bluuebunny/crossref_metadata_2025 huggingface dataset:
Thoughts on the potential to compensate a hearing loss in noise
Authors: Schädler Marc René
Published: April 2021

Background: The effect of hearing impairment on speech perception was described by Plomp (1978) as a sum of a loss of class A, due to signal attenuation, and a loss of class D, due to signal distortion. While a loss of class A can be compensated by linear amplification, a loss of class D, which severely limits the benefit of hearing aids in noisy listening conditions, cannot. The hearing loss of class D is assumed to be the main reason why not few users of hearing aids keep complaining about the limited benefit of their devices in noisy environments. Working compensation strategies against it are unknown.

Methods: Recently, in an approach to model human speech recognition by means of a re-purposed automatic speech recognition (ASR) system, the loss of class D was explained by introducing a level uncertainty which reduces the individual accuracy of spectro-temporal signal levels. Based on this finding, an implementation of a patented dynamic range manipulation scheme (PLATT) is proposed which aims to mitigate the effect of increased level uncertainty on speech recognition in noise by expanding spectral modulation patterns in the range of 2 to 4 ERB. This compensation approach is objectively evaluated regarding the benefit in speech recognition thresholds in noise using the ASR-based speech recognition model. Recommendations for an evaluation with human listeners are derived.

Results: The objective evaluation suggests that approximately half of the class D loss due to an increased level uncertainty might be compensable. To measure the effect with human listeners, an experiment needs to be carefully designed to prevent the confusion class A and D loss compensations.

Conclusions: A working compensation strategy for the class D loss could provide previously unexploited potential for relief. Evidence has to be provided in experiments with human listeners.
Compositional and Functional Analyses of Dioscorea Odoratissima (Bush Yam) Flour and Starch as Influenced by Pre-Treatment
Authors: Oluba Olarewaju M. , Babatunde Elizabeth B. , Akpor Oghenerobor B. , Olajide Olasunkanmi P. , Ogunremi Funsho J. , Babatola Leye J.
Published: April 2021

Dioscorea odoratissima (DO), an under-utilized famine crop is usually cooked, either peeled or unpeeled before consumption. Information on the effect of peeling on the nutritional attributes of D. odoratissima is scanty. In this study, nutritional and functional properties of flour and starch from peeled and unpeeled DO tuber were evaluated. Flour (UF) and starch (SU) from unpeeled yam tuber was significantly higher in starch compared to peeled yam flour (PF) and starch (PS), respectively. Crude protein content was significantly higher in UF and SU, compared to PF and PS. Alkaloids, phenolics, flavonoid, tannins, and trypsin inhibitor levels were significantly higher in UF and SU compared to PF and PS. PS exhibited significantly higher solubility, pasting clarity and swelling capacity compared to SU. In vitro starch digestibility, α-amylase and α-glucosidase activities positively correlate with amylose/amylopectin ratio in both flour and starch samples. UF and SU exhibited significantly higher antioxidant activity compared to PF and PS. These data emphasize the importance of pre-treatment with regard to applicability of DO flour and starch.
Comparative Study of Dietary Nutrition Index of Players of Sports Authority of India (SAI) and Tribal Schools of Kanker Chhattisgarh India
Authors: Singh Rashmi , Verma Vasu , Varoda Aniksha , Venugopal Reeta
Published: April 2021

Nutritional assessment of the adolescent is very important, as it provides the status of health. Calculating Dietary Nutrition Index (DNI) is an ideal method to the study nutritional status of any population. In the present study dietary index of the players who are studying in tribal schools of Chhattisgarh and players who are residing in urban area and training under Sports Authority of India was assessed. Total of 200 subjects aged between 14 to 17 years participated in this study. Descriptive statistics and ANOVA were used to compare the nutritional status of different groups. The result of the study revealed that DNI of tribal boys and girls and SAI girls is inadequate. Further it was found that there was a significant difference between the groups. SAI boys and girls showed better values as compared to tribal boys and girls. It is suggested that intervention to meet the dietary requirement of the players should be planned for optimal performance.
A TRAJETÓRIA DA PROFESSORA EUNICE DE JESUS PRUDENTE: MULHER NEGRA DAS CAMADAS POPULARES QUE SE TORNOU ADVOGADA E PROFESSORA TITULAR DA FACULDADE DE DIREITO DA UNIVERSIDADE DE SÃO PAULO
Authors: Cruz Ricardo Alexandre da
Published: April 2021

Este trabalho, visa apresentar uma personalidade negra, que semelhante a inúmeras outras, ficam, propositalmente, desconhecidas e têm suas biografias silenciadas na sociedade brasileira. Isto é, o trabalho apresenta a trajetória da professora Eunice A. J. Prudente, Mulher, negra, filha de operários que se torna a primeira professora negra da Faculdade de Direito da Universidade de São Paulo, além de ocupar outros cargos de destaque na sociedade. Para a realização deste trabalho, utilizamos alguns conceitos presentes ao longo da obra do sociólogo frances Pierre Bourdieu, com os conceitos de habitus, capital cultural, capital social e campo social. A fim de identificar quais foram as estratégias empregadas pela professora, empregou-se como metodologia a reconstrução da trajetória da professora Eunice Prudente por meio de entrevista.Palavras-chave: Negros e Educação; ascensão educacional e social; Trajetórias;
História das Áfricas e Literatura: as mulheres igbos na escrita literária de Flora Nwapa
Authors: Cassiano Tathiana Cristina
Published: April 2021

Por meio do diálogo teórico com intelectuais das Áfricas e de uma episteme que, oriunda de reflexões dos campos de estudos pós colonial e decolonial, permite emancipar os sujeitos da pesquisa enquanto produtores de conhecimento acerca de si mesmos e da realidade que os cerca, apresento neste trabalho resultados da pesquisa na qual propus construir interpretações acerca da vivência de mulheres igbos evidenciadas na escrita literária de Flora Nwapa, nigeriana e autora da obra Efuru. Dentro da perspectiva de articulação entre História das Áfricas e Literatura apresento possibilidades de utilização das literaturas africanas pós-coloniais na construção de conhecimentos sobre mulheres igbos e os processos históricos ocorridos na Nigéria da primeira metade do século XX, a partir de uma perspectiva africana.
PARA UMA NOVA GENEALOGIA DA NÉGRITUDE
Authors: Moïse Myriam
Published: April 2021

Esse artigo procura explorar, por meio da análise de publicações de Suzanne Roussi-Césaire e Paulette Nardal, como a ideologia da Négritude foi abraçada por homens e por mulheres por meio de seus ensaios, romances, poesias e obras de arte. As intelectuais, escritoras e artistas martinicanas não permaneceram em silêncio, elas articularam suas visões e forneceram importantes análises sobre as complexidades da construção da identidade africano-martinicana.
Ocupar o terreno: revisitando "Além dos significados de Miranda: des/silenciando o 'Terreno Demoníaco' da mulher de Calibã
Authors: Boyce-Davies Carole
Published: April 2021

Este artigo é uma revisita ao texto de Sylvia Wynter, intitulado originalmente “Beyond Miranda’s Meanings: Un/Silencing the ‘Demonic Ground’ of Caliban’s Woman” [Além dos Significados de Miranda: Des/Silenciando o ‘terreno demoníaco’ da Mulher de Calibã], e que figura como posfácio do livro Out of the Kumbla: Caribbean Women and Literature, publicado originalmente em 1990. Esse livro representa a primeira coletânea de textos voltados especificamente para o estudo de escritoras afro-caribenhas. Já o posfácio de Wynter destaca-se pela apresentação do conceito de “terreno demoníaco” (demonic ground), sobre o qual se debruça este artigo.
Antibacterial Properties of Scallop Shell Derived Calcium Hydroxide Powders
Authors: Aydin Gulsum , Kalemtas Ayse
Published: April 2021

Globally increased bivalve aquaculture production results in a vast amount of by-product discharges such as scallop shells. Utilization of these wastes to produce new products such as antibacterial agents can cooperate to reduce environmental problems and provide a high value-added product at a lower cost. In this study, scallop shells are heat-treated at 800°, 900°, 1000°, and 1100°C for 4 hours at atmospheric conditions. X-ray diffraction analysis revealed that calcium carbonate is the only inorganic phase in the powdered scallop shells. Ten weeks after the thermal treatment of the scallop shells, the calcium hydroxide phase was the only crystalline phase determined by X-ray diffraction analysis for the samples calcined at 1000° and 1100°C. At lower calcination temperatures, calcium carbonate and calcium hydroxide phases were co-existing in the samples. Scanning electron microscopy investigations depicted that using scallop shells as a starting material to synthesize nanometer-sized calcium hydroxide is achieved. It was determined that applied calcination temperature has a significant effect on the particle size of the obtained calcium hydroxide phase. Antimicrobial activity of calcined and uncalcined shell powders were tested against Escherichia coli and Staphylococcus aureus. No antibacterial activity was detected for the uncalcined scallop shell powders. However strong antibacterial activity was determined for the powders after subjection to calcination. Calcination of scallop shells is an environmentally friendly, readily applied, and low- cost approach to achieve nanometer-size calcium hydroxide that can be used as an inorganic antibacterial material in various composite systems.
Synthesis and Theoretical Calculations of 2-(p-Tolyl)-2,3-Dihydro-1H-Perimidine using Density Functional Theory
Authors: Adole Vishnu A. , Yelmame Ganesh B.
Published: April 2021

In the present study, 2-(p-tolyl)-2,3-dihydro-1H-perimidine (TDHP) is synthesized from 1,8-naphthalenediamine and 4-methylbenzaldehyde by embedding a one-carbon unit between the nitrogen followed by ring closure using green chemistry approach. 1H NMR and 13C NMR spectral techniques were used to validate the structure of the TDHP. The synthesized perimidine TDHP is studied using density functional theory (DFT) to provide valuable insights into structural, chemical, and thermochemical study.The structural and chemical properties of TDHP were computed using the DFT method on the B3LYP/6-311G(d,p) basis package. Bond lengths were predicted from the optimised molecular structure, and the physical and chemical properties of the molecules were inferred as a consequence. The HOMO and LUMO are computed, and quantum chemical parameters are determined using electronic energies. The calculated HOMO-LUMO energy gap is 4.25 eV indicating charge transfer phenomenon within the molecule. The electron density and chemical behaviour of the TDHP was predicted using Mulliken atomic charges and the molecular electrostatic surface potential plot.Amongst all carbon atoms, the C8 carbon as more positive and C27 as more negative carbon atoms. The high global electrophilicity index suggests electrophilic character of the TDHP.The harmonic vibrational frequencies were used to measure total energy, total molar entropy, and molar heat capacity.
Plant species diversity and crown cover response to vegetation regeneration in community-managed forest in Makawanpur District, Nepal
Authors: Ghimire Pramod , Lamichhane Uchita
Published: April 2021

Abstract. Ghimire P, Lamichhane U. 2020. Plant species diversity and crown cover response to vegetation regeneration in community-managed forest in Makawanpur District, Nepal. Asian J For 5: 36-41. Community forestry is considered as a win-win solution for forest conservation and livelihood provision of forest-based communities. Yet, limited knowledge is available regarding the status of vegetation regeneration in community forests. The study was carried out to assess plant species diversity and crown cover response to regeneration composition in Nawalpur Saraswati (Basamadi) Community Forest of Hetauda Municipality, Makawanpur District, Nepal in November 2020 to December 2020. A stratified random sampling method with a total of 94 sample plots was applied in the study. In total, 44 species belonging to 26 families were recorded in the study site, of which 23 species were represented in tree category, 14 in shrub, and 7 in herb category. Both Shannon-Weiner and Simpson's diversity indices indicated good floral species diversity in the study area. The forest was dominated by Shorea robusta with 396 stem ha-1, followed by Terminalia bellerica 29 stem ha-1, Lagerstroemia parviflora 25 stem ha-1, and Terminalia tomentosa 21 stem ha-1, respectively. Both seedling and sapling were found in good numbers with seedlings 11,583 number ha-1and saplings were 1,896 number ha-1. Both seedling and sapling density was recorded higher in open crown coverage (seedlings=32625 number ha-1; saplings=5033 number ha-1) than in close crown coverage (seedlings=13,708 number ha-1; saplings=2,550 number ha-1). Therefore, the study concluded that crown opening facilitates the growth and development of regeneration density in Shorea robusta and its associated forests. Furthermore, the information generated could be useful to predict future trends in species composition and stand structure in order to optimize the possible forest management strategies.
The Dilemmas of Flexibilisation of Vocational Education and Training: A Case Study of the Piano Makers
Authors: Baumeler Carmen , Engelage Sonja , Strebel Alexandra
Published: April 2021

Context: Dual VET systems are often praised for their labour market proximity because of economic stakeholders’ involvement. However, when labour market requirements change rapidly, a lack of flexibility is attributed to them. This occurs in times of fast socio-technological change like the current digital transformation. A repeatedly proposed measure to increase system flexibility is to reduce the number of occupations and create broader occupational profiles, for example, by combining similar occupations into so-called occupational fields. However, little is known about actually establishing occupational fields.Approach: Against this backdrop, we address the following research question: How was an occupational field created? As Switzerland attempted to merge occupations over a decade ago, we selected an information-rich and illuminative case concerning the research question: The piano makers’ occupation as one of the first occupations required to merge into an occupational field called musical instrument makers together with organ builders and wind instrument makers. Based on a qualitative case study, we reconstruct the process of occupational field construction by combining expert interviews with comprehensive document analysis and present its narrative.Findings: Based on this case study, we contribute to the understanding of VET flexibilisation by detailing occupational field creation and identifying opportunities and challenges. Here, we pay special attention to the institutional work of the affected occupational association and identify the importance of preserving its collective occupational identity. Although regulatory changes disrupted the piano makers’ occupation, the occupational association reinstitutionalised it as part of the musical instrument makers’ occupational field. Over a decade later, the piano makers reintroduced their former occupational title, which is deeply connected to their occupational identity. Conclusion: The results indicate that VET reforms that promote flexibilisation by creating occupational fields encounter serious limitations in collectively governed dual VET systems. In the Swiss system, occupational associations are core collective actors that rely on their members’ voluntary work. To maintain these economic stakeholders’ necessary commitment to VET, their collective occupational identity, symbolized by their long-standing occupational title, needs to be preserved.
Adaptation of the polarimetric multi-spectral Aerosol Limb Imager for high altitude aircraft and satellite observations
Authors: Kozun M. N. , Bourassa A. E. , Degenstein D. A. , Haley C. S. , Zheng S. H.
Published: April 2021

An elegant breadboard prototype of the Aerosol Limb Imager (ALI) has been developed to meet key performance parameters that will meet requirements for the retrieval of aerosol from the upper troposphere and stratosphere from limb scattered sunlight radiance measurements. Similar in concept to previous high altitude balloon-based generations, this instrument pairs a liquid crystal polarization rotator with an acousto-optic tunable filter to capture polarimetric multi-spectral images of the atmospheric limb. This design improves the vertical resolution, signal-to-noise ratio, and athermalization, all of which will facilitate observation from a moving high altitude aircraft platform, which provides a platform analogous to the spatially varying measurements that would be made from a satellite. Finally, a preliminary design is presented for a satellite-based generation of ALI.
Co-located angularly offset fiber Bragg grating pair for temperature-compensated unambiguous 3D shape sensing
Authors: Feng Dingyi , Albert Jacques , Hou Yueguo , Jiang Biqiang , Jiang Yajun , Ma Ying , Zhao Jianlin
Published: April 2021

A 10 mm-long three-dimensional shape sensor in a single-mode fiber is described and demonstrated experimentally. The sensor is based on a pair of fiber Bragg gratings inscribed at the same location along the fiber axis but offset along different radial directions away from the fiber center. Each offset grating generates cladding mode resonances over a

∼

20

n
m

-wide spectral bandwidth, and the two gratings are also offset in period so that their transmission spectra are separated by 40 nm, and thus non-overlapping and fully distinguishable. Directional bending sensitivity results from the differential amplitude response of the cladding mode resonances from the two gratings, depending on the relative orientation of the bend with the azimuthal direction of the grating offsets. It is further demonstrated that both axial deformation and temperature have no influence on the shape measurement as they both only cause a global wavelength shift of the spectra without amplitude change. The experimental results demonstrate that the shape orientation of an object can be unambiguously determined for bend directions covering the full 360° range around the fiber axis with sensitivities of the order of

1

d
B

/

m

−
1

and small curvatures between 0 and

1

m

−
1

.
Worldwide epidemiology of Crimean-Congo Hemorrhagic Fever Virus in humans, ticks and other animal species, a systematic review and meta-analysis
Authors: Belobo Jean Thierry Ebogo , Kenmoe Sebastien , Kengne-Nde Cyprien , Emoh Cynthia Paola Demeni , Bowo-Ngandji Arnol , Tchatchouang Serges , Sowe Wobessi Jocelyne Noel , Mbongue Mikangue Chris Andre , Tazokong Hervé Raoul , Kingue Bebey Sandrine Rachel , Atembeh Noura Efietngab , Ka’e Aude Christelle , Guiamdjo Simo Raïssa Estelle , Modiyinji Abdou Fatawou , Ngongang Dimitri Tchami , Che Emmanuel , Kenfack Sorel , Nzukui Nathalie Diane , Amvongo Adjia Nathalie , Babassagana Isabelle Tatiana , Mahamat Gadji , Mbaga Donatien Serge , Mbacham Wilfred Fon , Sadeuh-Mbah Serge Alain , Njouom Richard
Published: April 2021

There are uncertainties about the global epidemiological data of infections due to Crimean-Congo hemorrhagic fever virus (CCHFV). We estimated the global case fatality rate (CFR) of CCHFV infections and the prevalence of CCHFV in humans, ticks and other animal species. We also explored the socio-demographic and clinical factors that influence these parameters. In this systematic review with meta–analyses we searched publications from database inception to 03rd February 2020 in Pubmed, Scopus, and Global Index Medicus. Studies included in this review provided cross-sectional data on the CFR and/or prevalence of one or more targets used for the detection of CCHFV. Two independent investigators selected studies to be included. Data extraction and risk of bias assessment were conducted independently by all authors. Data collected were analysed using a random effect meta-analysis. In all, 2345 records were found and a total of 312 articles (802 prevalence and/or CFR data) that met the inclusion criteria were retained. The overall CFR was 11.7% (95% CI = 9.1–14.5), 8.0% (95% CI = 1.0–18.9), and 4.7% (95% CI = 0.0–37.6) in humans with acute, recent, and past CCHFV infections respectively. The overall CCHFV acute infections prevalence was 22.5% (95% CI = 15.7–30.1) in humans, 2.1% (95% CI = 1.3–2.9) in ticks, and 4.5% (95% CI = 1.9–7.9) in other animal species. The overall CCHFV recent infections seroprevalence was 11.6% (95% CI = 7.9–16.4) in humans and 0.4% (95% CI = 0.0–2.9) in other animal species. The overall CCHFV past infections seroprevalence was 4.3% (95% CI = 3.3–5.4) in humans and 12.0% (95% CI = 9.9–14.3) in other animal species. CFR was higher in low-income countries, countries in the WHO African, South-East Asia and Eastern Mediterranean regions, in adult and ambulatory patients. CCHFV detection rate in humans were higher in CCHFV suspected cases, healthcare workers, adult and hospitalized patients, ticks of the genus Ornithodoros and Amblyomma and in animals of the orders Perissodactyla and Bucerotiformes. This review highlights a significant disease burden due to CCHFV with a strong disparity according to country income levels, geographic regions, various human categories and tick and other animal species. Preventive measures in the light of these findings are expected.
Maternal and perinatal mortality and morbidity of uterine rupture and its association with prolonged duration of operation in Ethiopia: A systematic review and meta-analysis
Authors: Desta Melaku , Kassa Getachew Mullu , Getaneh Temesgen , Sharew Yewbmirt , Alemu Addisu Alehegn , Birhanu Molla Yigzaw , Yeneabat Tebikew , Alamneh Yoseph Merkeb , Amha Haile
Published: April 2021

Background

Uterine rupture is the leading cause of maternal and perinatal morbidity and it accounts for 36% of the maternal mortality in Ethiopia. The maternal and perinatal outcomes of uterine rupture were inconclusive for the country. Therefore, this systematic review and meta-analysis aimed to estimate the pooled maternal and perinatal mortality and morbidity of uterine rupture and its association with prolonged duration of operation.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used for this systematic review and meta-analysis. We systematically used PubMed, Cochrane Library, and African Journals online databases for searching. The Newcastle- Ottawa quality assessment scale was used for critical appraisal. Egger’s test and I2 statistic used to assess the check for publication bias and heterogeneity. The random-effect model was used to estimate the pooled prevalence and odds ratios with 95% confidence interval (CI).

Results

The pooled maternal mortality and morbidity due to uterine rupture in Ethiopia was 7.75% (95% CI: 4.14, 11.36) and 37.1% (95% CI: 8.44, 65.8), respectively. The highest maternal mortality occurred in Southern region (8.91%) and shock was the commonest maternal morbidity (24.43%) due to uterine rupture. The pooled perinatal death associated with uterine rupture was 86.1% (95% CI: 83.4, 89.9). The highest prevalence of perinatal death was observed in Amhara region (91.36%) and the lowest occurred in Tigray region (78.25%). Prolonged duration of operation was a significant predictor of maternal morbidity (OR = 1.39; 95% CI: 1.06, 1.81).

Conclusions

The percentage of maternal and perinatal deaths due to uterine rupture was high in Ethiopia. Uterine rupture was associated with maternal morbidity and prolonged duration of the operation was found to be associated with maternal morbidities. Therefore, birth preparedness and complication readiness plan, early referral and improving the duration of operation are recommended to improve maternal and perinatal outcomes of uterine rupture.
What gaps remain in the HIV cascade of care? Results of a population-based survey in Nsanje District, Malawi
Authors: Conan Nolwenn , Paye Cyrus P. , Ortuno Reinaldo , Chijuwa Alexander , Chiwandira Brown , Goemaere Eric , Belen Garone Daniela , Coulborn Rebecca M. , Chihana Menard , Maman David
Published: April 2021

Introduction

The Malawi Ministry of Health (MoH) has been in collaboration with Médecins sans Frontières (MSF) to increase access to quality HIV care through decentralization of antiretroviral therapy (ART) diagnosis and treatment from hospital to clinics in Nsanje District since 2011. A population-based household survey was implemented to provide information on HIV prevalence and cascade of care to inform and prioritize community-based HIV interventions in the district.

Methods

A cross-sectional survey was conducted between September 2016 and January 2017. Using two-stage cluster sampling, eligible adult individuals aged ≥15 years living in the selected households were asked to participate. Participants were interviewed and tested for HIV at home. Those tested HIV-positive had their HIV-RNA viral load (VL) measured, regardless of their ART status. All participants tested HIV-positive at the time of the survey were advised to report their HIV test result to the health facility of their choice that MSF was supported in the district. HIV-RNA VL results were made available in this health facility.

Results

Among 5,315 eligible individuals, 91.1% were included in the survey and accepted an HIV test. The overall prevalence was 12.1% (95% Confidence Interval (CI): 11.2–13.0) and was higher in women than in men: 14.0% versus 9.5%, P<0.001. Overall HIV-positive status awareness was 80.0% (95%CI: 76.4–83.1) and was associated with sex (P<0.05). Linkage to care was 78.0% (95%CI: 74.3–81.2) and participants in care 76.2% (95%CI: 72.4–79.5). ART coverage among participants aware of their HIV-positive status was 95.3% (95%CI: 92.9–96.9) and was not associated with sex (P = 0.55). Viral load suppression among participants on ART was 89.9% (95%CI: 86.6–92.4) and was not statistically different by sex (p = 0.40).

Conclusions

Despite encouraging results in HIV testing coverage, cascade of care, and UNAIDS targets in Nsanje District, some gap remains in the first 90, specifically among men and young adults. Enhanced community engagement and new strategies of testing, such as index testing, could be implemented to identify those who are still undiagnosed, particularly men and young adults.
Palliative care needs and preferences of female patients and their caregivers in Ethiopia: A rapid program evaluation in Addis Ababa and Sidama zone
Authors: Kaba Mirgissa , de Fouw Marlieke , Deribe Kalkidan Solomon , Abathun Ephrem , Peters Alexander Arnold Willem , Beltman Jogchum Jan
Published: April 2021

Introduction

In Ethiopia there is an extensive unmet need for palliative care, while the burden of non-communicable diseases and cancer is increasing. This study aimed to explore palliative care needs and preferences of patients, their caregivers, and the perspective of stakeholders on service provision in palliative programs for women, mostly affected by cervical cancer and breast cancer.

Methods

A rapid program evaluation using a qualitative study approach was conducted in three home-based palliative care programs in Addis Ababa and Yirgalem town, Ethiopia. Female patients enrolled in the programs, and their primary caregivers were interviewed on palliative care needs, preferences and service provision. We explored the views of purposely selected stakeholders on the organization of palliative care and its challenges. Audio-taped data was transcribed verbatim and translated into English and an inductive thematic analysis was applied. Descriptive analyses were used to label physical signs and symptoms using palliative outcome scale score.

Results

A total of 77 interviews (34 patients, 12 primary caregivers, 15 voluntary caregivers, 16 stakeholders) were conducted. The main physical complaints were moderate to severe pain (70.6%), followed by anorexia (50.0%), insomnia, nausea and vomiting (41.2%). Social interaction and daily activities were hampered by the patients’ condition. Both patients and caregivers reported that programs focus most on treatment of symptoms, with limited psychosocial, emotional, spiritual and economic support. Lack of organizational structures and policy directions limit the collaboration between stakeholders and the availability of holistic home-based palliative care services.

Conclusions

Although female patients and caregivers appreciated the palliative care and support provided, the existing services did not cover all needs. Pain management and all other needed supports were lacking. Multi-sectorial collaboration with active involvement of community-based structures is needed to improve quality of care and access to holistic palliative care services.
Birth preparedness and complication readiness practice and associated factors among pregnant women in Northwest Ethiopia: 2018
Authors: Debelie Tibeb Zena , Abdo Abdella Amano , Anteneh Kiber Temesgen , Limenih Miteku Andualem , Asaye Mengstu Melkamu , Lake Aynalem Getie , Ambaw Worku Mequannt , Kassie Belayneh Ayanaw , Abebe Solomon Mekonnen
Published: April 2021

Background

Birth-preparedness and complication readiness is a comprehensive strategy aimed at promoting the timely utilization of skilled maternal and neonatal health care. Pregnancy-related complications both on the mother and the newborn could be largely alleviated if there is a well-consolidated birth preparedness and complication readiness plan developed during pregnancy and implemented at the time of delivery.

Objective

To determine the prevalence of birth preparedness and complication readiness practice (BPCR) and associated factors among pregnant women in North Gondar Zone, Northwest Ethiopia, 2018.

Methods

A community based cross-sectional study was conducted among pregnant women in North Gondar Zone from March 2017 to February 2018. A multistage clustered sampling technique was used to enroll a total of 1620 participants. The data were collected by face to face interviews using pretested and semi-structured questionnaires at baseline and following delivery. The data were entered using EPI-data version 3.1 and analyzed using STATA version 14 software. Bivariate and multivariable logistic regression model was fitted to assess factors with BPCR practice. Adjusted odds ratio (AOR) with 95% confidence interval was used to determine the association between covariates and the outcome variable.

Results

From a total of 1620 pregnant women only 1523 (94.0%) mothers were followed at the end line. The prevalence of BPCR plan during pregnancy was 66.1% [95% CI: 63.8, 68.5] and the practice at the time of delivery was 73.5% [95% CI 71.3, 75.7]. Of the total respondents who mentioned having a BPCR plan, 76.4% practiced at the time of delivery. Frequency of ANC visits [AOR = 1.97; 95% CI: 1.67, 2.32], larger number of family in the household [AOR = 1.14; 95%CI: 1.00, 1.30], highest wealth asset [AOR = 1.87; 95%CI: 1.16, 3.01], Multigravidity [AOR = 0.30; 95% CI: 0.15, 0.62], husband involvement in decision making [AOR = 2.2; 95% CI: 1.25, 3.82], counseled on BPCR [AOR = 2.35; 95% CI: 1.51, 3.68], were found to be significantly associated with BPCR practice.

Conclusion

BPCR practice at the time of delivery was higher than previous studies conducted in the country. However, BPCR practice was found to be lower than the standard that every woman should practice the plan at the time of delivery. Intersectoral collaborative interventions required to improve the economic status and living standard of families in the community as well as various awareness creation strategies should be implemented to support women to attend ANC follow-up visits.
Puerarin blocks the aging phenotype in human dermal fibroblasts
Authors: Kamiya Yuki , Odama Mao , Mizuguti Aki , Murakami Shigeru , Ito Takashi
Published: April 2021

Dermal fibroblast aging contributes to aging-associated functional defects in the skin since dermal fibroblasts maintain skin homeostasis by interacting with the epidermis and extracellular matrix. Here, we found that puerarin, an isoflavone present in Pueraria lobata (Kudzu), can prevent the development of the aging-phenotype in human dermal fibroblasts. Normal human dermal fibroblasts (NHDFs) were subcultivated and high-passage cells were selected as senescent cells, whereas low-passage cells were selected as a young cell control. Puerarin treatment increased cell proliferation and decreased the proportion of senescence-associated beta-galactosidase-positive cells in a high-passage culture of NHDFs. Moreover, puerarin treatment reduced the number of smooth muscle actin (SMA)-positive myofibroblasts and the expression of a reticular fibroblast marker, calponin 1 (CNN1), which were induced in high-passage NHDFs. Fulvestrant, an estrogen receptor antagonist, blocked the puerarin-mediated downregulation of SMA and CNN1. Our results suggest that puerarin may be a useful functional food that alleviates aging-related functional defects in dermal fibroblasts.
Image-derived mean velocity measurement for prediction of coronary flow reserve in a canonical stenosis phantom using magnetic particle imaging
Authors: Siepmann Robert , Nilius Henning , Mueller Florian , Mueller Katrin , Luisi Claudio , Dadfar Seyed Mohammadali , Straub Marcel , Schulz Volkmar , Reinartz Sebastian Daniel
Published: April 2021

Introduction

Aim of this study is to evaluate whether magnetic particle imaging (MPI) is capable of measuring velocities occurring in the coronary arteries and to compute coronary flow reserve (CFR) in a canonical phantom as a preliminary study.

Methods

For basic velocity measurements, a circulation phantom was designed containing replaceable glass tubes with three varying inner diameters, matching coronary-vessel diameters. Standardised boluses of superparamagnetic-iron-oxide-nanoparticles were injected and visualised by MPI. Two image-based techniques were competitively applied to calibrate the respective glass tube and to compute the mean velocity: full-duration-at-half-maximum (FDHM) and tracer dilution (TD) method. For CFR-calculation, four necessary settings of the circulation model of a virtual vessel with an inner diameter of 4 mm were generated using differently sized glass tubes and a stenosis model. The respective velocities in stenotic glass tubes were computed without recalibration.

Results

On velocity level, comparison showed a good agreement (rFDHM = 0.869, rTD = 0.796) between techniques, preferably better for 4 mm and 6 mm inner diameter glass tubes. On CFR level MPI-derived CFR-prediction performed considerably inferior with a relative error of 20–44%.

Conclusions

MPI has the ability to reliably measure coronary blood velocities at rest as well as under hyperaemia and therefore may be suitable for CFR calculation. Calibration-associated accuracy of CFR-measurements has to be improved substantially in further studies.
Intensity of de novo DSA detected by Immucor Lifecodes assay and C3d fixing antibodies are not predictive of subclinical ABMR after Kidney Transplantation
Authors: Bertrand Dominique , Kaveri Rangolie , Laurent Charlotte , Gatault Philippe , Jauréguy Maïté , Garrouste Cyril , Sayegh Johnny , Bouvier Nicolas , Caillard Sophie , Lanfranco Luca , Thierry Antoine , François Arnaud , Hau Françoise , Etienne Isabelle , Guerrot Dominique , Farce Fabienne
Published: April 2021

De novo donor-specific antibodies (dnDSA) are associated with antibody-mediated rejection (ABMR) and allograft loss. We tested Immucor* (IM) Luminex Single-antigen beads (LSAB) assay and C3d-fixing antibodies in the setting of dnDSA and subclinical (s) ABMR. This retrospective multicentric study included 123 patients biopsied because of the presence of subclinical de novo DSA detected by One Lamda* Labscreen (MFI > 1000). In 112 patients, sera of the day of the biopsy were available and tested in a central lab with IM Lifecodes LSAB and C3d fixing antibodies assays. In 16 patients (14.3%), no DSA was detected using Immucor test. In 96 patients, at least one DSA was determined with IM. Systematic biopsies showed active sABMR in 30 patients (31.2%), chronic active sABMR in 17 patients (17.7%) and no lesions of sABMR in 49 KT recipients (51%). Intensitity criteria (BCM, BCR and AD-BCR) of DSA were not statistically different between these 3 histological groups. The proportion of patients with C3d-fixing DSA was not statistically different between the 3 groups and did not offer any prognostic value regarding graft survival. Performing biopsy for dnDSA could not be guided by the intensity criteria of IM LSAB assay. C3d-fixing DSA do not offer added value.
Octreotide inhibits secretion of IGF-1 from orbital fibroblasts in patients with thyroid-associated ophthalmopathy via inhibition of the NF-κB pathway
Authors: Kim Sung Eun , Kim Jia , Lee Ji-Young , Lee Seong-Beom , Paik Ji-Sun , Yang Suk-Woo
Published: April 2021

Purpose

We investigated the effect of octreotide, a long-acting somatostatin (SST) analogue, on IGF-1 secretion and its possible mechanism of action in orbital fibroblasts (OFs) from patients with thyroid-associated ophthalmopathy (TAO).

Materials and methods

OFs were isolated from the orbital fat of patients with TAO or healthy individuals. The expression level of insulin-like growth factor (IGF)-1, at the protein and mRNA level, was determined with ELISA and quantitative RT-PCR, respectively. The expression pattern of somatostatin receptor (SSTR) 2, which has the highest affinity for octreotide, was examined by flow cytometry. The activity of NF-κB pathway was determined by examining the levels of phosphorylation of IKKα/β and p65, and degradation of IκB via western blot analysis, and by measuring the activity of NF-kB-dependent luciferase via transfection with plasmids containing luciferase and NF-κB binding site.

Results

OFs from patients with TAO showed significantly higher levels of IGF-1 secretion and NF-κB activity even in the absence of stimulation, compared to those from controls. Treatment with octreotide reduced the level of IGF-1 secretion in OFs from patients with TAO, but not in OFs from controls. OFs from patients with TAO expressed higher levels of SSTR2 on the cell surface, compared to controls. In addition, the expression of IGF-1 at the protein and mRNA level was dependent on the activity of NF-κB pathway in OFs from patients with TAO. Furthermore, treatment with octreotide reduced on the activity of NF-κB pathway in OFs from patients with TAO.

Conclusion

OFs from patients with TAO showed significantly higher levels of IGF-1 secretion via up-regulation of NF-κB activity. Treatment with octreotide inhibited the secretion of IGF-1 by reducing the NF-κB pathway in OFs, which expressed higher levels of SSRT2 on the cell surface, from patients with TAO.
Impact of Friendship Bench problem-solving therapy on adherence to ART in young people living with HIV in Zimbabwe: A qualitative study
Authors: Ouansafi Ilhame , Chibanda Dixon , Munetsi Epiphania , Simms Victoria
Published: April 2021

Background

Adolescents and young people globally are highly vulnerable to poor mental health especially depression, and they account for 36% of new HIV infections in Eastern and Southern Africa. HIV services remain inadequate for this population and their adherence to ART is low. The Friendship Bench (FB), an evidence-based model developed in Zimbabwe to bridge the mental health gap, is a brief psychological intervention delivered on benches in primary care facilities by lay health workers (“grandmothers”) trained in problem-solving therapy. This study explored the experience of young people living with HIV attending FB, and their perception of how problem-solving therapy impacted their adherence to ART.

Methods

Semi-structured interviews were conducted in July 2019 with 10 young people living with HIV aged 18–24 years, who had recently completed FB counselling in Harare. Participants were purposively sampled and recruited from three primary care facilities. Interviews were conducted in Shona, audio-recorded, transcribed verbatim and translated into English. Transcripts were analysed in NVivo12 using inductive thematic analysis.

Results

Study findings revealed a clear emotional denial towards HIV, particularly for young people infected perinatally, and a resulting low adherence to ART. The study also unpacked the issues of internal stigma and how young people living with perinatally acquired HIV are informed of their HIV status. Participants reported that FB had a critical role in helping them accept their HIV status. Grandmothers’ empathic attitude was key during counselling on adherence to ART, to demystify the disease and treatment, normalize the reality of living with HIV, encourage young people to socialize with peers and free them of guilt. Interviewees unanimously reported improved ART adherence following FB counselling, and many described enhanced health and wellbeing.

Conclusion

Participants saw FB as a strong contributor to their general well-being, evident in decreased symptoms of depression and improved adherence to ART. FB problem-solving therapy should be rolled out to further support young people after post-test counselling or HIV serostatus disclosure for perinatally acquired HIV, for acceptance of HIV status and adherence to ART.
Acceptance of criteria for health and driver scoring in the general public in Germany
Authors: Rebitschek Felix G. , Gigerenzer Gerd , Keitel Ariane , Sommer Sarah , Groß Christian , Wagner Gert G.
Published: April 2021

Numerous health insurers offer bonus programmes that score customers’ health behaviour, and car insurers offer telematics tariffs that score driving behaviour. In many countries, however, only a minority of customers participate in these programmes. In a population-representative survey of private households in Germany (N = 2,215), we study the acceptance of the criteria (features) on which the scoring programmes are based: the features for driver scoring (speed, texting while driving, time of driving, area of driving, accelerating and braking behaviour, respectively) and for health scoring (walking distance per day, sleeping hours per night, alcohol consumption, weight, participation in recommended cancer screenings, smoking status). In a second step, we model participants’ acceptance of both programmes with regard to the underlying feature acceptance. We find that insurers in Germany rarely use the features which the participants consider to be the most relevant and justifiable, that is, smoking status for health scoring and smartphone use for driver scoring. Heuristic models (fast-and-frugal trees) show that programme acceptance depends on the acceptance of a few features. These models can help to understand customers’ preferences and to design scoring programmes that are based on scientific evidence regarding behaviours and factors associated with good health and safe driving and are thus more likely to be accepted.
A biome-wide experiment to assess the effects of propagule size and treatment on the survival of Portulacaria afra (spekboom) truncheons planted to restore degraded subtropical thicket of South Africa
Authors: van der Vyver Marius L. , Mills Anthony J. , Cowling Richard M.
Published: April 2021

Insights from biome-wide experiments can improve efficacy of landscape-scale ecological restoration projects. Such insights enable implementers to set temporal and geographical benchmarks and to identify key drivers of success during the often decades-long restoration trajectory. Here we report on a biome-wide experiment aimed at informing the ecological restoration of thousands of hectares of degraded subtropical thicket dominated by the succulent shrub, Portulacaria afra (spekboom). Restoration using spekboom truncheons has the potential to sequester, for a semi-arid region, large amounts of ecosystem carbon, while regenerating a host of associated ecosystem services. This study evaluates, after about three years post-propagation, the effects of spekboom truncheon size and treatment on survivorship in 40 fence-enclosed (0.25 ha) plots located in target habitat across the entire spekboom thicket biome. In each plot, locally harvested spekboom truncheons, comprising eight size/treatment combinations, were planted in replicated rows of between 24 and 49 individuals, depending on treatment. The experiment assessed the role of truncheon size, spacing, application of rooting hormone and watering at planting on survivorship percentage as an indicator of restoration success. All eight combinations recorded extreme minimum survivorship values of zero, while the range of extreme maximum values was 70-100%. Larger truncheons (>22.5 mm diameter) had almost double the survivorship (ca. 45%) than smaller truncheons (< 15 mm) (ca. 25%). Planting large, untreated truncheons at 1 m intervals—as opposed to 2 m intervals recommended in the current restoration protocol—resulted in no significant change in survivorship. The application of rooting hormone and water at planting had no significant effect on restoration success for both large and small truncheons. While our results do not provide an evidence base for changing the current spekboom planting protocol, we recommend research on the financial and economic costs and benefits of different propagation strategies in real-world contexts.
Over half of clinical practice guidelines use non-systematic methods to inform recommendations: A methods study
Authors: Lunny Carole , Ramasubbu Cynthia , Puil Lorri , Liu Tracy , Gerrish Savannah , Salzwedel Douglas M. , Mintzes Barbara , Wright James M.
Published: April 2021

Introduction

Assessing the process used to synthesize the evidence in clinical practice guidelines enables users to determine the trustworthiness of the recommendations. Clinicians are increasingly dependent on guidelines to keep up with vast quantities of medical literature, and guidelines are followed to avoid malpractice suits. We aimed to assess whether systematic methods were used when synthesizing the evidence for guidelines; and to determine the type of review cited in support of recommendations.

Methods

Guidelines published in 2017 and 2018 were retrieved from the TRIP and Epistemonikos databases. We randomly sorted and sequentially screened clinical guidelines on all topics to select the first 50 that met our inclusion criteria. Our primary outcomes were the number of guidelines using either a systematic or non-systematic process to gather, assess, and synthesise evidence; and the numbers of recommendations within guidelines based on different types of evidence synthesis (systematic or non-systematic reviews). If a review was cited, we looked for evidence that it was critically appraised, and recorded which quality assessment tool was used. Finally, we examined the relation between the use of the GRADE approach, systematic review process, and type of funder.

Results

Of the 50 guidelines, 17 (34%) systematically synthesised the evidence to inform recommendations. These 17 guidelines clearly reported their objectives and eligibility criteria, conducted comprehensive search strategies, and assessed the quality of the studies. Of the 29/50 guidelines that included reviews, 6 (21%) assessed the risk of bias of the review. The quality of primary studies was reported in 30/50 (60%) guidelines.

Conclusions

High quality, systematic review products provide the best available evidence to inform guideline recommendations. Using non-systematic methods compromises the validity and reliability of the evidence used to inform guideline recommendations, leading to potentially misleading and untrustworthy results.