscal difficulties, making it challenging to use of local government funds to provide financial support for TB patients. We suggest that stakeholders at multiple sectors should engage in transparent and responsive communications, coordinate policy developments, and integrate resources to improve the integration of social protection schemes.

Conclusions

The Chinese government is examining the establishment of multi-source financing for TB treatment by mobilization of funds from the government and social protection schemes. These efforts require strengthening the cooperation of multiple sectors and improving the accountability of different government agencies. All key stakeholders must take concrete actions in the near future to assure significant progress toward the goal of alleviating the financial burden faced by TB and MDR-TB patients.

Graphic abstract
Pre-arrest diversion to addiction treatment by law enforcement: protocol for the community-level policing initiative to reduce addiction-related harm, including crime
Authors: Zgierska Aleksandra E. , White Veronica M. , Balles Joseph , Nelson Cory , Freedman Jason , Nguyen Thao H. , Johnson Sarah C.
Published: March 2021

Background

Despite evidence that treatment reduces addiction-related harms, including crime and overdose, only a minority of addiction-affected individuals receive it. Linking individuals who committed an addiction-related crime to addiction treatment could improve outcomes.

Methods

The aim of this city-wide, pre-arrest diversion program, Madison Addiction Recovery Initiative (MARI) is to reduce crime and improve health (i.e., reduce the overdose deaths) among adults who committed a minor, non-violent, drug use-related offense by offering them a referral to treatment in lieu of arrest and prosecution of criminal charges. This manuscript outlines the protocol and methods for the MARI program development and implementation. MARI requires its participants to engage in the recommended treatment, without reoffending, during the six-month program, after which the initial criminal charges are “voided” by the law enforcement agency. The project, implemented in a mid-size U.S. city, has involved numerous partners, including law enforcement, criminal justice, public health, and academia. It includes training of the police officer workforce and collaboration with clinical partners for treatment need assessment, treatment placement, and peer support. Program evaluation includes formative, process, outcome (participant-level) and exploratory impact (community-level) assessments. For outcome evaluation, we will compare crime (primary outcome), overdose-related offenses, and incarceration-related data 12 months before and 12 months after the index crime between participants who completed (Group 1), started but not completed (Group 2), and were offered but did not start (Group 3) the program, and adults who would have been eligible should MARI existed (Historical Comparison, Group 4). Clinical characteristics will be compared at baseline between Groups 1–2, and pre-post the program within Group 1. Participant baseline data will be assessed as potential covariates. Surveys of police officers and program completers, and community-level indicators of crime and overdose pre- versus post-program will provide additional data on the program impact.

Discussion

By offering addiction treatment in lieu of arrest and prosecution of criminal charges, this pre-arrest diversion program has the potential to disrupt the cycle of crime, reduce the likelihood of future offenses, and promote public health and safety.
Advances in the automated synthesis of 6-[18F]Fluoro-L-DOPA
Authors: Neves Ângela C. B. , Hrynchak Ivanna , Fonseca Inês , Alves Vítor H. P. , Pereira Mariette M. , Falcão Amílcar , Abrunhosa Antero J.
Published: March 2021

The neurotracer 6-[18F]FDOPA has been, for many years, a powerful tool in PET imaging of neuropsychiatric diseases, movement disorders and brain malignancies. More recently, it also demonstrated good results in the diagnosis of other malignancies such as neuroendocrine tumours, pheochromocytoma or pancreatic adenocarcinoma.

The multiple clinical applications of this tracer fostered a very strong interest in the development of new and improved methods for its radiosynthesis. The no-carrier-added nucleophilic 18F-fluorination process has gained increasing attention, in recent years, due to the high molar activities obtained, when compared with the other methods although the radiochemical yield remains low (17–30%). This led to the development of several nucleophilic synthetic processes in order to obtain the product with molar activity, radiochemical yield and enantiomeric purity suitable for human PET studies.

Automation of the synthetic processes is crucial for routine clinical use and compliance with GMP requirements. Nevertheless, the complexity of the synthesis makes the production challenging, increasing the chance of failure in routine production. Thus, for large-scale clinical application and wider use of this radiopharmaceutical, progress in the automation of this complex radiosynthesis is of critical importance.

This review summarizes the most recent developments of 6-[18F]FDOPA radiosynthesis and discusses the key issues regarding its automation for routine clinical use.
Accuracy and diagnostic value of diffusion-weighted whole body imaging with background body signal suppression (DWIBS) in metastatic breast cancer
Authors: Eissawy Mohamed Gaber , Saadawy Amr M. Ismaeel , Farag Kamel , Akl Tamer , Kamr Wael Hamza
Published: March 2021

Background

Breast cancer is the most common malignant tumor among women. The mortality of the patients could be mainly attributed to metastasis and spread of breast cancer to distant sites. The objective of the current study is to evaluate and express the role of diffusion-weighted whole body imaging with background body signal suppression (DWIBS) in detection of osseous and soft tissue metastatic lesions in patients with cancer breast.

Results

The current prospective study included 50 female patients with pathologically proven breast cancer. The overall sensitivity of DWIBS and STIR were 97.5% and 92.5%, respectively. DWIBS was the most sensitive sequence with highest negative predictive values. DWIBS and STIR were the most sensitive with the highest negative predictive value. Both DWIBS and STIR detected more vertebral metastatic deposits (100% and 97.8%, respectively) and more soft tissue lesions (94.4% for both) than WB DWI and T1WI.

Conclusion

DWIBS MRI sequence is an effective method for detection of solid organ, bone and lymph node metastasis but not specific for characterization of lesions.
Predictive values of Alvarado score, serum C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis: a prospective study
Authors: Talabi Ademola Olusegun , Adedeji Tewogbade Adeoye , Sowande Oludayo Adedapo , Adejuyigbe Olusanya
Published: March 2021

Background

The diagnosis of acute appendicitis in children is quite challenging as the rate of negative appendectomy varies between 15 and 57%. Increased utilization of imaging diagnostic facilities in advanced countries seems to have reduced the incidence of operating on normal appendix to a single digit. In low- and middle-income countries, the incidence remains unacceptably high (double digits). Inflammatory markers and scoring systems may be a suitable adjunct to increase diagnostic yield in most third world countries. Thus, the aim of this study was to evaluate the diagnostic value of Alvarado score, white blood cell count, and serum C-reactive protein in children with acute appendicitis.

Results

The ages of patients ranged between 4 and 15 years with a mean of 11.2 ± 2.8 years. The male to female ratio was 1.4 to 1.0. Nineteen percent of patients had negative appendiceal findings on histological examination. The sensitivity and specificity of Alvarado score, C-reactive protein estimation, total white blood cell count in diagnosing acute appendicitis were 86.4% and 63.2%, 98.8% and 36.8%, and 51.9% and 89.5% respectively. Alvarado score has the highest area under ROC curve analysis 0.824, 95% CI of 0.724 to 0.924 compared with CRP, 0.769. 95% CI of = 0.647 to 0.891 and WBC count, 0.765, 95% CI of 0.643 to 0.887. Both CRP and WBC count showed higher discriminatory values between complicated and uncomplicated appendicitis, p < 0.001.

Conclusion

Alvarado score outperformed other tests in setting the diagnosis of acute appendicitis. However, none of the tests can be relied on wholly for operative decision. Clinical judgement remains the bedrock for diagnosis and operative management.
Imposing interpretational constraints on a seismic interpretation convolutional neural network
Authors: Di Haibin , Li Cen , Smith Stewart , Li Zhun , Abubakar Aria
Published: March 2021

With the expanding size of 3D seismic data, manual seismic interpretation becomes time-consuming and labor-intensive. For automating this process, recent progress in machine learning, in particular the convolutional neural network (CNN), has been introduced into the seismic community and successfully implemented for interpreting seismic structural and stratigraphic features. In principle, such automation aims at mimicking the intelligence of experienced seismic interpreters to annotate subsurface geology accurately and efficiently. However, most of the implementations and applications are relatively simple in their CNN architectures, which primary rely on the seismic amplitude but undesirably fail to fully use the preknown geologic knowledge and/or solid interpretational rules of an experienced interpreter who works on the same task. We have developed a generally applicable framework for integrating a seismic interpretation CNN with such commonly used knowledge and rules as constraints. Three example use cases, including relative geologic time-guided facies analysis, layer-customized fault detection, and fault-oriented stratigraphy mapping, are provided for illustrating how one or more constraints can be technically imposed and demonstrating what added values such a constrained CNN can bring. It is concluded that the imposition of interpretational constraints is capable of improving CNN-assisted seismic interpretation and better assisting the tasks of subsurface mapping and modeling.