bluuebunny/crossref_metadata_2025 huggingface dataset:
Political History of Zimbabwe Since 1980
Authors: Kufakurinani Ushehwedu
Published: January 2021

The political history of Zimbabwe has been one of radical shifts and turns. Winning its political independence from white minority rule in 1980, Zimbabwe emerged as a promising nation. The new prime minister, Robert Gabriel Mugabe, preached hope and reconciliation. There was euphoria at independence as the nation celebrated political freedom achieved through war and highly emotive negotiations at Lancaster House Conference. Before the first half of the decade passed, the new government was already engaged in a war against its citizens, dubbed Gukurahundi. By the end of the decade, it was also clear that its socialist rhetoric and corruption, among other things, were plunging the nation into an economic crisis, which drove the nation into the jaws of the IMF and World Bank. The economic crisis only worsened, and the so-called neoliberal era in the 1990s sent the nation into an economic quagmire. The economy has always been inextricably intertwined with the politics of the country. Political (mis)calculations triggered economic problems, while on other occasions the reverse was true. The years 2000–2009, in particular, were truly a lost decade. The century began with the controvertible Fast Track Land Reform Programme (FTLRP). After a period of extreme political tensions in the country, a Government of National Unit (GNU) was established in 2009 in which the ruling party, the Zimbabwe African National Union–Patriotic Front (ZANU PF), and the opposition party, the Movement for Democratic Change (MDC), came to form a government. The period from 2010 to 2013 seemed to offer some relief to the nation, partly as a result of the GNU. However, this honeymoon was short-lived. As soon as ZANU PF regained power after the contested 2013 elections, there was a noticeable decline of the economy. Meanwhile, as the economy melted, power struggles intensified within ZANU PF. These reached their peak in 2017, culminating in what has come to be known as the November coup that saw the demise of Mugabe and the takeover by his deputy, Emmerson Dambudzo Mnangagwa, as president. The post-coup era in Zimbabwe has been a period of political drama and deeper economic challenges.
Dutch Slave Trade in the Atlantic, 1600–1800
Authors: Emmer Pieter , den Heijer Henk
Published: January 2021

The Dutch share in the Atlantic slave trade averaged about 5 to 6 percent of the total, but the volume differed sharply over time. The beginning of the Dutch transatlantic slave trade can be dated to 1636, after the Dutch West India Company (WIC) had acquired its own plantation colony around Recife in Brazil. In order to set up a regular trade in slaves, the WIC also took Elmina on the Gold Coast and Luanda in Angola from the Portuguese. The slave trade to Dutch Brazil was short-lived, and after the loss of Dutch Brazil and Luanda, the WIC as well as private merchants from Amsterdam started to sell slaves to colonists in the Spanish, English, and French Caribbean via Curaçao, the WIC trade hub in the region. In 1667, in addition to the small colonies of Berbice and Essequibo, the Dutch conquered Suriname and during the 18th century established Demerara. The Dutch slave trade became more and more focused on these plantation colonies.

Between 1700 and 1725, after the Dutch had been banned from selling slaves in foreign colonies, the Dutch slave trade declined, but the volume increased again after 1730 when the WIC lost its monopoly and private shipping companies were allowed to enter the trade. In addition, Amsterdam-based investors poured money into the Dutch plantation colonies expecting windfall profits from a new cash crop: coffee. These profits did not materialize, and the majority of the planters in the Dutch plantation colonies went bankrupt. These bankruptcies, another war with Britain, and the French occupation caused the Dutch slave trade to decline sharply. The last Dutch slave ship sailed to Suriname in 1802. In 1814, the Dutch government yielded to British abolitionist pressure and abolished the slave trade in the hope of regaining its colonial possessions occupied by Britain.
Behavioral Interventions as Policy Instruments to Manage Household Water Use
Authors: Ching Leong , Tay Swee Kiat
Published: January 2021

Water planners and policy analysts need to pay closer attention to the behavioral aspects of water use, including the use of nonprice measures such as norms, public communications, and intrinsic motivations. Empirical research has shown that people are motivated by normative as well as economic incentives when it comes to water. In fact, this research finds that after exposure to feedback about water use, adding an economic incentive (rebate) for reducing water use holds no additional power. In other cases, nonprice measures can be a way to increase the salience, and subsequently, effectiveness of any adopted pricing mechanisms. We review these empirical findings and locate them within more general literature on normative incentives for behavioral change. Given increasing water scarcity and decreasing water security in cities, policy planners need to make more room for normative incentives when designing rules for proenvironmental behavior.
British Business on the West Coast of South America
Authors: Greenhill Robert G. , Miller Rory M.
Published: January 2021

Broadly speaking, historians have considered the development of British business on the west coast of South America in the 19th and 20th centuries with a strong focus on Chile and Peru and in the light of two different historiographical approaches: debate over the organization of British business overseas and controversies over informal imperialism and dependency. Initially, the most visible examples of British business influence were merchants who arrived at the time of independence in the early 19th century, although from the middle of the century there was also significant investment in government bonds (sovereign debt). After the War of the Pacific (1879–1883), “freestanding companies” and investment groups, often organized by commercial houses handling Latin American exports, became the main vehicle for British capital flows. The activities of merchants and other suppliers of business services, such as shipping firms, banks, and insurance companies, together with the development of freestanding companies in railways and resource extraction after the War of the Pacific, certainly accelerated the incorporation of Peru and Chile into the expanding global economy. While it is difficult to find concrete examples of direct intervention by British firms in local politics, the growth of foreign business did set constraints on the autonomy of Latin American governments, which became dependent on the direct and indirect income from commodity exports. However, it also provided opportunities for local politicians and business elites, especially in the 1880s and the decade before the First World War when London financial institutions were seeking new openings for direct investment overseas. During the interwar period, British business influence began to fade as merchants and banks ran into greater difficulties, and US participation in the west coast economies, especially in resource extraction (mining and oil), grew. Although some major British multinational firms did invest in industry in Peru and Chile following the Second World War, little British business remained in the region after the 1970s.
Topicalization in the Romance Languages
Authors: Cruschina Silvio
Published: January 2021

Topic and topicalization are key notions to understand processes of syntactic and prosodic readjustments in Romance. More specifically, topicalization refers to the syntactic mechanisms and constructions available in a language to mark an expression as the topic of the sentence. Despite the lack of a uniform definition of topic, often based on the notions of aboutness or givenness, significant advances have been made in Romance linguistics since the 1990s, yielding a better understanding of the topicalization constructions, their properties, and their grammatical correlates. Prosodically, topics are generally described as being contained in independent intonational phrases. The syntactic and pragmatic characteristics of a specific topicalization construction, by contrast, depend both on the form of resumption of the dislocated topic within the clause and on the types of topic (aboutness, given, and contrastive topics). We can thus distinguish between hanging topic (left dislocation) (HTLD) and clitic left-dislocation (ClLD) for sentence-initial topics, and clitic right-dislocation (ClRD) for sentence-final dislocated constituents. These topicalization constructions are available in most Romance languages, although variation may affect the type and the obligatory presence of the resumptive element.

Scholars working on topic and topicalization in the Romance languages have also addressed controversial issues such as the relation between topics and subjects, both grammatical (nominative) subjects and ‘oblique’ subjects such as dative experiencers and locative expressions. Moreover, topicalization has been discussed for medieval Romance, in conjunction with its alleged V2 syntactic status. Some topicalization constructions such as subject inversion, especially in the non-null subject Romance languages, and Resumptive Preposing may indeed be viewed as potential residues of medieval V2 property in contemporary Romance.
Prehistoric Agriculture in China: Food Globalization in Prehistory
Authors: Motuzaitė Matuzevičiūtė Giedrė , Liu Xinyi
Published: January 2021

It is commonly recognised that farming activities initiated independently in different parts of the world between approximately 12,000 and 8,000 years ago. Two of such agricultural centres is situated in modern-day China, where systems based on the cultivation of plants and animal husbandry has developed. Recent investigations have shown that between 5000 and 1500 cal. bce, the Eurasian and African landmass underpinned a continental-scale process of food “globalisation of staple crops. In the narrative of food domestication and global food dispersal processes, China has played a particularly important role, contributing key staple food domesticates such as rice, broomcorn, and foxtail millet. The millets dispersed from China across Eurasia during the Bronze Age, becoming an essential food for many ancient communities. In counterpoise, southwest Asian crops, such as wheat or barley, found new habitats among the ancient populations of China, dramatically changing the course of its development. The processes of plant domestication and prehistoric agriculture in China have been a topic of extensive research, review, and discussion by many scholars around the world, and there is a great deal of literature on these topics. One of the consequences of these discoveries concerning the origins of agriculture in China has been to undermine the notion of a single centre of origin for civilisation, agriculture, and urbanism, which was a popular and widespread narrative in the past. It has become clear that agricultural centres of development in China were concurrent with, rather than after, the Fertile Crescent.
Predicting the probability of violence in actor–target relational dyads: Self-control and interpersonal provocations as mutual properties
Authors: Schreck Christopher J , Berg Mark T , Rogers Ethan M
Published: January 2021

If disputes are ever-present in human interaction, all relational dyads contain potential offenders and targets. We theorize that each dyad partner’s self-control independently influences the likelihood of violence and that low self-control will express itself in provocative behaviour. Using two waves from the Interpersonal and Conflict Resolution survey, with measures collected from each member of 443 couples, we create dyads and analyse the independent contributions of the specified variables for both would-be offenders and the potential target. We found that a potential target with low self-control was more likely to be attacked by the actor, irrespective of the actor’s self-control. This effect was explained by a tendency of both partners to engage in verbally provocative behaviour. These results are supportive of self-control theory’s predictions concerning the importance of target decision-making and indicate that other criminological theories can profit from considering the target’s role in violent crime causation.
Changing Epidemiology of Hepatitis B Virus and Hepatitis C Virus Coinfection in a Human Immunodeficiency Virus–Positive Population in China: Results From the Third and Fourth Nationwide Molecular Epidemiologic Surveys
Authors: Liu Lin , Wang Lin , Zhang Hua , Ou Weidong , Li Dan , Feng Yi , Zhuang Hui , Shao Yiming
Published: January 2021

Background

The transmission of human immunodeficiency virus (HIV) and hepatitis B virus (HBV)/hepatitis C virus (HCV) is similar in modes/routes and related risk factors. Understanding the long-term changing epidemiology of HIV, HBV, and HCV coinfection is important for evaluation of existing disease control policy and healthcare planning. We describe HBV and HCV coinfection based on the latest 2 nationwide molecular epidemiologic surveys of HIV infection in mainland China in 2007 and 2015.

Methods

Seroprevalence of HBV and HCV infections was determined in antiretroviral treatment (ART)–naive people living with HIV-1 (PLWH) from 2 nationwide surveys conducted in 2007 and 2015 from 31 provinces, municipalities, and autonomous regions in mainland China. Demographic characteristics, route of HIV transmission, and CD4+ cell count were captured in the national database. Logistic regression was used to study the association between coinfection status and possible relevant risk factors.

Results

A total of 6611 (n = 1571 in 2007; n = 5040 in 2015) ART-naive PLWH met the eligibility criteria. The prevalence of HBV and HCV coinfection in PLWH decreased from 61.1% in 2007 to 18.0% in 2015. Significant coinfection proportion reduction was found for HCV (from 53.7% to 4.9%), and a moderate decrease for HBV (17.8% to 13.9%). There was an increase of HBV/HIV coinfections among 12 provinces, municipalities, and autonomous regions, associated with domestic migration (adjusted odds ratio, 6.34 [95% confidence interval, 1.82–22.09]).

Conclusions

A significant decrease of HBV and HCV coinfection in PLWH was observed. Due to limited health resources and high transmission efficiency, concerted efforts should be made to further control viral hepatitis epidemics in HIV-positive populations.
A Highly Contiguous Genome Assembly of a Polyphagous Predatory Mite Stratiolaelaps scimitus (Womersley) (Acari: Laelapidae)
Authors: Yan Yi , Zhang Na , Liu Chenglin , Wu Xinran , Liu Kai , Yin Zhan , Zhou Xuguo , Xie Lixia
Published: January 2021

As a polyphagous soil-dwelling predatory mite, Stratiolaelaps scimitus (Womersley) (Acari: Laelapidae), formerly known as Stratiolaelaps miles (Berlese), is native to the Northern hemisphere and preys on soil invertebrates, including fungus gnats, springtails, thrips nymphs, nematodes, and other species of mites. Already mass-produced and commercialized in North America, Europe, Oceania and China, S. scimitus will highly likely be introduced to other countries and regions as a biocontrol agent against edaphic pests in the near future. The introduction, however, can lead to unexpected genetic changes within populations of biological control agents, which might decrease the efficacy of pest management or increase the risks to local environments. To better understand the genetic basis of its biology and behavior, we sequenced and assembled the draft genome of S. scimitus using the PacBio Sequel platform II. We generated ∼150× (64.81 Gb) PacBio long reads with an average read length of 12.60 kb. Reads longer than 5 kb were assembled into contigs, resulting in the final assembly of 158 contigs with an N50 length of 7.66 Mb, and captured 93.1% of the BUSCO (Benchmarking Universal Single-Copy Orthologs) gene set (n = 1,066). We identified 16.39% (69.91 Mb) repetitive elements, 1,686 noncoding RNAs, and 13,305 protein-coding genes, which represented 95.8% BUSCO completeness. Combining analyses of genome family evolution and function enrichment of gene ontology and pathway, a total of 135 families experienced significant expansions, which were mainly involved in digestion, detoxification, immunity, and venom. Major expansions of the detoxification enzymes, that is, P450s and carboxylesterases, suggest a possible genetic mechanism underlying polyphagy and ecological adaptions. Our high-quality genome assembly and annotation provide new insights on the evolutionary biology, soil ecology, and biological control for predaceous mites.
The Importance of Improving Educational Attainment for Dementia Prevalence Trends From 2000 to 2014, Among Older Non-Hispanic Black and White Americans
Authors: Hayward Mark D , Farina Mateo P , Zhang Yuan S , Kim Jung Ki , Crimmins Eileen M
Published: January 2021

Objectives

While a number of studies have documented a notable decline in age-standardized prevalence in dementia in the U.S. population, relatively little is known about how dementia has declined for specific age and race groups, and the importance of changing educational attainment on the downward trend. We assess (a) how the trends in dementia prevalence may have differed across age and race groups and (b) the role of changing educational attainment in understanding these trends.

Methods

This article estimates a series of logistic regression models using data from the Health and Retirement Study (2000–2014) to assess the relative annual decline in dementia prevalence and the importance of improving educational attainment for non-Hispanic Whites and non-Hispanic Blacks.

Results

Consistent with other studies, we found significant declines in dementia for non-Hispanic Blacks and non-Hispanic Whites across this period. Nonetheless, these declines were not uniform across age and race groups. Non-Hispanic Blacks aged 65–74 years had the steepest decline in this period. We also found that improved educational attainment in the population was fundamentally important in understanding declining dementia prevalence in the United States.

Discussion

This study shows the importance of improvement in educational attainment in the early part of the twentieth century to understand the downward trend in dementia prevalence in the United States from 2000 to 2014.
Secretory products of the corpus luteum and preeclampsia
Authors: Pereira María M , Mainigi Monica , Strauss Jerome F
Published: January 2021

BACKGROUND

Despite significant advances in our understanding of the pathophysiology of preeclampsia (PE), there are still many unknowns and controversies in the field. Women undergoing frozen-thawed embryo transfer (FET) to a hormonally prepared endometrium have been found to have an unexpected increased risk of PE compared to women who receive embryos in a natural FET cycle. The differences in risk have been hypothesized to be related to the absence or presence of a functioning corpus luteum (CL).

OBJECTIVE AND RATIONALE

To evaluate the literature on secretory products of the CL that could be essential for a healthy pregnancy and could reduce the risk of PE in the setting of FET.

SEARCH METHODS

For this review, pertinent studies were searched in PubMed/Medline (updated June 2020) using common keywords applied in the field of assisted reproductive technologies, CL physiology and preeclampsia. We also screened the complete list of references in recent publications in English (both animal and human studies) on the topics investigated. Given the design of this work as a narrative review, no formal criteria for study selection or appraisal were utilized.

OUTCOMES

The CL is a major source of multiple factors regulating reproduction. Progesterone, estradiol, relaxin and vasoactive and angiogenic substances produced by the CL have important roles in regulating its functional lifespan and are also secreted into the circulation to act remotely during early stages of pregnancy. Beyond the known actions of progesterone and estradiol on the uterus in early pregnancy, their metabolites have angiogenic properties that may optimize implantation and placentation. Serum levels of relaxin are almost undetectable in pregnant women without a CL, which precludes some maternal cardiovascular and renal adaptations to early pregnancy. We suggest that an imbalance in steroid hormones and their metabolites and polypeptides influencing early physiologic processes such as decidualization, implantation, angiogenesis and maternal haemodynamics could contribute to the increased PE risk among women undergoing programmed FET cycles.

WIDER IMPLICATIONS

A better understanding of the critical roles of the secretory products of the CL during early pregnancy holds the promise of improving the efficacy and safety of ART based on programmed FET cycles.
TREATMENT PATTERNS OF NEWLY DIAGNOSED PEDIATRIC ULCERATIVE COLITIS AND CROHN’S DISEASE PATIENTS IN THE IMPROVECARENOW REGISTRY
Authors: Hunter Theresa , Komocsar Wendy , Colletti Richard , Liu Chunyan , Benkov Keith , Dotson Jennifer , Steiner Steven , Zhang Nanhua , Crandall Wallace
Published: January 2021

Objectives

The objective of this study was to assess current treatment patterns of pediatric ulcerative colitis (UC) and Crohn’s disease (CD) patients, using data in the ImproveCareNow (ICN) registry.

Methods

Pediatric (2–17 years) patients in the United States who were newly diagnosed with UC or CD between June 1, 2013-December 31, 2019, who had their first recorded ICN visit within 6 months of diagnosis and who were actively followed for at least 12 months (± 90 days) were included in this study. Descriptive statistics of baseline patient demographics were summarized for the overall IBD patient population and separately for UC and CD. Treatment patterns (including use of corticosteroids, 5-aminosalicylic acid (5-ASA), 6-mercaptopurine/azathioprine (6-MP/AZA), methotrexate, tumor necrosis factor inhibitors (TNFi) [adalimumab, infliximab, certolizumab, golimumab, and their biosimilars], ustekinumab, vedolizumab, and other medications [natalizumab and tofacitinib]) were assessed at the initial baseline visit, and at 1-year and 3-year time points.

Results

A total of 6,504 pediatric IBD patients (UC=1,784; CD=4,720) were included in this study. Patients had a mean age at diagnosis of 13.0 years (UC=13.2; CD=12.9), 57.1% were male (UC=49.6%; CD=60.0%), and 81.0% were White (UC=81.2%; CD=81.0%) (Table 1). At the initial ICN visit, 46.4% of UC patients were prescribed a corticosteroid, while 19.8% received a 5-ASA, 12.6% received a TNFi, 10.4% received a 6-MP/AZA, 3.0% received methotrexate, and 0.3% received vedolizumab. At the initial visit, 40.2% of CD patients were prescribed a corticosteroid, while 29.1% received a TNFi, 18.5% received a 6-MP/AZA, 12.4% received methotrexate, and 3.3% received a 5-ASA. At the 1-year and 3-year time points, rates of 5-ASA and corticosteroid use decreased among UC patients; however, rates of 6-MP/AZA, methotrexate, and TNFi increased (Table 2). Similarly, at the 1-year and 3-year time points, rates of corticosteroids among CD patients decreased; however, rates of methotrexate and TNFi increased (Table 2). There was also an increase in use of ustekinumab and vedolizumab over time among UC and CD patients.

Conclusion

These results highlight the current treatment patterns of pediatric UC and CD patients in the United States. At the initial ICN visit, the 46% of UC and 40% of CD patients were receiving corticosteroids, however, at 1-year and 3-years after initial visit, over 30% of UC patients and over 60% of CD patients were receiving TNF inhibitors with considerably reduced corticosteroid use.
GENETIC SUSCEPTIBILITY TO IBD OPERATES VIA CONTROL OF APICAL JUNCTIONAL COMPLEXES
Authors: Hébert-Milette Isabelle , Lévesque Chloé , Charron Guy , Rioux John
Published: January 2021

Introduction

Intestinal permeability is increased in unaffected 1st degree relatives of patients with inflammatory bowel disease (IBD), and is considered a risk factor for the development of IBD, likely increasing the interactions between intestinal microorganisms and the immune system. We recently reported that C1orf106, a gene located within a genomic region associated with IBD, regulates epithelial permeability. We further demonstrated that a rare coding variant within C1orf106 (p.Y333F) decreases protein stability and that lower levels of C1orf106 protein leads altered stability of adherens junctions (AJ) and to an increase in epithelial permeability.

Hypothesis

In addition to altering AJ, we believe that C1orf106 is also involved in the regulation of tight junction (TJ) formation, which also impacts epithelial permeability.

Objectives

The objectives of the project are to (a) validate the impact of C1orf106 on tight junctions and (b) verify the impact of C1orf106 IBD-associated variants on intestinal barrier integrity.

Results

We observed that knocking down the expression of C1orf106 in Caco-2 cells leads to a number of phenotypes in human epithelial monolayer (2D) and spheroid (3D) cultures that are associated with alterations in TJs. Specifically, when studying the dynamic reformation of TJ in 2D cultures after transient withdrawal of calcium, which is required for TJ stability, we observed that lower levels of C1orf106 resulted in (1) decreased recovery of barrier function as measured by transepithelial electrical resistance (TEER); (2) an alteration of tight junction protein localization; and (3) thickening of the circumferential actin belt. Moreover, in 3D cultures, we observed an altered spheroid formation associated with impaired epithelial polarization. In addition, our preliminary studies of human induced pluripotent stem cell (hiPSC)-derived epithelial cultures support that Y333F heterozygotes also have altered structure and function of their tight junctions.

Conclusion

Our observations indicate an important role of C1orf106 in apical junctional complex (AJC) formation likely mediated by a regulation of the circumferential actin belt. This can affect other functions of AJC, like the establishment of cell polarity. AJC formation is important for epithelial repair after an injury and its dysregulation impairs the formation of an impermeable epithelial barrier, which likely facilitates the passage of microorganisms and the induction and maintenance of intestinal inflammation.
NATIONWIDE ANALYSIS OF THE IMPACT OF NAFLD ON CLINICAL OUTCOMES IN IBD PATIENTS
Authors: Noorian Shaya , Jeon Yejoo , Nguyen Minh Thu , Sauk Jenny , Limketkai Berkeley
Published: January 2021

Background

Non-alcoholic fatty liver disease (NAFLD) is the fastest growing cause of chronic liver disease among patients with inflammatory bowel diseases (IBD). Studies have suggested that patients with IBD develop NAFLD with fewer metabolic risk factors than those without IBD. Data have also suggested associations between NAFLD and factors inherent to IBD such as disease activity, disease duration, and prior IBD surgery. Despite this complex relationship, the impact of NAFLD on clinical outcomes in IBD patients has not been examined on a large scale.

Methods

We performed a propensity-score matched study among hospitalized IBD patients using the Nationwide Readmissions Database from 2016–2017. ICD-10 codes were used to identify patients with IBD, NAFLD, and comorbidities. Patients with NAFLD were matched to those without NAFLD based on the following variables: age, sex, IBD type, metabolic syndrome (MS), and diabetes mellitus (DM). Cox regression was used to evaluate the primary outcomes of interest: readmission and death. Linear regression was used to evaluate healthcare utilization, including length of stay (LOS) and cost of care (COC). Multivariable models accounted for matched variables and adjusted for hospital characteristics, source of payment, patient income, and elective status of admissions. Statistical analyses accounted for the complex survey design.

Results

The prevalence of NAFLD in all hospitalized Crohn’s disease (CD) and ulcerative colitis (UC) was 2.4% and 2.1%, respectively. After matching based on predetermined variables, 11,497 patients with CD and 6,120 patients with UC were included in our study. NAFLD was associated with a higher risk of readmission for both CD (HR 1.93, 95% CI 1.93–2.12, p<0.001) and UC (HR 1.92, 95% CI 1.63–2.25, p<0.001). No significant association was noted between NAFLD and death in CD (HR 1.59, 95% CI 0.86–2.94, p=0.141) or UC (HR 1.42, CI 0.68–2.97, p=0.35). For healthcare utilization, NAFLD was associated with a longer LOS by 0.69 days (95% CI 0.25–1.13 days, p=0.002) and 0.82 days (95% CI 0.31–1.32 days, p=0.002) in CD and UC respectively. Additionally, NAFLD was associated with a $7,322 higher COC (95% CI $2,295–12,349, p<0.01) in CD and $11,272 (95% CI $4,155–18,388, p=0.02) in UC.

Conclusions

NAFLD is associated with higher readmission rates, longer lengths of stay, and higher costs of care in IBD patients. Identification and management of metabolic factors should be considered in the care of patients with IBD and future research should elucidate the roles of non-metabolic factors in the development of NAFLD, given the large impact of NAFLD on clinical outcomes in IBD.
PHOTOVOICE AS A TOOL TO IMPROVE PATIENT - PROVIDER COMMUNICAITON IN INFLAMMATORY BOWEL DISEASE CLNIIC: A PILOT OF FEASIBILITY STUDY
Authors: Gorbenko Ksenia , Riggs Alexa , Phlegar Sydney , Koeppel Brooke , Dubinsky Marla , Ungaro Ryan , Keefer Laurie
Published: January 2021

Introduction

The emotional health of patients with IBD has been difficult to elucidate in routine IBD care, but is critical to medication adoption, adherence and self-management. Patients often are unsure how to communicate their preferences and concerns to their providers in ways that could directly inform shared decision making. Photovoice is an established research methodology used to give vulnerable patients a voice through alternative communication strategies, but has not been previously used in IBD.

Aim

Our goal was to determine the acceptability and feasibility of developing a communication tool using photovoice in an IBD clinic. The ultimate goal is to adapt Photovoice to facilitate doctor – patient communication around treatment and wellness goals in the clinic setting.

Methods

We recruited patients at a single tertiary care IBD center in 2019 to participate in a pilot Photovoice study. Patients received a digital camera, training on basic usage and 10 disease specific prompts focused on goals/strategies they used to manage IBD. For example, “What is the most important thing for your doctor to know about you?” Patients then participated in in-depth interviews where they shared the photos they took and described rationale for their photo choice. The interviews lasted approximately one hour and were audio recorded and professionally transcribed. Three analysts coded transcripts for themes using qualitative analysis software QSR NVivo 11. Subsequently, five physicians were recruited and also participated in in-depth interviews to gauge provider feasibility of incorporating Photovoice into clinical practice.

Results

Fifteen patients were enrolled, median age 28 IQR (24–40), 66% women, 86% white. Three patients (20%) identified as Hispanic and six (40%) identified as Ashkenazi Jewish. Fourteen transcripts were available for analysis (9 patient and 5 providers). A total of 87 photos were taken and reviewed with patients, with a subset of 15 photos reviewed with physicians. The general themes from patients were physical and psychological aspects of disease, logistical/practical aspects, and future with IBD. Physician response was overwhelmingly supportive of incorporating Photovoice into clinical practice and suggested several ways to incorporate: 1. As discrete parts of visits to foster goal-setting and identify patient priorities. 2. Displayed in the hallways of the clinic to foster community among patients. 3. As part of electronic medical records or as prompts in the waiting room to generate referrals to other resources like psychotherapy, social work and diet consults.

Conclusions

Photovoice is a feasible methodology for patients with IBD and acceptable to providers to use in a clinical setting. Photovoice may help providers identify patient concerns and tailor their communication and enhance approaches to shared decision making.
Robotic open-thoracotomy-view approach using vertical port placement and confronting monitor setting
Authors: Sakakura Noriaki , Nakada Takeo , Shirai Suguru , Takahara Hirotomo , Nakanishi Keita , Matsui Takuya , Ueno Harushi , Takahashi Yusuke , Kuroda Hiroaki
Published: January 2021

OBJECTIVES

Robotic lung resections (RLRs) are conventionally performed using look-up views of the thorax from the caudal side. To conduct RLR with views similar to those in open thoracotomy, we adopted a vertical port placement and confronting upside-down monitor setting, which we called robotic ‘open-thoracotomy-view approach’. We herein present our experience of this procedure.

METHODS

We retrospectively reviewed 58 patients who underwent RLR (43 with lobectomy; 15 with segmentectomy) with 3-arm open-thoracotomy-view approach using the da Vinci Surgical System between February 2019 and October 2020. The patient cart was rolled in from the left cranial side of the patient regardless of the side to be operated on. Robotic ports were vertically placed along the axillary line, and 2 confronting monitors and 2 assistants were positioned on each side of the patient. The right-side monitor, which was set up for the left-side assistant to view, projected the upside-down image of the console surgeon’s view.

RESULTS

All procedures were safely performed. The median duration of surgery and console operation was 215 and 164 min, respectively. Emergency conversion into thoracotomy and severe morbidities did not occur, and the median postoperative hospitalization duration was 3 days. In all procedures, the console surgeon and 2 assistants had direct ‘bird-eye’ views of the cranially located intrathoracic structures and instrument tips, which are sometimes undetectable with the conventional look-up view.

CONCLUSIONS

The open-thoracotomy-view approach setting is a possible option for RLR. It offers natural thoracotomy views and can circumvent some of the known limitations of the conventional procedure.
Improvement in right ventricular function by mitral valve closure in hypoplastic left heart syndrome
Authors: Asada Dai , Kawai Yoko , Maeda Yoshinobu , Yamagishi Masaaki
Published: January 2021

A male neonate presented with the aortic/mitral stenotic variant of hypoplastic left heart syndrome, wherein the suprasystemic left ventricular pressure and relatively large left ventricle had shifted the intraventricular septum. Despite bilateral pulmonary artery banding, the stroke volume was difficult to maintain owing to the compressed right ventricle, causing heart failure symptoms. Percutaneous balloon aortic valvuloplasty decreased the left ventricular pressure, restoring the right ventricular function. Norwood procedure with mitral valve closure after catheter intervention reduced the left ventricular size and improved the right ventricular function. This paper refers to the potential of mitral valve closure for hypoplastic left heart syndrome.
Economic evaluation of pharmacists prescribing for minor ailments in Ontario, Canada: a cost-minimization analysis
Authors: Kim John J , Tian Adeline H , Pham Lee , Nakhla Nardine , Houle Sherilyn K D , Wong William W L , Alsabbagh Mhd Wasem
Published: January 2021

Objectives

The objective of this study was to use a decision-analytic model to examine the potential economic impact of establishing a remunerated programme for pharmacists prescribing for minor ailments (PPMA) in Ontario, Canada.

Methods

A novel decision tool was developed to assess the economic impact of pharmacists prescribing for upper respiratory tract infections (URTIs), contact dermatitis (CD) and conjunctivitis by performing a cost-minimization analysis from a public payer perspective. Two prescribing strategies were compared: (1) PPMA, where patients may seek care from pharmacists or physicians, and (2) the usual care model (UCM), where all patients receive care from physicians. Two remuneration models for the PPMA strategy were also compared: (1) a prescription-detached scenario (PDS), where pharmacists were remunerated CAD$18.00 for each consultation, and (2) a Prescription-Attached Scenario (PAS), where pharmacists were only remunerated if a decision to prescribe was made.

Key findings

At a service uptake rate of 38% for the PDS, the PPMA model led to savings of $7.51, $4.08 and $5.15 per patient for URTIs, CD and conjunctivitis, respectively. Per 30 000 patients, the PPMA model for these minor ailments was projected to lead to cumulative reductions in visits to the emergency department, family physician and walk-in clinics by 799, 3677 and 5090, respectively.

Conclusions

The results of the study strongly suggest that enabling community pharmacists to assess and prescribe for minor ailments could potentially lead to large savings for the government in Ontario, Canada. In 100% of the PAS scenarios simulated, pharmacists as prescribers led to cost savings.
Learning deep linear neural networks: Riemannian gradient flows and convergence to global minimizers
Authors: Bah Bubacarr , Rauhut Holger , Terstiege Ulrich , Westdickenberg Michael
Published: January 2021

We study the convergence of gradient flows related to learning deep linear neural networks (where the activation function is the identity map) from data. In this case, the composition of the network layers amounts to simply multiplying the weight matrices of all layers together, resulting in an overparameterized problem. The gradient flow with respect to these factors can be re-interpreted as a Riemannian gradient flow on the manifold of rank-$r$ matrices endowed with a suitable Riemannian metric. We show that the flow always converges to a critical point of the underlying functional. Moreover, we establish that, for almost all initializations, the flow converges to a global minimum on the manifold of rank $k$ matrices for some $k\leq r$.
Effect of dietary folate level on organ weight, digesta pH, short-chain fatty acid concentration, and intestinal microbiota of weaned piglets
Authors: Wang Lei , Zou Lijun , Li Jianzhong , Yang Huansheng , Yin Yulong
Published: January 2021

Folate is increasingly thought to promote gastrointestinal health and regulate the diversity of gut microbiota to alleviate weaning stress in piglets. The present study was conducted to investigate the effects of folate on organ weight, digesta pH, short-chain fatty acids (SCFAs) concentration, and intestinal microbiota in weaned piglets. A total of 28 piglets (6.73 ± 0.62 kg) were allocated to four dietary treatments consisting of a control group, 3, 9, and 18 mg/kg of folate supplementation in a 14-d feeding trial. The results showed that piglets fed with 9 and 18 mg/kg of folate supplementation had greater (P < 0.05) average liver and spleen weight than the control group. Folate supplementation (9 and 18 mg/kg) can significantly increase (P < 0.05) the stomach pH and tend (P < 0.10) to decrease the cecum pH. Folate treatment (9 and 18 mg/kg) had a positive effect on the metabolism of SCFAs in piglets, in particular, compared with the control group, and the content of acetic acid (AA) and valeric acid was markedly increased (P < 0.05) in the cecum and colon, respectively. Moreover, isobutyric acid, butyric acid, and isovaleric acid were tended (P < 0.10) to increase in the colon. Cecum contents samples were used to determine bacterial community diversity by 16S rRNA gene amplicon sequencing. At the genus level, in the cecum, there was a higher (P < 0.05) relative abundance of Lactobacillus reuteri, Lactobacillus salivarius, and Lactobacillus mucosae in the 9 mg/kg folate supplementation group. The functional pathways analysis predicted that folate may modify nutrient metabolism by changing the gut microbiota function of weaned piglets. Furthermore, the data showed that Lactobacillus was positively correlated with AA in the cecum. Overall, these findings suggested that folate treatment could increase the organ weight and the stomach pH of weaned piglets and had beneficial effects on gut health, which might be attributed to the alteration in intestinal microbiota induced by folate and the interaction of the intestinal microbiota with SCFAs.
Individual distinctiveness across call types of the southern white rhinoceros (Ceratotherium simum simum)
Authors: Linn Sabrina Nicolleta , Schmidt Sabine , Scheumann Marina
Published: January 2021

Individual distinctiveness in the acoustic structure of vocalizations provides a basis for individual recognition in mammals and plays an important role in social behavior. Within a species, call types can differ in individual distinctiveness, which can be explained by three factors, namely differences in the social function, the distance of the caller to the receiver, and the acoustic structure of the call. We explored the variation in individual distinctiveness across three call types (Grunt, Hiss, Snort) of the southern white rhinoceros (Ceratotherium simum simum) and investigated to what extent the abovementioned factors account for individual distinctiveness. Calls were recorded from 25 adult southern white rhinoceroses in six different zoos. We used three methods to compare the level of individual distinctiveness across call types, namely discriminant function analysis (DFA), potential for individual identity coding (PIC), and the information criterion (Hs). The three call types possessed an acoustic structure capable of showing individual variation to different extents. Individual distinctiveness was lowest for Snorts, intermediate for Hisses, and highest for Grunts. The level of individual distinctiveness of all three call types was lower than that previously reported for Pant calls of this species. Calls functioning to mediate intragroup social interactions had the highest individual distinctiveness. This highlights that a given communicative function and the need for individual discrimination during a social interaction have a major influence on the degree of individual distinctiveness.
Study on the heterogeneous material coupling connection characteristics and mechanical strength of Oratosquilla oratoria mantis shrimp saddle
Authors: Liang Yunhong , Zhang Hao , Zhao Qian , Lin Zhaohua , Zhang Zhihui , Han Zhiwu , Ren Luquan
Published: January 2021

The microstructure, chemical composition and mechanical strength of heterogeneous materials of mantis shrimp (Oratosquilla oratoria) saddle were studied. As the key component of the striking system, the saddle comprised two distinct layers including outer layer and inner layer. The outer layer contained blocky microtubules and exhibited compact appearance. The inner layer presented a typical periodic lamellar structure. Due to the change of the thickness of the mineralized outer layer, the organic multilamellar structure became the foundation and enhanced the connection strength (4.55 MPa) at the connect regions between the saddle and merus exoskeleton and membrane, respectively. In the process of fracture, the lamellar structure dispersed the stress effectively by the change of the crack deflection direction and the microfibrils ordered arrangement. The exploration of mantis shrimp saddle region is beneficial to understand the striking system and provided the possibility for the stable connection of heterogeneous materials in engineering fields. The microstructure, heterogeneous material connection characteristics and high mechanical strength of saddle provide bionic models for the preparation of fiber-reinforced resin composites and soft composites.
Palestinians and Europe’s ‘Refugee Crisis’ Seeking Asylum in France in the Wake of the Syrian War
Authors: Gabiam Nell
Published: January 2021

This article examines French immigration policy through the experiences of Palestinians displaced by the war in Syria who are currently residing in France. In response to the Syrian refugee crisis, France has instituted an ‘asylum visa’ that enables refugees from Syria who are awarded the visa to travel legally from the Middle East to France to apply for asylum there. The asylum visa, also referred to as a ‘humanitarian visa’, extends to Syro-Palestinians. Humanitarian visas have been celebrated by some as a means by which individuals in need of international protection can seek asylum in Europe in a dignified and safe manner. I argue that it is too early to celebrate the French asylum visa. Indeed, evidence shows that steps to provide legal routes to Europe for asylum-seekers through humanitarian visas coexist with rather than overturn broader policies that seek to deter the majority of asylum-seekers from entering Europe.
Yellow fever in Asia–a risk analysis
Authors: Cracknell Daniels Bethan , Gaythorpe Katy , Imai Natsuko , Dorigatti Ilaria
Published: January 2021

Background

There is concern about the risk of yellow fever (YF) establishment in Asia, owing to rising numbers of urban outbreaks in endemic countries and globalisation. Following an outbreak in Angola in 2016, YF cases were introduced into China. Prior to this, YF had never been recorded in Asia, despite climatic suitability and the presence of mosquitoes. An outbreak in Asia could result in widespread fatalities and huge economic impact. Therefore, quantifying the potential risk of YF outbreaks in Asia is a public health priority.

Methods

Using international flight data and YF incidence estimates from 2016, we quantified the risk of YF introduction via air travel into Asia. In locations with evidence of a competent mosquito population, the potential for autochthonous YF transmission was estimated using a temperature-dependent model of the reproduction number and a branching process model assuming a negative binomial distribution.

Results

In total, 25 cities across Asia were estimated to be at risk of receiving at least one YF viraemic traveller during 2016. At their average temperatures, we estimated the probability of autochthonous transmission to be <50% in all cities, which was primarily due to the limited number of estimated introductions that year.

Conclusion

Despite the rise in air travel, we found low support for travel patterns between YF endemic countries and Asia resulting in autochthonous transmission during 2016. This supports the historic absence of YF in Asia and suggests it could be due to a limited number of introductions in previous years. Future increases in travel volumes or YF incidence can increase the number of introductions and the risk of autochthonous transmission. Given the high proportion of asymptomatic or mild infections and the challenges of YF surveillance, our model can be used to estimate the introduction and outbreak risk and can provide useful information to surveillance systems.
s.Four New Challenges, 15 Health and Human Rights through Development: The Right to Development, Rights-Based Approach to Development, and Sustainable Development Goals
Authors: Stephen P Marks , Alice Han
Published: January 2021

This chapter examines the evolution of sustainable human development as central to health governance, drawing on international human rights norms and standards to establish a human rights-based approach to development. The progression of economic development theories and the international development agenda has led to a discernible paradigm shift in considering development to be a human right. This right to development holds promise in contributing to global health and influencing the Sustainable Development Agenda—positing a rights-based approach to international development cooperation. Bilateral and multilateral development policies and practices have begun to make some progress in implementing a human rights-based approach to development, but the mutually reinforcing goals of health, human rights, and development must be integrated in governance. Global health governance stands to benefit from applying a human rights framework for sustainable human development, yet obstacles remain in realizing the health-related Sustainable Development Goals and advancing the right to development.