bluuebunny/crossref_metadata_2025 huggingface dataset:
Regional socio-environmental characteristics associated with inadequate prenatal care during pregnancy: an ecological study of 47 prefectures in Japan
Authors: Osawa Eri , Kodama Tomoko
Published: September 2021

Background

Prenatal care (PNC) is a crucial health service that reduces the potential risks of adverse pregnancy and childbirth outcomes. It is monitored as one of the indicators of Universal Health Coverage (UHC) under the United Nations’ Sustainable Development Goals. However, there are still mothers who do not use PNC, even when UHC has been achieved. As there have been few reports on the impact of local socio-environmental characteristics within the country, this study aimed to examine the association between local socio-environmental factors and inadequate use of PNC in Japan.

Methods

We conducted an ecological analysis of 47 prefectures in Japan using public open data. The dependent variables were the inadequate use of PNC, which are the rates of pregnant women who missed visiting PNC until 28 weeks’ gestational age (GA) or those who never attended PNC before childbirth, and the independent variables were prefectural data of socio-economic, educational, and healthcare workforce-related factors. Multiple logistic regression analysis was used to examine the associations.

Results

The rate of pregnant women with late PNC initiation and never attending PNC before childbirth was 3.00–11.24 and 0.23–8.06 per 1000 pregnant women, respectively. Population numbers and densities, divorce rates, percentages of non-Japanese nationalities, and low percentages of high school enrolment were positively associated with inadequate PNC use. There was no statistically significant association with healthcare workforce, such as the number of obstetricians and gynaecologists.

Conclusions

This ecological study revealed that inadequate PNC use is more common in urban areas with more non-Japanese nationality and lower education enrolment. There may be a need to provide education for those who do not have access to reproductive health education, such as that offered in high schools. Further studies are required to examine factors that affect access to PNC in Japan.
Safety evaluation of the atmospheric low-temperature plasma (ALTP) on the conjunctiva: an animal study and histopathological findings; 6-month follow-up
Authors: Nejat Farhad , Jadidi Khosrow , Amoli Fahimeh Asadi , Bagheri Shiva , Aghamollaei Hossein , Nejat Mohammad-Amin , Nabavi Nazanin-Sadat , Eghtedari Shima
Published: September 2021

Background

Plasma medicine is an innovative research field focused on the application of atmospheric-pressure low-temperature plasmas (ALTP) for therapeutic purposes. Considering the potentials of plasma in ophthalmology, in this study, we evaluated the safety of plasma on the conjunctival tissue in animal models for 6 months.

Methods

Twelve adult male New Zealand albino rabbits were divided into four groups. The right eye of each rabbit was chosen for the test and the left eye was considered as the control. Experiments were performed using the Plexr device (GMV, Rocca Priora, RM, Italy). Four plasma spots were applied on the superior part of the conjunctiva (from 10 to 2 o’clock positions) using the continuous mode and a low power level (white handpiece) of the Plexr. For evaluation of the plasma safety, the histopathological changes were assessed 1 week (A), 1 month (B), 3 months (C), and 6 months (D) after the intervention.

Results

According to the histopathological findings, a mild decrease in blood vessels and severe stromal edema, as well as a superficial epithelium loss, were observed in group A. No chronic inflammation, scar tissue, deposition, and hemorrhage were found in group B. Epithelialization was confirmed by the histological examinations after 1 month. There was no evidence of atypia or dysplasia after 3 and 6 months.

Conclusion

In conclusion, there were no persistent histopathological changes on conjunctival tissue after plasma exposure. Then, plasma can be considered as a minimally invasive alternative method for treating some ocular surface disorders.
Migration in times of pandemic: SARS-CoV-2 infection among the Warao indigenous refugees in Belém, Pará, Amazonia, Brazil
Authors: da Silva Hilton Pereira , Abreu Isabella Nogueira , Lima Carlos Neandro Cordeiro , de Lima Aline Cecy Rocha , do Nascimento Barbosa Alexandre , de Oliveira Lehi Rodrigues , Fujishima Mayumi Aragão , Lima Sandra Souza , de Lima Vitor Nina , Castelo-Branco Socorro , Vallinoto Antonio Carlos Rosário
Published: September 2021

Background

The emergence of the new causative agent of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the city of Wuhan, China, in December 2019, and its spread worldwide, led the World Health Organization (WHO) to declare a pandemic. The disease has caused high mortality among traditional populations and the most socially vulnerable groups such indigenous and refugees. The present study aims to investigate the prevalence of anti-SARS-CoV-2 IgG antibodies in the population of Venezuelan indigenous Warao refugees residing in private and public shelters in the city of Belem, capital of Para State, in the Brazilian Amazon.

Methods

One hundred one individuals of both sexes (43 men and 58 women) with ages varying from 18 to 77 years (average of 36 years) were investigated. Whole blood samples were collected and subsequently separated into plasma and leukocytes. Serological analysis was performed using an enzyme-linked immunosorbent assay - ELISA (Anti-SARS-COV-2 S1 IgG, EUROIMMUN, USA).

Results

The results indicate a positive serum prevalence of 83.2% (84), of which 77.6% (45/58) were females and 90.7% (39/43) were males. An indeterminate profile was observed in 6.9% (7), where it was not possible to confirm the presence of antibodies, and 9.9% (10) individuals were negative for IgG antibodies.

Conclusions

The finding of the high seroprevalence of IgG anti-SARS-CoV-2 antibodies reveals a high exposure of the Warao population in Belem to infection with the new coronavirus. These results underscore the importance of maintaining epidemiological surveillance with testing in traditional populations due to the high possibility of spreading the virus, especially among the most socioeconomically vulnerable groups, which depend exclusively on the Unified Health System (SUS), such as refugees and indigenous people.
Comparison of ureteroscopy (URS) complementary treatment after extracorporeal shock wave lithotripsy failure with primary URS lithotripsy with holmium laser treatment for proximal ureteral stones larger than10mm
Authors: Yao Feng , Jiang XiaoLiang , Xie Bin , Liu Ning
Published: September 2021

Background

To compare ureteroscopy (URS) complementary treatment following extracorporeal shock wave lithotripsy (SWL) failure with primary URS lithotripsy for proximal ureteral stones > 10 mm, and try to find out acceptable number of SWL sessions followed by safe URS.

Methods

This was a retrospective study following approval from Medical Ethics Committee of People's Hospital of Chongqing Banan District. Patients (n = 340) who received URS in our hospital for stones > 10 mm from Jan 2015 to June 2020 were divided into two groups according to their previous SWL history. Group 1 consisted of 160 patients that underwent unsuccessful SWL before URS. Group 2 encompassed 180 patients without SWL before URS. Patient’s operative outcomes were compared. A logistic regression and receiver operator characteristics (ROC) were used to identify the acceptable number of SWL sessions prior to URS, regarding the intra-operative complications of URS.

Results

The group 1 required more surgery time (41.38 ± 11.39 min vs. 36.43 ± 13.36 min, p = 0.01). At the same time, more intra-operative (68.1% VS 22.8%, p < 0.05) and post-operative (35% VS 18.0%, p = 0.001) complications occurred in group 1. Need more hospital stay in group 1 (2.7 ± 1.2 days vs 1.6 ± 1.1 days, p < 0.05). More patients in group 1 need further URS (16.3% VS 8.9%, p = 0.029). After second URS, the SFR of URS in two groups was insignificant differences (82.5% VS 88.9%, p > 0.05). The median (25–75%) of SWL sessions before URS was 2 (1–3) in group 1. According to the results of logistic regression analysis, patients suffered more SWL failure have an increased risk of complications during URS (OR = 1.995, 95% CI: 1.636–2.434). ROC showed that the optimal number of SWL session followed by URS were 0.5, with a sensitivity of 67.7% and specificity of 71.5%. Intra-operative complication rates of URS treatment were higher in patients who suffered > 1 SWL failure (72.6% vs 57.4%, p = 0.047).

Conclusion

There was no acceptable number of SWL sessions that could be followed by URS with fewer intra-operative complications. Patients who underwent previous SWL were likely to suffer more intra-operative complications, the average operating time, hospitalization time, and needing further treatment, during URS treatment for proximal ureteral stones larger than 10 mm.
Isolation of bioactive compounds from medicinal plants used in traditional medicine: Rautandiol B, a potential lead compound against Plasmodium falciparum
Authors: Dawurung Christiana J. , Nguyen Minh T. H. , Pengon Jutharat , Dokladda Kanchana , Bunyong Ratchanu , Rattanajak Roonglawan , Kamchonwongpaisan Sumalee , Nguyen Phuong T. M. , Pyne Stephen G.
Published: September 2021

Background

Neorautanenia mitis, Hydnora abyssinica, and Senna surattensis are medicinal plants with a variety of traditional uses. In this study, we sought to isolate the bioactive compounds responsible for some of these activities, and to uncover their other potential medicinal properties.

Methods

The DCM and ethanol extracts of the roots of N. mitis and H. abyssinica, and the leaves of S. surattensis were prepared and their phytochemical components were isolated and purified using chromatographic methods. These extracts and their pure phytochemical components were evaluated in in-vitro models for their inhibitory activities against Plasmodium falciparum, Trypanosoma brucei rhodesiense, Mycobacterium tuberculosis, α-amylase (AA), and α-glucosidase (AG).

Results

Rautandiol B had significant inhibitory activities against two strains of Plasmodium falciparum showing a high safety ratio (SR) and IC50 values of 0.40 ± 0.07 μM (SR - 108) and 0.74 ± 0.29 μM (SR - 133) against TM4/8.2 and K1CB1, respectively. While (−)-2-isopentenyl-3-hydroxy-8-9-methylenedioxypterocarpan showed the highest inhibitory activity against T. brucei rhodesiense with an IC50 value of 4.87 ± 0.49 μM (SR > 5.83). All crude extracts showed inhibitory activities against AA and AG, with three of the most active phytochemical components; rautandiol A, catechin, and dolineon, having only modest activities against AG with IC50 values of 0.28 mM, 0.36 mM and 0.66 mM, respectively.

Conclusion

These studies have led to the identification of lead compounds with potential for future drug development, including Rautandiol B, as a potential lead compound against Plasmodium falciparum. The relatively higher inhibitory activities of the crude extracts against AG and AA over their isolated components could be due to the synergistic effects between their phytochemical components. These crude extracts could potentially serve as alternative inhibitors of AG and AA and as therapeutics for diabetes.
Solutions to bridge the theory-practice gap in nursing education in the UAE: a qualitative study
Authors: Saifan Ahmad , Devadas Briliya , Daradkeh Fares , Abdel-Fattah Hadya , Aljabery Mohannad , Michael Lintu Maria
Published: September 2021

Background

The theoretical knowledge of nursing underpins the practice, while the practice environment determines the circumstances within which the theoretical knowledge is applied. The biggest challenge facing nursing as an academic field is the theory-practice gap, which is a universal issue in nursing. This study aimed to raise solutions to close the gap between theory and practice in nursing education through the eyes of nursing students in UAE.

Methods

A qualitative descriptive approach was followed; whereby 25 Emirati nursing students were interviewed.

Results

Two main themes are discussed in this study: ‘Clinical Culture Creation’ and ‘Curriculum Content Reformation’. The students suggested to decreased the loud and stress on their clinical educators. They also suggested creating synchronization between what is taught in classrooms and labs and what is offered in the clinical training. Moreover, some of the students expected to have more benefit if they get their clinical training in health institutions owned by their college. On the other side, many of the participants suggested to move from the integration system to the block system. Another interesting suggestion includes having the same college staff to teach the theory and the clinical. The final suggestion includes decreasing the paper work during clinical training.

Conclusions

This study explored the solutions to bridge the theory-practice gap in nursing education in the UAE. The study has implications for nursing education and practice within the UAE and is imperative for graduating workplace ready professional nurses within the country.
Regorafenib enhances anti-PD1 immunotherapy efficacy in murine colorectal cancers and their combination prevents tumor regrowth
Authors: Doleschel Dennis , Hoff Sabine , Koletnik Susanne , Rix Anne , Zopf Dieter , Kiessling Fabian , Lederle Wiltrud
Published: September 2021

Background

Patients with advanced colorectal cancer (CRC) have a poor prognosis. Combinations of immunotherapies and anti-angiogenic agents are currently being evaluated in clinical trials. In this study, the multikinase inhibitor regorafenib (REG) was combined with an anti-programmed cell death protein 1 (aPD1) antibody in syngeneic murine microsatellite-stable (MSS) CT26 and hypermutated MC38 colon cancer models to gain mechanistic insights into potential drug synergism.

Methods

Growth and progression of orthotopic CT26 and subcutaneous MC38 colon cancers were studied under treatment with varying doses of REG and aPD1 alone or in combination. Sustained effects were studied after treatment discontinuation. Changes in the tumor microenvironment were assessed by dynamic contrast-enhanced MRI, and histological and molecular analyses.

Results

In both models, REG and aPD1 combination therapy significantly improved anti-tumor activity compared with single agents. However, in the CT26 model, the additive benefit of aPD1 only became apparent after treatment cessation. The combination treatment efficiently prevented tumor regrowth and completely suppressed liver metastasis, whereas the anti-tumorigenic effects of REG alone were abrogated soon after drug discontinuation. During treatment, REG significantly reduced the infiltration of immunosuppressive macrophages and regulatory T (Treg) cells into the tumor microenvironment. aPD1 significantly enhanced intratumoral IFNγ levels. The drugs synergized to induce sustained M1 polarization and durable reduction of Treg cells, which can explain the sustained tumor suppression.

Conclusions

This study highlights the synergistic immunomodulatory effects of REG and aPD1 combination therapy in mediating a sustained inhibition of colon cancer regrowth, strongly warranting clinical evaluation in CRC, including MSS tumors.
The swimming trace Undichna from the latest Devonian Hangenberg Sandstone equivalent of Morocco
Authors: Klug Christian , Lagnaoui Abdelouahed , Jobbins Melina , Bel Haouz Wahiba , Najih Amine
Published: September 2021

Trace fossils occur in several strata of the Devonian and Carboniferous of the eastern Anti-Atlas, but they are still poorly documented. Here, we describe a fossil swimming trace from strata overlying the Hangenberg Black Shale (correlation largely based on lithostratigraphy; Postclymenia ammonoid genozone, ca. 370 Ma old). We discuss the systematic position of the tracemaker and its body size. This ichnofossil is important for three main reasons: (1) it is considered here to be the first record of Undichna from the Devonian of Gondwana, as far as we know; (2) it is the oldest record of vertebrate trace fossils from Africa; (3) it provides a unique window into the behaviour of Late Devonian fishes for which body-fossils cannot provide direct evidence. Further, we put this discovery into the macroecological context of the palaeoenvironment following the Late Devonian Hangenberg biodiversity crisis.
Cost of provision of essential health Services in Public Health Centers of Jimma zone, Southwest Ethiopia; a provider perspective, the pointer for major area of public expenditure
Authors: Feyisa Diriba , Yitbarek Kiddus , Daba Teferi
Published: September 2021

Background

Provision of up-to-date cost information is crucial for not only addressing knowledge gap on the cost of essential health services (EHS) but also budgeting, allocating adequate resources and improving institutional efficiency at public health centers where basic health services are delivered the most.

Objective

To analyze the costs of essential health services at public health centers in Jimma Zone.

Methods

A facility based cross-sectional study was conducted in public health centers of Jimma zone from April 10, 2018 to May 9, 2018. The study was conducted from a provider perspective using retrospective standard costing approach of one fiscal year time horizon. Step-down allocation was used to allocate costs to final services. All costs for provision EHS were taken into account and expressed in United States dollar (USD). Sixteen public health centers located in eight districts were randomly selected for the study.

Results

The Average annual cost of providing essential health services at health centers in Jimma zone was USD 109,806.03 ± 50,564.9. Most (83.7%) of the total Annual cost was spent on recurrent items. Nearly half (45%) of total annual cost was incurred by personnel followed by drugs and consumables that accounted around one third (29%) of the total Annual cost. Around two third (65.9%) of the total annual cost was incurred for provision of EHS at the final cost center. The average overall unit cost was USD 7.4 per EHS per year.

Conclusion

Cost providing an EHS at public health centers was low and so, necessitating funding of significant resources to provide standard health care. The variability in unit costs and cost components for EHS also suggest that the potential exists to be more efficient via better use of both human and material resources.
Vaccine injury compensation: the Israeli case
Authors: Kamin-Friedman Shelly , Davidovitch Nadav
Published: September 2021

Background

Following other countries, Israel passed the Vaccine Injury Compensation Law in 1989, which provides for compensation to vaccine recipients who had suffered injuries without proving negligence. In 2021, after deliberations between the ministries of health and of finance Covid-19 vaccines (administered from the beginning of the campaign on December 20, 2020 and up to December 21, 2022) were included within the compensation law. The current study aims to examine the objectives of Israel’s Vaccine Injury Compensation Law, at the time of its enactment, and to explore barriers to their fulfillment. These issues are especially relevant in light of the discussions held on the option for liability exemption which excludes the possibility of redress from the Covid-19 vaccine manufacturers in case of injury attributed to the vaccine, and considering the heavy burden of proof required in standard tort law.

Methods

The study employed a qualitative methodology which made use of both content analysis of relevant documents and in-depth interviews.

Results

In passing the Vaccine Injury Compensation Law, legislators sought to assist vaccine recipients who had suffered injuries by both lowering their burden of proof as well as establishing a short and efficient procedure for deliberating their claims. Furthermore, legislators believed that the assurance of compensation to vaccine recipients who had suffered injuries would help to encourage a high rate of vaccination compliance. An examination of the law’s implementation over time revealed that the aforementioned goals were not attained.

Conclusions

Implementation of the law since its enactment missed the opportunity to fulfill its original purposes to promote public health fundamental principles of fairness and solidarity. In addition, the adversarial proceedings as well as some of the law’s provisions have the potential to undermine public trust in the State’s willingness to grant compensation for injuries that are attributed to vaccines and thereby subvert the law’s pivotal objective of promoting trust and vaccine compliance. We suggest that allowing circumstantial evidence as to an association between vaccine and an injury, transitioning to administrative deliberation, making available to the public details of cases where compensation was awarded, as well as other possible emendations would help it better reflect the values of fairness and solidarity that underlying the law's purpose. These would also promote the level of trust in healthcare authorities which is essential to preserving high vaccine coverage.
Improved annotation and quantification of metabolites in rice (Oryza sativa L.) seeds using two-dimensional gas chromatography–time-of-flight mass spectrometry
Authors: Baek Seung-A. , Kim So Yeon , Park Young Jin , Kim Tae Jin , Lim Sun-Hyung , Park Sang Un , Kim Jae Kwang
Published: September 2021

Two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC  ×  GC-TOFMS) is a powerful tool for identification of compounds in complex samples. Herein, we compared the GC  ×  GC-TOFMS and GC-TOFMS systems for polar metabolite profiling of rice seeds. Forty-seven and thirty-six metabolites were detected in a Korean rice cultivar, Dongjin, using GC  ×  GC-TOFMS and GC-TOFMS, respectively. The limits of detection of shikimic, p-coumaric, and sinapinic acids were 30.0-, 1.6-, and 2.5-times lower, respectively, with GC  ×  GC-TOFMS than with GC-TOFMS. The overlapped peaks of glycerol and phosphoric acid in GC-TOFMS were separated in GC  ×  GC-TOFMS. Polar metabolite profiling of two white and six red rice cultivars was performed using GC  ×  GC-TOFMS and the obtained data were subjected to principal component analysis. Remarkably, principal component 1 separated Heugdaegu from other cultivars, indicating that Heugdaegu has high levels of caffeic, sinapinic, and vanillic acids. Findings from this work may aid breeding programs aimed at improving the quality of rice seeds.
Oxytocin in pig seminal plasma is positively related with in vivo fertility of inseminated sows
Authors: Padilla Lorena , López-Arjona Marina , Martinez-Subiela Silvia , Rodriguez-Martinez Heriberto , Roca Jordi , Barranco Isabel
Published: September 2021

Background

Identification of relevant in vivo biomarkers for fertility remains a challenge for the livestock industry. Concentrations of the small peptide hormone oxytocin (OXT), involved in male reproductive function and present in the seminal plasma (SP) of several species could be a robust one. This study characterized concentrations of SP-OXT in ejaculates from boars used in artificial insemination (AI) programs aiming to evaluate its relationship with sperm quality variables and in vivo fertility of their liquid-stored AI-semen. Seminal OXT concentrations (ng/mL) were measured in 169 ejaculates from 61 boars of the Duroc, Pietrain, Landrace and Large White breeds using a direct competitive immunoassay test based on AlphaLISA® technology. Ejaculate (ejaculate volume, sperm concentration, total sperm count) and sperm parameters (motility, viability, intracellular generation of reactive oxygen species, plasma membrane fluidity) were assessed at 0 h and 72 h in AI-semen samples stored at 17 °C. In vivo fertility included only 18 Large White and Landrace boars whose AI-semen was used to inseminated > 100 sows and evaluated both farrowing rate and litter size of 3,167 sows.

Results

The results showed that SP-OXT differed between boars and between ejaculates within boar (P < 0.05) but not between breeds (Duroc, Pietrain, Landrace and Large White). Ejaculates with higher SP-OXT concentration/mL (hierarchically grouped; P < 0.001) had larger volume and came from younger boars (P < 0.05). Ejaculates of boars showing positive farrowing rate deviation exhibited higher (P < 0.05) SP-OXT concentration/mL than those with negative farrowing rate deviation.

Conclusion

The SP concentrations of OXT are boar, ejaculate and age dependent, and positively related with ejaculate volume and farrowing rates of liquid-stored semen AI-doses.
Cooperation between host immunity and the gut bacteria is essential for helminth-evoked suppression of colitis
Authors: Shute Adam , Callejas Blanca E. , Li ShuHua , Wang Arthur , Jayme Timothy S. , Ohland Christina , Lewis Ian A. , Layden Brian T. , Buret André G. , McKay Derek M.
Published: September 2021

Background

Studies on the inhibition of inflammation by infection with helminth parasites have, until recently, overlooked a key determinant of health: the gut microbiota. Infection with helminths evokes changes in the composition of their host’s microbiota: one outcome of which is an altered metabolome (e.g., levels of short-chain fatty acids (SCFAs)) in the gut lumen. The functional implications of helminth-evoked changes in the enteric microbiome (composition and metabolites) are poorly understood and are explored with respect to controlling enteric inflammation.

Methods

Antibiotic-treated wild-type, germ-free (GF) and free fatty-acid receptor-2 (ffar2) deficient mice were infected with the tapeworm Hymenolepis diminuta, then challenged with DNBS-colitis and disease severity and gut expression of the il-10 receptor-α and SCFA receptors/transporters assessed 3 days later. Gut bacteria composition was assessed by 16 s rRNA sequencing and SCFAs were measured. Other studies assessed the ability of feces or a bacteria-free fecal filtrate from H. diminuta-infected mice to inhibit colitis.

Results

Protection against disease by infection with H. diminuta was abrogated by antibiotic treatment and was not observed in GF-mice. Bacterial community profiling revealed an increase in variants belonging to the families Lachnospiraceae and Clostridium cluster XIVa in mice 8 days post-infection with H. diminuta, and the transfer of feces from these mice suppressed DNBS-colitis in GF-mice. Mice treated with a bacteria-free filtrate of feces from H. diminuta-infected mice were protected from DNBS-colitis. Metabolomic analysis revealed increased acetate and butyrate (both or which can reduce colitis) in feces from H. diminuta-infected mice, but not from antibiotic-treated H. diminuta-infected mice. H. diminuta-induced protection against DNBS-colitis was not observed in ffar2−/− mice. Immunologically, anti-il-10 antibodies inhibited the anti-colitic effect of H. diminuta-infection. Analyses of epithelial cell lines, colonoids, and colon segments uncovered reciprocity between butyrate and il-10 in the induction of the il-10-receptor and butyrate transporters.

Conclusion

Having defined a feed-forward signaling loop between il-10 and butyrate following infection with H. diminuta, this study identifies the gut microbiome as a critical component of the anti-colitic effect of this helminth therapy. We suggest that any intention-to-treat with helminth therapy should be based on the characterization of the patient’s immunological and microbiological response to the helminth.
Evaluating an urban pediatric hospital’s scald burn prevention program
Authors: Thompson Rochelle , Budziszewski Ross , Nanassy Autumn D. , Meyer Loreen K. , Glat Paul , Burkey Brooke
Published: September 2021

Background

Over 450,000 individuals are hospitalized with burns annually and roughly 35% are scald burns. Children younger than 5 years of age are at the greatest risk of scald burn injury. Caregiver burn prevention programs have been found to reduce the prevalence of injuries in young children; however, low-income and underserved populations seldomly have access to these programs. The impact of scald burn prevention programs in underserved populations remains unexplored. The objective of the current study was to evaluate the efficacy of a scald burn prevention program at a Level One Pediatric Trauma Center in a low-income, underserved community.

Methods

Our hospital developed a one-hour scald burn prevention program for caregivers with children 5 years of age or younger. The program educated caregivers on ways to prevent scald burns and create safeguards in their home. Caregivers completed a pre-post survey to measure their ability to identify hot or cold objects, as well as respond to items about their perceptions of the program’s utility, their willingness to share it with others, and the likelihood that they would use the information in the future. Data was analyzed using a paired t-test.

Results

Two-hundred and sixty-nine (N = 269) caregivers participated in the program. Before the program, caregivers could identify potentially hot objects 83.17% of the time, and after the program, they were able to identify these items 92.31% of the time: t (268) = 12.46, p < .001, d = 1.07. Additionally, 95% of caregivers indicated that the program was helpful, 99% stated that they were likely to share this information with others, and 100% indicated that they would use the information from the program.

Conclusions

Education is a critical component to prevent scald burns. Results indicate that a hospital-led scald burn prevention program can positively impact a caregiver’s ability to identify possible scald-burn risks. Providing education to caregivers who typically do not receive this information could lower the prevalence of scald burns not only institutionally, but in communities that are disproportionately impacted by this mechanism of injury.
The dark side of nighttime all-terrain vehicle use
Authors: Jennissen Charles A. , Stange Nicholas R. , Fjeld AnnaMarie , Denning Gerene M.
Published: September 2021

Background

Driving at night is considered a risk factor for all-terrain vehicle (ATV) crashes and injuries but few studies have addressed this issue. Our objective was to compare daytime and nighttime ATV crashes to better understand the potential risk factors associated with riding at night.

Methods

A retrospective study was conducted on Iowa ATV-related crashes and injuries from January 1, 2002 through December 31, 2019 using four statewide datasets: the Iowa Department of Transportation (2002–2019), the Iowa Department of Natural Resources (2002–2019), the Iowa State Trauma Registry (2002–2018) and Iowa newspaper clippings (2009–2019). A standardized coding system was developed, and matching records were identified using Link Plus®. Descriptive (frequencies) and bivariate (chi-square, Fisher's exact test) analyses were performed using VassarStats (Statistical Computation Website).

Results

Among crash victims where light conditions were documented (2125/3752, 57%), about one-quarter (485/2125, 23%) were injured at night. Nighttime crash victims were less likely youth (14% vs. 30%,p < 0.0001), less likely to be wearing helmets (11% vs. 18%,p = 0.003), and less frequently involved in motor vehicle crashes (7% vs. 14%,p < 0.0001) as compared to daytime victims. Nighttime victims were also more likely to be passengers (22% vs. 15%,p = 0.002), to test positive for alcohol (44% vs. 13% in adults,p < 0.0001), and to be injured on a roadway (53% vs. 45%,p = 0.007) and on weekends (76% vs. 63%,p < 0.0001). Numerous differences between daytime and nighttime characteristics were observed for males, females, and adults, whereas most characteristics were similar for youth. The severity of injuries and proportion of fatalities were similar among daytime and nighttime crash victims.

Conclusions

Nighttime crash victims, particularly adults, were characterized by more frequent risky behaviors like carrying passengers, roadway riding, alcohol use, and lack of helmets. Whereas the frequency of risky behaviors among youth was similar for daytime and nighttime crashes, these behaviors put children at potential risk for injury. Multi-factorial, targeted injury prevention strategies are needed, including improved vehicle design, education about the dangers of nighttime operation, and passage and enforcement of ATV safety laws. Particularly relevant to our study are laws that prohibit nighttime riding.
A firm recommendation: measuring the softness of infant sleep surfaces
Authors: Gillani Sheena H. , Lowell Gina S. , Quinlan Kyran P.
Published: September 2021

Background

Approximately 3600 sudden unexpected infant deaths (SUID) occur annually in the United States, and a quarter of SUIDs are caused by unintentional suffocation and strangulation in bed, with soft bedding use being a significant risk factor. Therefore, The American Academy of Pediatrics (AAP) recommends infants sleep on a “firm” surface, though neither an objective definition nor national standard has been established. The purpose of this study is to report on the performance of a device that measures mattress softness and to provide quantitative values of softness for various infant sleep surfaces.

Methods

In collaboration with the authors and a national child product safety organization (Kids in Danger), University of Michigan engineering students designed and validated a device that measures the vertical depression (softness) of a simulated 2-month-old’s head on a sleep surface. A total of 17 infant sleep surfaces − 14 household surfaces and 3 hospital mattresses - were measured between April 2019 and January 2020. The average softness of each surface was calculated. Surfaces were also measured with soft bedding, which included an infant fleece blanket, and firm and soft pillows.

Results

The average softness for the 14 household sleep surfaces ranged from 7.4–36.9 mm. The 2019 cribette playard and the 2018 infant spring had similar softness (21 mm) as the 2018 and 2019 adult foam and 2015 sofa. An infant’s fleece blanket folded once added an additional 2.3–6.5 mm of softness, folded twice added 4.8–11.6 mm, and folded three times added 11–21.8 mm. Using a firm pillow added 4.0–20.9 mm of softness while using a soft pillow added 24.5–46.4 mm. The softness for the 3 hospital sleep surfaces ranged from 14 to 36.9 mm, with the infant bassinet being the firmest and the pediatrics mattress being the softest.

Conclusions

We found a wide range of softness among sleep surfaces, with some infant mattresses as soft as some adult mattresses. Adding blankets and pillows to mattresses measurably increased softness. Quantifying sleep surface softness will advance our understanding of how softness relates to SUID risk. We hope this new information will further inform safe infant sleep recommendations and improve mattress safety standards nationally.
miR-146a-5p-mediated suppression on trophoblast cell progression and epithelial-mesenchymal transition in preeclampsia
Authors: Peng Pingping , Song Huamei , Xie Chenghong , Zheng Wenfei , Ma Huigai , Xin Dandan , Zhan Jingqiong , Yuan Xiaoqing , Chen Aihua , Tao Jing , Qin Jufang
Published: September 2021

Objective

This study aims to identify the effect of miR-146a-5p on trophoblast cell invasion as well as the mechanism in preeclampsia (PE).

Methods

Expression levels of miR-146a-5p and Wnt2 in preeclamptic and normal placentae were quantified. Trophoblast cells (HTR-8) were separately transfected with miR-146a-5p mimic, miR-146a-5p inhibitor, pcDNA3.1-Wnt2 or sh-Wnt2, and then the expression levels of miR-146a-5p, Wnt2, and epithelial-mesenchymal transition (EMT)-related proteins (Vimentin, N-cadherin and E-cadherin) were measured. Moreover, the proliferative, migratory and invasive capacities of trophoblast cells were detected, respectively. Dual luciferase reporter assay determined the binding of miR-146a-5p and Wnt2.

Results

Compared with normal placental tissues, the placentae from PE patients showed higher miR-146a-5p expression and lower Wnt2 expression. Transfection of miR-146a-5p inhibitor or pcDNA3.1-Wnt2 exerted pro-migratory and pro-invasive effects on HTR-8 cells and encouraged EMT in HTR-8 cells; transfection with miR-146a-5p mimic or sh-Wnt2 weakened the proliferative, migratory and invasive capacities as well as reduced EMT process of HTR-8 cells. Moreover, Wnt2 overexpression could partially counteract the suppressive effects of miR-146a-5p overexpression on the progression and EMT of HTR-8 cells.

Conclusion

miR-146a-5p mediates trophoblast cell proliferation and invasion through regulating Wnt2 expression.
Preventive effect of Nigella sativa on M1/M2 ratio, reducing risk of endothelial dysfunction in cigarette smoked Wistars
Authors: Ardiana Meity , Utami Eka , Pikir Budi , Santoso Anwar
Published: September 2021

Background: Smoking is one of the top three causes of cardiovascular disease (CVD). Natural antioxidants including black cumin (Nigella sativa) may inhibit the pathogenesis of initial process of atherosclerosis. The aim of this study was to determine the effect of black cumin (Nigella sativa) in preventing endothelial dysfunction mainly through macrophage M1 / M2 inflammatory response in cigarette smoked male Wistars. Methods: In total, 50 Wistar rats were randomly allocated to five experimental groups: two control groups, namely no intervention (K-) and exposure to smoke of 40 cigarettes each day (K+); and three treatment groups: rats given a dose of 0.3 g (P1), 0.6 g (P2) or 1.2 g (P3) black cumin per kilograms bodyweight/ day, respectively, and exposed to smoke of 40 cigarettes each day. After 28 days of cigarette smoke exposure, macrophage M1 / M2 ratio was evaluated by counting total M1 and M2 in ten microscope field of view. Data were analysed by Mann-Whitney test. Results: The M1 / M2 ratio on K (-) was 0.9 7 ± 0.9 8 (<1) which means M2 was dominant, while the M1 / M2 ratio on K (+) was of 4.97 ± 3.42 (> 1) which means M1 dominant. There was no significant difference in the number of M1 count in treatment groups P1, P2, P3 (p value = 0.996; 0.170; 0.884, respectively) when compared with K+. Additionally, P2 group has the lower M1 number with the highest significance value when compared to K+. The number of M1 counts on P1 did not differ significantly when compared to P2 with p = 0.121 and P3 with p = 0.936. Conclusions: In sum, ethanol extract of black cumin prevents endothelial dysfunction by inhibiting increase in macrophages M1 / M2 ratio in rats Wistar exposed to sub-chronic cigarette smoke.
Non-invasive health prediction from visually observable features
Authors: Khong Fan Yi , Connie Tee , Goh Michael Kah Ong , Wong Li Pei , Teh Pin Shen , Choo Ai Ling
Published: September 2021

Background: The unprecedented development of Artificial Intelligence has revolutionised the healthcare industry. In the next generation of healthcare systems, self-diagnosis will be pivotal to personalised healthcare services. During the COVID-19 pandemic, new screening and diagnostic approaches like mobile health are well-positioned to reduce disease spread and overcome geographical barriers. This paper presents a non-invasive screening approach to predict the health of a person from visually observable features using machine learning techniques. Images like face and skin surface of the patients are acquired using camera or mobile devices and analysed to derive clinical reasoning and prediction of the person’s health.

Methods: In specific, a two-level classification approach is presented. The proposed hierarchical model chooses a class by training a binary classifier at the node of the hierarchy. Prediction is then made using a set of class-specific reduced feature set.

Results: Testing accuracies of 86.87% and 76.84% are reported for the first and second-level classification. Empirical results demonstrate that the proposed approach yields favourable prediction results while greatly reduces the computational time.

Conclusions: The study suggests that it is possible to predict the health condition of a person based on his/her face appearance using cost-effective machine learning approaches.
Individual-level variations in malaria susceptibility and acquisition of clinical protection
Authors: Valletta John Joseph , Addy John W.G. , Reid Adam J. , Ndungu Francis M. , Bediako Yaw , Mwacharo Jedida , Said Khadija , Musyoki Jennifer , Ngoi Joyce Mwongeli , Wambua Joshua , Otieno Edward , Berriman Matt , Bejon Philip , Marsh Kevin , Langhorne Jean , Newbold Chris I. , Recker Mario
Published: September 2021

After decades of research, our understanding of when and why individuals infected with Plasmodium falciparum develop clinical malaria is still limited. Correlates of immune protection are often sought through prospective cohort studies, where measured host factors are correlated against the incidence of clinical disease over a set period of time. However, robustly inferring individual-level protection from these population-level findings has proved difficult due to small effect sizes and high levels of variance underlying such data. In order to better understand the nature of these inter-individual variations, we analysed the long-term malaria epidemiology of children ≤12 years old growing up under seasonal exposure to the parasite in the sub-location of Junju, Kenya. Despite the cohort’s limited geographic expanse (ca. 3km x 10km), our data reveal a high degree of spatial and temporal variability in malaria prevalence and incidence rates, causing individuals to experience varying levels of exposure to the parasite at different times during their life. Analysing individual-level infection histories further reveal an unexpectedly high variability in the rate at which children experience clinical malaria episodes. Besides exposure to the parasite, measured as disease prevalence in the surrounding area, we find that the birth time of year has an independent effect on the individual’s risk of experiencing a clinical episode. Furthermore, our analyses reveal that those children with a history of an above average number of episodes are more likely to experience further episodes during the upcoming transmission season. These findings are indicative of phenotypic differences in the rates by which children acquire clinical protection to malaria and offer important insights into the natural variability underlying malaria epidemiology.
Protocol for a prospective cohort study of open tibia fractures in Malawi with a nested implementation of open fracture guidelines
Authors: Schade Alexander Thomas , Nyamulani Nohakhelha , Banza Leonard Ngoe , Metcalfe Andrew John , Leather Andrew , Madan Jason J. , Lallloo David G. , Harrison Williams James , MacPherson Peter
Published: September 2021

Background: Road traffic injury (RTI) is the largest cause of death amongst 15–39-year-old people worldwide, and the burden of injuries such as open tibia fractures are rapidly increasing in Malawi. This study aims to investigate disability and economic outcomes of people with open tibia fractures in Malawi and improve these with locally delivered implementation of open fracture guidelines.

Methods: This is a prospective cohort study describing function, quality of life and economic burden of open tibia fractures in Malawi. In total, 160 participants will be recruited across six centres and will be followed-up with face-to-face interviews at six weeks, three months, six months and one year following injury. The primary outcome will be function at one year measured by the short musculoskeletal functional assessment (SMFA) score. Secondary outcomes will include quality of life measured by EuroQol EQ-5D-3L, catastrophic loss of income and implementation outcomes (acceptability, adoption, appropriateness, costs, feasibility, fidelity, penetration, and sustainability) at one year. A nested pilot pre-post implementation study of an interventional bundle for all open fractures will be developed based on other implementation studies from low- and middle-income countries (LMICs). Regression analysis will be used to model and investigate associations between SMFA score and fracture severity, infection and the pre- and post-training course period.

Outcome: This prospective cohort study will report patient reported outcomes from open tibia fractures in low-resource settings. Subsequent detailed evaluation of both the clinical and implementation components of the study will promote sustainability of improved open fractures management in the study sites and further scale-up of open fracture management guidelines.

Ethics: Ethics approval has been obtained from the Liverpool School of Tropical Medicine and College of Medicine Research and Ethics committee.
Radiation-Hygienic Monitoring in Potentially Radon-Hazardous Territories
Authors: Laschenova Tat'yana , Karl L. , Marennyy A.
Published: September 2021

Modern radioecological studies to assess the effect of natural radiation on the human body have shown that at the moment of development of society, the main contribution to the exposure of the population is made by natural sources of ionizing radiation, while from 50 to 90 % of the dose load are caused by the gas radon-222 (222Rn) and daughter products of its decay.

This paper presents the results of radiation-hygienic monitoring of the potentially radon-hazardous territory of the city of Baley, Trans-Baikal Territory. The measurement of the volumetric activity of radon (OARn) was carried out in the premises of residential and public buildings by the integral method using track exposure meters REI-4. According to the indicator of the equivalent equilibrium volumetric activity of radon (EROARn), a radiation-hygienic assessment of the premises and the calculation of potential dose loads on the population living in this territory were carried out.

Studies have shown that OARn in residential and public buildings depends on the geological characteristics of the territory, on the design and design of buildings and structures, and on the building materials used. It was found that the main criterion for assessing the potential radon hazard of territories is the value of OARn in rooms on the 1st floors of buildings. According to the degree of potential radon hazard, the territory of the city of Baley can be conditionally divided into 3 types: 1 type – the territory located on a geological fault; Type 2 – the southern part of the city, represented by sedimentary rocks; Type 3 – the northern part of the city, represented by rocks of the basic gabbroid group with a low content of natural radionuclides. The types of buildings and structures and the type of building materials affect the dose load, but do not determine it.
Personalized Robo-Advising: Enhancing Investment Through Client Interaction
Authors: Capponi Agostino , Ólafsson Sveinn , Zariphopoulou Thaleia
Published: September 2021

Automated investment managers, or robo-advisors, have emerged as an alternative to traditional financial advisors. The viability of robo-advisors crucially depends on their ability to offer personalized financial advice. We introduce a novel framework in which a robo-advisor interacts with a client to solve an adaptive mean-variance portfolio optimization problem. The risk-return tradeoff adapts to the client’s risk profile, which depends on idiosyncratic characteristics, market returns, and economic conditions. We show that the optimal investment strategy includes both myopic and intertemporal hedging terms that reflect the dynamic risk profile of the client. We characterize the optimal portfolio personalization via a tradeoff faced by the robo-advisor between receiving information from the client in a timely manner and mitigating behavioral biases in the communicated risk profile. We argue that the optimal portfolio’s Sharpe ratio and return distribution improve if the robo-advisor counters the client’s tendency to reduce market exposure during economic contractions when the market risk-return tradeoff is more favorable.

This paper was accepted by David Simchi-Levi, stochastic models and simulation.