bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of single fraction Gamma Knife radiosurgery for intraventricular central neurocytomas and the utility of F-18 fluroethyltyrosine: two case reports
Authors: Dedeciusova Michaela , Prior John O. , Schiappacasse Luis , Patin David , Levivier Marc , Tuleasca Constantin
Published: November 2022

Background

Primary treatment of central neurocytomas is surgical resection. Gamma Knife surgery is considered a valuable therapeutic option in case of residual (after subtotal resection) or recurrent central neurocytomas. Here, we focused on the role of F-18 fluroethyltyrosine as a marker to document tumor progression after initial resection, in the context of an atypical central neurocytoma. We also describe MIB-1’s role in evaluating therapeutic decision-making.

Case presentation

Two patients with central neurocytomas were treated by Gamma Knife surgery in our center. The first case (31-year-old Caucasian male) had atypical central neurocytoma. Four and a half years after surgical resection, magnetic resonance imaging and F-18 fluroethyltyrosine documented clear progression of residual central neurocytoma, further treated by Gamma Knife surgery (18 Gy at 50%, target volume 1.4 cc, and prescription isodose volume 1.8 cc). The initial post-Gamma Knife surgery clinical course was uneventful, with progressive volumetric reduction of residual tumor up to 4.5 years, when out-of-field recurrence was suspected and confirmed by local F-18 fluroethyltyrosine hyperactivity. Second single-fraction Gamma Knife surgery was performed (18 Gy at 50%, target volume 0.49 cc, prescription isodose volume 0.72 cc). The second (32-year-old Caucasian female) had previous subtotal resection and typical central neurocytoma. Seven years later, she had residual tumor progression. Single-fraction Gamma Knife surgery was performed (16 Gy at 50% isodose line, target volume 1.7 cc, and prescription isodose volume 2.5 cc). Last follow-up showed tumor volume reduction. Follow-up magnetic resonance imaging showed important volumetric reduction of both treated lesions.

Conclusions

In atypical central neurocytomas, F-18 fluroethyltyrosine could be used as postoperative examination to detect small tumor remnants, follow-up evaluation following the Gamma Knife surgery or, in select cases, following surgical resection. The role of MIB-1 is important in therapeutic decision-making, as tumors with MIB-1 exceeding 2% are characterized by more aggressive clinical course. Single-fraction Gamma Knife surgery remains a valuable therapeutic option for postoperative residual atypical central neurocytomas and central neurocytoma recurrences.
Unusual presentation of aneurysmal bone cyst with scoliosis: a case report
Authors: Aljamaan Yousef M. , Alhathloul Hisham S. , Aleissa Sami I. , Abaalkhail Majid S. , Alhelal Fahad H. , Konbaz Faisal M.
Published: November 2022

Background

Aneurysmal bone cysts are benign bone tumors that not uncommonly involves the spine. However, this involvement can cause scoliosis, albeit rarely. This report focuses on the importance of proper management for complete tumor resection to prevent recurrence and spinal deformity.

Case presentation

A 12-year-old Middle Eastern boy, with a history of T11 aneurysmal bone cyst resection and bone grafting carried out at another hospital, presented with spine deformity of 4 months’ duration. The deformity was not associated with pain or neurological deficit. A whole-spine magnetic resonance imaging with contrast confirmed the recurrence of the aneurysmal bone cyst. Posterior spinal instrumentation with corpectomy of T11 was then performed, and confirmed with histopathology the recurrence of aneurysmal bone cyst. Two years post-corpectomy, deformity correction was done from T5–L4.

Conclusion

Management of aneurysmal bone cysts requires meticulous planning and full excision to prevent recurrence, especially in the growing spine. If neglected, it can cause major spinal deformities and cord compression, which places a medical burden on the patient and family. To avoid such complications, treating aneurysmal bone cysts along with scoliosis correction can prevent deformity progression.
The role of market linkage in growth of micro and small scale enterprises: the case of Ambo town, Ethiopia
Authors: Ensermu Gudeta Obsa , Tulu Daniel Tadesse
Published: November 2022

The research aims to investigate the roles of market linkage for the growth of MSE in Ambo town. The data were collected through questionnaires and interviews. A stratified sampling technique is used to select among the seven business sectors. Data were analyzed using descriptive and inferential statistics. The study elicited five major factors that affects the growth of MSE which include financial capacity, government support, entrepreneurial competency, marketing information, and types of business sectors. The findings from correlation and regression further indicate that there exists a positive and significant relationship between MSEs growth and, financial capacity, government support, entrepreneurial competency, marketing information, and types of business sectors. The concerned bodies should facilitate market linkage enhancement between MSE and the market. MSEs on their part are expected to improve financial capacity and competence. Furthermore, adequate market information has to be collected continuously to improve the linkage. By and general, growth of MSE is attributed to internal as well as external market linkage factors. In addition entrepreneurial competency of the person leading the enterprises is vital in creating good market linkage which in turn brings MSE growth.
‘Getting our voices heard in research: a review of peer researcher’s roles and experiences on a qualitative study of adult safeguarding policy
Authors: Montgomery Lorna , Kelly Berni , Campbell Ursula , Davidson Gavin , Gibson Leanne , Hughes Louise , Menham Jadzia , McKendry Linda , Newton Leslie-Anne , Parkinson Alex , Redmond Ethan , Turnbull Joseph , Webb Paul , Wood Lisamarie
Published: November 2022

Background

Historically, disabled people have been marginalised in research that traditionally adopted a medical model perspective. Since the 1970’s, there has been a shift from research on disabled people to research with disabled people with a strong emphasis on co-produced participatory research. Co-production involves disabled people working with academics to produce research and outcomes which are informed by the end user. This paper reflects on the role and experiences of peer researchers in co-producing a recent UK-wide research project called ‘Getting our Voices Heard’. This project sought to identify the best approaches for people with a learning disability and their supporting organisations to influence adult safeguarding policies, across the four jurisdictions of the UK.

Methods

A co-produced participatory design was used to address the project aims; achieved through the establishment of a collaborative research team comprising academic researchers, key stakeholders and six peer researchers, each of whom had a learning disability. Semi-structured interviews were completed with senior policy makers. Following this, in each of the four Nations, an organisational case-study was completed (four in total). Organisations were purposively sampled to identify one organisation in each country which was recognised as being successful in influencing adult safeguarding policy. Data were gathered through focus groups discussions and semi-structured interviews with key stakeholders. Findings were developed into an Impact Strategy and Action Plan. Co-production methods were used throughout.

Results

Six individuals with a learning disability were recruited and trained to work as peer researchers, involved at key stages of the project, working alongside a wider research team. The role and experiences of the peer researchers in the context of policy are presented. Peer researchers provided largely positive first-hand accounts of their experiences. The importance of collaboration, the invaluable role of Learning Disability support organisations, and the need for additional time and resources to facilitate co-production, was noted.

Conclusion

Whilst peer researchers were positive about their experiences, some success in promoting co-produced research and areas for improvement were evident. Collaboration at all stages would have been strengthened with research funding which enabled involvement of all team members in all research activities.
Verification of nanoparticle formation, skin permeation, and apoptosis using nobiletin as a methoxyflavonoid derivative
Authors: Inoue Yutaka , Ishizawa Moe , Itakura Shoko , Tanikawa Takashi , Todo Hiroaki
Published: November 2022

Purpose

Nobiletin (NOB), a polymethoxyflavonoid, is known for its antioxidant and anti-inflammatory effects and has antitumor activity. However, its poor solubility and low bioavailability pose a significant challenge in its delivery. In this experiment, NOB was added to Soluplus® (Sol)/l-ascorbyl 2,6-dipalmitate (ASC-DP) as a ternary system, and Sol/ASC-DP/NOB nanoparticles were obtained using the hydration method. The purpose of this study was to enhance the solubility of NOB, apply it for skin permeation, and improve antitumor activity.

Methods

The preparation of Sol/ASC-DP/NOB nanoparticles was attempted using the hydration method, and particle size, zeta potential, and stability tests were performed to evaluate the formation of nanoparticles. 1H-1H NOESY/ROESY NMR spectral measurements were also performed to identify molecular interaction between NOB and Sol/ASC-DP. To evaluate its functionality, DPPH radical scavenging, skin permeation, fluorescence microscopy, and cell viability analyses were performed.

Results

The particles were approximately 100 nm in size in the ternary system (weight ratio (Sol/ASCDP/NOB=8/1/1)) and were relatively stable for approximately 7 days at 25 °C under light-shielded conditions. From the NMR spectrum measurements of Sol/ASCDP/NOB, a cross-peak was observed between the –OCH3 group: C6,8 (3.8 ppm) derived from NOB, the methyl group (2.0 ppm) derived from Sol, and the side chain portion (1.2 ppm) derived from ASC-DP. Cross-peaks were observed between the polyethylene glycol (PEG) backbone of Sol (3.6 ppm) and the side chain of ASC-DP (0.8–1.2 ppm). The formation of Sol/ASC-DP/NOB nanoparticles facilitated its skin permeation, and fluorescence microscopy confirmed improved permeation. The DPPH radical scavenging test revealed that Sol/ASC-DP/NOB had an IC50of 46.7 μg/mL. Cell viability assays showed a 20–40% decrease in cell viability with the addition of Sol/ASC-DP/NOB at 0.1 mg/mL.

Conclusion

Sol/ASC-DP/NOB nanoparticles were successfully prepared, and these were found to inhibit melanin formation and have antitumor activity.
Rare sites of metastases in patients with differentiated thyroid carcinoma and added value of SPECT/CT over planar whole body radioactive iodine scan
Authors: Bashank Nahla , Farghaly Hussein , Hassanein Sara , Abdel-Tawab Mohamed , Wahman Mohamed , Mahmoud Hemat
Published: November 2022

Background

Being aware of the unusual or rare location of thyroid metastases helps in early diagnosis and proper patient management. Rare metastases (RM) can be missed resulting in diagnostic pitfalls and delayed treatment. The use of single-photon emission computed tomography/computed tomography (SPECT/CT) imaging in the follow-up of differentiated thyroid cancer (DTC) patients provides precise anatomical localization and characterization of RM that may be missed or misinterpreted in planar whole body iodine-131 (WBI) scan. There is a lack of knowledge about dealing with such patients, the treatment they should receive, and therapy response due to the rarity of such cases. In this work, we reported these rare cases increasing awareness about them and their methods of treatment with response to therapy and evaluated the added value of SPECT/CT imaging in changing patients’ management.

Materials and methods

In this study we reviewed all patients with DTC referred to our unit either for initial radioactive iodine-131 therapy (RAIT) or under follow-up from January 2019 to January 2022. When a suspected lesion was detected in a conventional planar WBI scan whether follow-up scan or post-therapeutic scan, SPECT/CT was acquired immediately in the same session for that region. Additional imaging modalities were performed for confirmation. Response to the given treatment either disease progression (DP) or favorable response which include complete response (CR), partial regression (PR) and stable disease (SD) recorded for each patient.

Results

Two hundred and forty patients with DTC referred to our unit over a three-year period (from January 2019 to January 2022) were reviewed. Forty patients developed lung and bone distant metastases. Twenty-one patients were thought to have metastases at unusual sites. Due to incomplete data (no SPECT/CT pictures or confirmatory imaging), 6/21 patients were eliminated. We studied 15 patients with RM (9 females, 6 males) with a median age of 52 years (range 27–79). All patients received the initial RAIT after thyroidectomy in addition to other therapeutic modalities, e.g., radiotherapy (RTH), chemotherapy (CTH) or surgical tumor excision after detection of RM. Ten out of 15 patients (66.67%) showed favorable response to therapy (2 patients had CR, 6 patients had PR and 2 patients had SD), whereas only 5 patients had DP. Additional SPECT/CT changed management in 10/15 patients (66, 67%) of patients.

Conclusion

RM identification is mandatory to avoid misdiagnosis and delayed therapy. Increasing the awareness about such rare cases allows for better management. SPECT/CT could significantly impact patients' management through its precise anatomic localization and lesion characterization.
Frequency of non-thyroidal illness syndrome in pediatric patients with sepsis and septic shock
Authors: Abdelgawad Tarek Ahmed , Magdy Sondos Mohamed , Mahmoud Rana Abdelhakaim Ahmed , Taha Sara Ibrahim Abdelfatah , Ali Safaa Yossef Abd Elhameed
Published: November 2022

Background

Non-thyroidal illness syndrome (NTIS) is considered when patients demonstrate altered thyroid hormones and is frequently seen in patients with sepsis and septic shock. Levels keep affected with disease progression and usually get normalized after the sickness is cured. NTIS is not studied well in pediatric population.

Aim of the work

Our primary outcome was to assess the frequency of hormonal changes of NTIS in sepsis and septic shock patients. The secondary outcome was to follow-up the severity of NTIS and its effect on the prognosis of the primary illness.

Patients and methods

This study (1st phase: cross-sectional, 2nd phase: prospective) included 40 critically ill children categorized into two groups: (i) sepsis group: defined according to standard international criteria using pediatric Sequential Organ Failure Assessment (p SOFA) score and sepsis was considered when p SOFA score > 2; (ii) septic shock group: defined by a vasopressor requirement to maintain a mean arterial pressure ≥ 65 mmHg and having a serum lactate level > 2 mmol/L despite adequate fluid resuscitation, with 20 patients in each group. Patients were admitted to the pediatric intensive care unit (PICU). Thyroid hormone levels were assessed and compared in day 1 and day 5 in all patients and subgroups. All patients were followed up until discharge or death.

Results

NTIS was found in 47.5% of patients. NTIS was higher among septic shock group than sepsis 65.5% versus 30% (p= 0.027). NTIS was associated with each of ventilation, catecholamines infusion and SOFA score (p= 0.044, 0.027, and 0.033) respectively. FT3 (free triiodothyronine) levels were lower and rT3 (reverse T3) levels were higher in day 5 of sickness than day 1 (p= 0.041 and 0.000) respectively. Furthermore, FT3 levels in day 5 were lower, and rT3 levels in day 1 and day 5 were higher in non-survivors than survivors (p= 0.002, 0.015, and 0.003) respectively. ROC curve was done to assess predictors of mortality and revealed that FT3 levels in day 5 was the best in predicting PICU mortality, followed by SOFA score day 5.

Conclusion

NTIS is common among critically ill children and higher among septic shock group than sepsis. Also, beside the SOFA score, FT3 measured in day 5 of sickness were the best predictors of PICU mortality.
Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews
Authors: Vamos Cheryl A. , Griner Stacey B. , Daley Ellen M. , Cayama Morgan Richardson , Beckstead Jason , Boggess Kim , Quinonez Rocio B. , Damschroder Laura
Published: November 2022

Background

Pregnancy presents an opportune time for oral health promotion and intervention; however, implementation of the prenatal oral health guidelines remains a challenge among prenatal and oral health providers. The purpose of this study was twofold: To employ a theory-based approach to identify high-priority Consolidated Framework for Implementation Research (CFIR) constructs with the greatest potential to impact prenatal oral health guideline implementation, and to operationalize and pre-test survey items based on the prioritized CFIR constructs. Identifying barriers and facilitators to guideline implementation will inform the development of targeted interventions that address gaps in adherence which can positively impact oral-systemic health.

Methods

The online survey development process employed three rounds of a modified-Delphi technique with prenatal (i.e., MD/DO, CNM) and oral health (i.e., DMD) Practice Advisory Board Members, cognitive interviews with prenatal and oral health providers, and deliberations among the research team and a Scientific Advisory Board (OBGYN, pediatric dentist, and researchers). High-impact CFIR constructs were identified and translated into survey items that were subsequently piloted and finalized.

Results

During three modified-Delphi rounds, a total of 39 CFIR constructs were evaluated with final input and deliberations with the Practice Advisory Board, Scientific Advisory Board, and the research team achieving consensus on 19 constructs. The instrument was pre-tested with four prenatal and two oral health providers. Overall, participants reported that the survey items were feasible to respond to, took an appropriate length of time to complete, and were well-organized. Participants identified specific areas of improvement to clarify CFIR items. The final survey instrument included 21 CFIR items across four domains, with five constructs included from the intervention characteristics domain, two from the process domain, two from the outer setting domain, and 12 from the inner setting domain.

Conclusions

Lessons learned from the survey development process include the importance of soliciting diverse scientific and practice-based input, distinguishing between importance/impact and direction of impact (barrier/facilitator), and the need for additional qualitative methods during interdisciplinary collaborations. Overall, this study illustrated an iterative approach to identifying high-priority CFIR constructs that may influence the implementation of the prenatal oral health guidelines into practice settings.
Symptomatic giant solitary bile cyst with intracystic bleeding in a 13-year-old girl: a case report and literature review
Authors: Junqueira José Otávio Guedes , de Pinho João Henrique Sendrete , de Oliveira Junqueira Thaís Bandeira , de Oliveira Junqueira Bruna Bandeira , Vidigal Fernando Mendonça , Furtado Maria Cristina Vasconcelos , de Souza Gláucio Silva
Published: November 2022

Background

Simple hepatic cyst is a rare disease in childhood. They occur in the general population with a prevalence of up to 5%. The incidence and size of cysts increase dramatically in adults older than 50 years. We performed a systematic literature review of all cases of simple hepatic cysts in the pediatric population undergoing surgical treatment. We found 52 cases reported in literature with a mean age of 2.54 years, 15% were pedicled cysts and only one case reported intracystic bleeding, detected only in the anatomopathological examination. We report a case of a 13-year-old girl who was presented with a symptomatic giant solitary bile cyst, the second biggest simple hepatic cyst reported in pediatric population, the biggest pedicled cyst and the only case of intracystic bleeding detected in pre-operative image examination in this group. This case brings important considerations about this complication and its pre-operative diagnosis.

Case presentation

We report a case of a 13-year-old girl with a giant solitary biliary cyst in the left hepatic lobe, symptomatic and with intracystic bleeding noted on magnetic resonance imaging. Diagnosis was difficult due to nonspecific symptoms and the non-typical images of simple hepatic cyst due to intracystic bleeding. The patient underwent a laparotomy, showing a large pedicled cyst, linked to segments II and III without adherence to other organs. Complete excision of the lesion was performed because the risk of torsion. The postoperative period passed without complications.

Conclusions

Although intracystic bleeding is the most common complication in adults, this is not reported in the pediatric population according to our review. Knowing how to recognize intracystic bleeding is important, because this complication predisposes the cyst to rupture and changes the appearance of the lesion on imaging tests, which can be more easily confused with cystadenoma or a cystadenocarcinoma. The magnetic resonance imaging is essential in the intracystic bleeding investigation. Comparisons between ultrasound and computed tomography findings associated with anemia history can prove the probability of this complication.
Unused opioid prescription prevalence after pediatric ambulatory surgery: a survey study
Authors: Dixit Anjali A. , Ho Nhi , Inglis-Arkell Christina , Chen Catherine L. , Ferschl Marla , Manuel Solmaz P.
Published: November 2022

Background

Surgery is a risk factor for opioid initiation, persistent use, and subsequent misuse in pediatric patients. The objective of this study was to assess the rate of postoperative opioid prescribing and extent of unused opioid prescriptions on the first postoperative day after pediatric ambulatory surgery.

Methods

A telephone survey was administered on postoperative day 1 (POD1) to guardians of all pediatric patients who underwent ambulatory surgery at a single medical center. Participants were asked whether postoperative opioids were prescribed, and, if yes, whether they were currently taking them. Multivariable logistic regression was used to assess factors associated with postoperative opioid prescribing and unused opioids on POD1.

Results

Of 1344 pediatric patients who underwent ambulatory surgical procedures, 849 (63.1%) guardians responded to the survey. 275 (32.4%) were prescribed postoperative opioids, and 164 (59.6%) reported not taking opioids on POD1. The highest rates of unused opioid prescriptions were from orthopedic and plastic surgery services (28% and 29%, respectively). Governmental insurance status predicted having unused opioids (OR 0.59, CI 0.35–0.97).

Conclusions

Unused opioid prescriptions were prevalent in this pediatric ambulatory surgical population. Opportunities remain to streamline opioid prescribing in pediatric patients undergoing ambulatory surgical procedures.
Co-infection of fasciolosis and hydatidosis and their financial loss in cattle slaughtered at Wolaita Sodo municipal abattoir, southern Ethiopia
Authors: Fesseha Haben , Asefa Isayas
Published: November 2022

Fasciolosis and hydatidosis are the world’s most common zoonotic major parasitic ailments of domesticated animals with financial and public health implications. A cross-sectional study was conducted on 384 randomly selected cattle slaughtered at Wolaita Sodo municipal abattoir to estimate the prevalence and associated risk factors for co-infection of hydatidosis and fasciolosis using the ante- and postmortem examination techniques. Of the 384 examined cattle, 4.17% were found to harbor co-infections of hydatidosis and fasciolosis. Similarly, the prevalence of concurrent fasciolosis and hydatidosis infections was 76.56% and 23.44% in local and crossbred animals, respectively. The current study took into account risk factors such as age, breed, origin, and body condition score; however, there is a statistically insignificant association between the risk factors and the prevalence of concurrent fasciolosis and hydatidosis infection. In this study, overall fasciolosis was recorded at a rate of 9.38%, with the highest prevalence of F. hepatica at 8.59%, followed by unidentified flukes at 4.17% and F. gigantica at 0.78%. Likewise, the single prevalence of hydatidosis was recorded at 10.94%. Of the 142 examined cysts, the liver alone harbors 54 cysts, and the lung alone harbors 88 cysts, with a total of 43 calcified, 21 sterile, 56 viable, 9 nonviable, and 13 mixed cysts. The predicted yearly financial loss from organ condemnation was 15,436,142.00 ETB Birr. This study demonstrated that hydatidosis and fasciolosis are two relatively widespread parasite diseases of cattle in Ethiopia, causing significant economic loss attributable to organ rejection and indirect weight loss. Thus, awareness of the impact of the disease on the community could disrupt the parasite’s life cycle, and its economic significance was forwarded to other points.
The interactions between vitamin D and neurofilament light chain levels on cognitive domains in bipolar disorder
Authors: Chen Wen-Yin , Huang Ming-Chyi , Chiu Chih Chiang , Cheng Ying-Chih , Kuo Chian-Jue , Chen Po-Yu , Kuo Po-Hsiu
Published: November 2022

Background

Bipolar disorder is a chronic mental disorder related to cognitive deficits. Low serum vitamin D levels are significantly associated with compromised cognition in neuropsychiatric disorders. Although patients with bipolar disorder frequently exhibit hypovitaminosis D, the association between vitamin D and cognition in bipolar disorder, and their neuroaxonal integrity, is unclear.

Aims

To investigate the interaction effects between vitamin D and neurofilament light chain (NfL) levels on cognitive domains in bipolar disorder.

Method

Serum vitamin D and NfL levels were determined in 100 euthymic patients with bipolar disorder in a cross-sectional study. Cognitive function was measured with the Brief Assessment of Cognition in Affective Disorders. We stratified by age groups and used general linear models to identify associations between vitamin D and NfL levels and their interaction effects on cognitive domains.

Results

The mean vitamin D and NfL levels were 16.46 ng/nL and 11.10 pg/mL, respectively; 72% of patients were vitamin D deficient. In the older group, more frequent hospital admissions and lower physical activity were identified in the group with versus without vitamin D deficiency. The age-modified interaction effect of vitamin D and NfL was associated with composite neurocognitive scores and verbal fluency in both age groups, and with processing speed domain in the younger group.

Conclusions

We observed a high vitamin D deficiency prevalence in bipolar disorder. We identified the interaction of vitamin D and NfL on cognitive domains, and the effect was modified by age. Longitudinal or randomised controlled studies enrolling patients with various illness durations and mood statuses are required to validate our findings.
The Black Englishmen of Old Calabar
Authors: Mbah Ndubueze L.
Published: November 2022

This article recovers the Afropolitan histories of Liberated Africans by examining their mobility and freedom politics. Liberated Africans enacted Afropolitanism when they returned from Sierra Leone to Old Calabar and fashioned themselves into Black Englishmen. Their Afropolitanism incorporated a dissident mode of Anglo-cosmopolitanism, thereby undermining orthodox British visions of imperial subjecthood. In using petitions to British authorities to assert their identity as British subjects, they secured their precarious freedom but challenged British monopoly of the Bight of Biafra’s transatlantic palm oil trade. Rather than being mere recipients of abolition, Liberated Africans refashioned abolition. They used forged “freedom papers” to emancipate, repossess, and traffic slaves from Old Calabar society while defending their behavior as “redemption” of slaves. Contrary to imperial fixity of African subjects, Liberated Africans evinced an Afropolitan vision of belonging. They simultaneously claimed to be natives of Sierra Leone and Old Calabar. Their contradictory ideologies and practices mitigated their marginality and confounded African elites and British imperial agents.
Urban Iconographies
Authors: Fulton Dawn
Published: November 2022

This article examines literary evocations of Afropolitanism in French, with particular attention to millennial works by Black women writers. Narratives and portraits by Lauren Ekué, Léonora Miano, and Rokhaya Diallo reject the Afro-pessimism of twentieth-century visions of urban migration by foregrounding the consumerism and cultural capital of their female protagonists. Rethinking Paris as a stage rather than a site, these works present new models of Afropolitan iconography, featuring women who are eminently alert to the contradictions and contingencies of contemporary Black experience. In teasing out the links among presentism, hip-hop culture, and the European beauty industry, these explorations generate a unique brand of performed consumerism that forges a dialogue between Black female cosmopolitanism and historicity.
Awareness of COVID-19 at the Local Level: Perceptions and Political Consequences
Authors: Haselswerdt Jake , Gollust Sarah
Published: November 2022

Context: Although the COVID-19 pandemic has affected all Americans, its effects have been unequally distributed across geographic areas. These variations in the pandemic's severity—and public perceptions thereof—likely have political consequences. This study examines the factors that shape perceptions of COVID-19 at the local level and assesses the consequences of these perceptions for public opinion and political behaviors.

Methods: The authors use questions from the 2020 Cooperative Election Study linked with county-level COVID-19 rates to examine predictors of respondents' perceptions of the pandemic's severity in their county, including demographic, political, and informational characteristics. The study also examines whether these perceptions are associated with public opinion and voter behavior.

Findings: Respondents' perceptions are correlated with case rates. Liberals and Democrats estimate the pandemic to be more severe than Republicans and conservatives do, as do CNN viewers compared to Fox News viewers. The study found only limited evidence of a relationship between perceptions of the pandemic in a respondent's county and political outcomes.

Conclusions: The results add to the accumulating evidence that both news media and political predispositions shape perceptions of COVID-19, and they raise important questions about whether and how the pandemic has shaped—and will continue to shape—political outcomes.
The Paradoxical Politics of Community Health Centers from the Great Society to the COVID-19 Pandemic
Authors: Skinner Daniel , Wright Brad
Published: November 2022

Context: Although community health centers (CHCs) arose in the 1960s as part of a Democratic policy push committed to social justice, subsequent support has been shaped by paradoxical politics wherein Republican and Democratic support for CHCs continually morphed in response to changes in the health policy landscape.

Methods: Drawing on the CHC literature and empirical examples from firsthand accounts and reporting, this article explains CHCs’ curious historical development from 1965 to the present.

Findings: Both Republicans and Democrats have calibrated their support for CHCs in response to a broader set of political considerations, from antiwelfare policy commitments to aspirations of establishing a national health care plan.

Conclusions: CHCs have proven to be a politically malleable policy tool within the broader context of American health care policy. The COVID-19 pandemic raised new questions about CHCs’ sustainability and future, but CHCs will continue to play a critical role in providing health care access to underserved populations. They also will continue to be an attractive bipartisan policy option within the larger framework of US health policy.
Convex Supply Curves
Authors: Boehm Christoph E. , Pandalai-Nayar Nitya
Published: November 2022

We provide evidence that industries' supply curves are convex. To guide our empirical analysis, we develop a model in which capacity constraints at the firm level generate supply curves that are convex in logs at the industry level. The industry's capacity utilization rate is a sufficient statistic for the supply elasticity. Using data on capacity utilization and three different instruments, we estimate the supply curve and find robust evidence for an economically sizable degree of convexity. The nonlinearity we identify has several macroeconomic implications, including that responses to shocks are state dependent and that the Phillips curve is convex. (JEL D21, E22, E23, E32, E62, L60)
A digital twin enabled wearable device for customized healthcare
Authors: Zhu Zhengxu , Zhong Ray Y
Published: November 2022

Background: The traditional healthcare process centers on the hospital rather than the individual patient. The demand for continuous monitoring is increasing with the increasing proportion of patients with chronic diseases and the elderly. Wearable medical devices have brought medical monitoring into the Internet age. To improve the devices' adaptability, this research proposes a combination between digital twin (DT) and wearable medical devices is proposed to provide personalized wearable medical devices and personalized healthcare efficiently.

Methods: A DT-enabled smart system is proposed for personalization in the design, manufacturing, and data tracking of a healthcare device prototype. A case study is made for three healthcare monitoring scenarios: rehabilitation training, wheelchair, and human fall. Based on computer-aided design and additive print, a triaxial vibration collection bracelet with a simple Internet of things mode is designed and manufactured in personalization.

Results: The bracelet shows great application ability in this case study, including design, manufacturing, and remote connection. 10 groups of data were recorded in each scenario. In rehabilitation training and wheelchair experiments, the average values of correlation coefficient between models and the actual data are 0.991 and 0.749 respectively. In human fall experiment, the motion signal parameters of the user and movement pattern were clearly identified. These results provide the basis for applications in different scenarios.

Conclusions: The device is representative, with good personalization and health monitoring performance, and has excellent potential for large-scale application. DT will provide a new feasible solution for the realization of personalized medicine.
Effectiveness of an mHealth application on remote monitoring and self-management of persons with hypertension in a coastal taluk of Udupi district: A study protocol
Authors: Salins Prajwal L , Nair Suma , Kundapur Poornima P , Pandey Akhilesh K , Reshmi Bhageerathy , Mandapam Sabu K
Published: November 2022

Background: Hypertension is the most important risk factor for cardiovascular disease, a major cause of death and disability globally. There is increasing evidence that demonstrates clinically relevant benefits from self-monitoring and self-management of blood pressure. Evidence suggests a reduction of systolic BP by 3.2 mm/hg through self-monitoring. The use of mHealth applications in health care monitoring and self-management can help in the timely delivery of health information. Around 33% of Indians use mHealth applications in their daily life. However, well-designed, user complied mHealth applications are essential to reach the masses and to be effective. A previously conducted study in India demonstrated that applications are not customized according to users' needs and expectations and lacked usability assessment by patients. Therefore, we aimed to develop and test a novel mHealth application on remote monitoring and self-management in hypertension.

Methods: The study will be carried out in three phases. The first phase will be an in-depth interview to identify the required parameters to develop a customized mHealth android-based application to monitor hypertension. The second phase is to develop the customized application through the Agile development design using the android studio platform. In the third phase, a community-based cluster randomized trial will be carried out to assess the effectiveness of the mHealth intervention on the remote monitoring and self-management of people with hypertension. A sample of 236 people from 12 villages will be randomized and the mHealth application will be delivered to the intervention group and the standard regimen will be continued in the control group.

Results: In the proposed study if the intervention is found to be helpful, then hypertension patients in the community can be encouraged to install the mHealth application. This application, if found effective can improve the health status, knowledge, and self-care approach among hypertensive patients.

Registration: CTR India (CTRI/2022/03/041544).
Dynamic geographical accessibility assessments to improve health equity: protocol for a test case in Cali, Colombia
Authors: Cuervo Luis Gabriel , Jaramillo Ciro , Cuervo Daniel , Martínez-Herrera Eliana , Hatcher-Roberts Janet , Pinilla Luis Fernando , Bula María Olga , Osorio Lyda , Zapata Pablo , Piquero Villegas Felipe , Ospina Maria Beatriz , Villamizar Carmen Juliana
Published: November 2022

This protocol proposes an approach to assessing the place of residence as a spatial determinant of health in cities where traffic congestion might impact health services accessibility. The study provides dynamic travel times presenting data in ways that help shape decisions and spur action by diverse stakeholders and sectors. 

Equity assessments in geographical accessibility to health services typically rely on static metrics, such as distance or average travel times. This new approach uses dynamic spatial accessibility measures providing travel times from the place of residence to the health service with the shortest journey time. It will show the interplay between traffic congestion, accessibility, and health equity and should be used to inform urban and health services monitoring and planning.

Available digitised data enable efficient and accurate accessibility measurements for urban areas using publicly available sources and provide disaggregated sociodemographic information and an equity perspective.

Test cases are done for urgent and frequent care (i.e., repeated ambulatory care). Situational analyses will be done with cross-sectional urban assessments; estimated potential improvements will be made for one or two new services, and findings will inform recommendations and future studies.

This study will use visualisations and descriptive statistics to allow non-specialized stakeholders to understand the effects of accessibility on populations and health equity. This includes “time-to-destination” metrics or the proportion of the people that can reach a service by car within a given travel time threshold from the place of residence.

The study is part of the AMORE Collaborative Project, in which a diverse group of stakeholders seeks to address equity for accessibility to essential health services, including health service users and providers, authorities, and community members, including academia.
Could treatment with immunomodulatory agents targeting IL-1, IL-6, or JAK signalling improve outcomes in patients with severe influenza pneumonia? A systematic and narrative review
Authors: Hays Leanne M C , Black Melissa , Prunty Michael P , Murthy Srinivas , van de Veerdonk Frank L , Annane Djillali , Binnie Alexandra , Burrell Aidan , Derde Lennie P G , Gordon Anthony C , Green Cameron , Guillon Antoine , Keat Karuna , Lawler Patrick R , Lye David C , Mayr Florian B , McArthur Colin J , McAuley Danny F , McVerry Bryan J , Morpeth Susan C , Phua Jason , Pletz Mathias , Reyes Luis Felipe , Saxena Manoj , Seppelt Ian , Shankar-Hari Manu , Sligl Wendy I , Turner Anne M , Uyeki Timothy M , Vazquez-Grande Gloria , Webb Steve A , Ainscough Kate , P Haren Andrea , Hills Thomas , Nichol Alistair
Published: November 2022

Background: Influenza is a global cause of morbidity and mortality and a significant risk for a future pandemic infection. Host hyperinflammation, similar to that seen in COVID-19, may occur in response to influenza virus pneumonia, with Janus kinase (JAK) signalling and proinflammatory cytokines Interleukin (IL)-1 and IL-6 involved. Immune modulation treatment of hospitalised and critically ill COVID-19 patients, including with IL-6 and JAK inhibitors, has been found to be beneficial. Significant interest exists in the use of immunomodulatory agents targeting these pathways in the treatment of severe influenza pneumonia.

Methods: We conducted a review with both systematic and narrative methods to assess whether, in patients with severe influenza pneumonia, treatment with immunomodulatory agents targeting IL-1, IL-6 or JAK signalling, in comparison to no immune modulation, is beneficial and improves clinical outcomes.

Results: Our systematic search screened 5409 records and found no randomised controlled trials of IL-1, IL-6 or JAK immunomodulatory agents in patients with severe influenza pneumonia. To support this systematic search, we provide a narrative review of the biological rationale, previous use of these agents, including in hospitalised patients with COVID-19, and an overview of their safety profiles.

Conclusions: Although immune modulation has proven successful in treating hospitalised and critically ill patients with COVID-19 and a biological rationale exists for testing these agents in influenza, no agents targeting IL-1, IL-6 or JAK signalling have been assessed in randomised controlled trials of patients with severe influenza pneumonia. This highlights a significant evidence gap.
Analysis of business models for delivering energy efficiency through smart energy services to the European commercial rented sector
Authors: De Tommasi Luciano , Papadelis Sotiris , Agrawal Ruchi , Lyons Padraig
Published: November 2022

In this paper, we perform a comparative analysis of business models used by Energy Service Companies (ESCOs), suitable for the deployment of energy efficiency measures in the commercial rented sector across Europe. These models can effectively contribute to solving the split-incentive issue that arises in the rented building scenario. Some of them are obtained from their “traditional” counterparts, which do not consider the rented scenario, but just a bipartite agreement between an Energy Service Company and its client. The EU Horizon 2020 project SmartSPIN (Smart energy services to solve the SPlit INcentive problem in the commercial rented sector) targets delivery of enhanced energy services for commercial rented sector. These enhanced energy services (a) combine demand management services and energy efficiency interventions, (b) facilitate the adoption of renewables, (c) optimize the balance between demand and supply, (d) alleviate the split incentive issue. The pilot implementation of project will be performed in a business park in Greece, in an office building in Ireland and in two shopping centers in Spain. Key recommendations toward the implementation of such a smart energy service are provided in this paper. They have been obtained from a detailed analysis of ten interviews of key stakeholders of the energy efficiency section and of the commercial rented sector, along with an analysis of a selection of the most relevant technical literature.
Pharmacokinetics of antitubercular drugs in patients hospitalized with HIV-associated tuberculosis: a population modeling analysis
Authors: Abdelgawad Noha , Chirehwa Maxwell , Schutz Charlotte , Barr David , Ward Amy , Janssen Saskia , Burton Rosie , Wilkinson Robert J. , Shey Muki , Wiesner Lubbe , McIlleron Helen , Maartens Gary , Meintjes Graeme , Denti Paolo
Published: November 2022

Background.

Early mortality among hospitalized HIV-associated tuberculosis (TB/HIV) patients is high despite treatment. The pharmacokinetics of rifampicin, isoniazid, and pyrazinamide were investigated in hospitalized TB/HIV patients and a cohort of outpatients with TB (with or without HIV) to determine whether drug exposures differed between groups.

Methods.

Standard first-line TB treatment was given daily as per national guidelines, which consisted of oral 4-drug fixed-dose combination tablets containing 150 mg rifampicin, 75 mg isoniazid, 400 mg pyrazinamide, and 275 mg ethambutol. Plasma samples were drawn on the 3rd day of treatment over eight hours post-dose. Rifampicin, isoniazid, and pyrazinamide in plasma were quantified and NONMEM® was used to analyze the data.

Results.

Data from 60 hospitalized patients (11 of whom died within 12 weeks of starting treatment) and 48 outpatients were available. Median (range) weight and age were 56 (35 - 88) kg, and 37 (19 - 77) years, respectively. Bioavailability and clearance of the three drugs were similar between TB/HIV hospitalized and TB outpatients. However, rifampicin’s absorption was slower in hospitalized patients than in outpatients; mean absorption time was 49.9% and 154% more in hospitalized survivors and hospitalized deaths, respectively, than in outpatients. Higher levels of conjugated bilirubin correlated with lower rifampicin clearance. Isoniazid’s clearance estimates were 25.5 L/h for fast metabolizers and 9.76 L/h for slow metabolizers. Pyrazinamide’s clearance was more variable among hospitalized patients. The variability in clearance among patients  was 1.70 and 3.56 times more for hospitalized survivors and hospitalized deaths, respectively, than outpatients.  

Conclusion.

We showed that the pharmacokinetics of first-line TB drugs are not substantially different between hospitalized TB/HIV patients and TB (with or without HIV) outpatients. Hospitalized patients do not seem to be underexposed compared to their outpatient counterparts, as well as hospitalized patients who survived vs who died within 12 weeks of hospitalization.
Posttraumatic single-stage ear reconstruction with a contralateral temporoparietal free flap: a case report
Authors: Suh Young Chul , Lee Nara , Kim Young Seok , Roh Tae Suk , Yun In Sik
Published: November 2022

In addition to the inherent difficulties of ear reconstruction, including its three-dimensional, symmetrical, and bilateral nature, posttraumatic ear reconstruction is even more challenging because of the destruction of the adjacent soft tissues and vessels following trauma. In severe cases, ipsilateral reconstruction becomes especially difficult. In the case herein, we present posttraumatic single-stage ear reconstruction with a contralateral temporoparietal fascial free flap using a branch of a facial artery as the recipient vessel. Posttraumatic ear reconstruction should be performed after considering the extent of tissue damage, the available treatment options, and the patient’s preferences. In challenging posttraumatic ear reconstruction cases that involve a lack of soft tissue and vessels on the ipsilateral side, a contralateral temporoparietal fascial free flap using a facial artery as the recipient vessel should be considered as a treatment option.