bluuebunny/crossref_metadata_2025 huggingface dataset:
Health facility management and primary health care performance in Uganda
Authors: Kim June-Ho , Bell Griffith A. , Bitton Asaf , Desai Eesha V. , Hirschhorn Lisa R. , Makumbi Fredrick , Nabiwemba Elizabeth , Ratcliffe Hannah L. , Wabwire-Mangen Fred , Kibira Simon P. S. , Schwarz Dan
Published: March 2022

Background

Primary health care is a critical foundation of high-quality health systems. Health facility management has been studied in high-income countries, but there are significant measurement gaps about facility management and primary health care performance in low and middle-income countries. A primary health care facility management evaluation tool (PRIME-Tool) was initially piloted in Ghana where better facility management was associated with higher performance on select primary health care outcomes such as essential drug availability, trust in providers, ease of following a provider’s advice, and overall patient-reported quality rating. In this study, we sought to understand health facility management within Uganda's decentralized primary health care system.

Methods

We administered and analyzed a cross-sectional household and health facility survey conducted in Uganda in 2019, assessing facility management using the PRIME-Tool.

Results

Better facility management was associated with better essential drug availability but not better performance on measures of stocking equipment. Facilities with better PRIME-Tool management scores trended towards better performance on a number of experiential quality measures. We found significant disparities in the management performance of primary health care facilities. In particular, patients with greater wealth and education and those living in urban areas sought care at facilities that performed better on management. Private facilities and hospitals performed better on the management index than public facilities and health centers and clinics.

Conclusions

These results suggest that investments in stronger facility management in Uganda may strengthen key aspects of facility readiness such as essential drug availability and potentially could affect experiential quality of care. Nevertheless, the stark disparities demonstrate that Uganda policymakers need to target investments strategically in order to improve primary health care equitably across socioeconomic status and geography. Moreover, other low and middle-income countries may benefit from the use of the PRIME-Tool to rapidly assess facility management with the goal of understanding and improving primary health care performance.
Photodermatitis and ocular changes in nine horses after ingestion of wild parsnip (pastinaca sativa)
Authors: Winter Judith C. , Thieme Katharina , Eule J. Corinna , Saliu Eva-Maria , Kershaw Olivia , Gehlen Heidrun
Published: February 2022

Background

Primary photosensitization rarely occurs in horses and can easily be misinterpreted. Descriptions of the disease in horses after ingestion of parsnip are lacking. The aim of this case series was to describe the dermatological and ocular changes due to photosensitization and to raise awareness of parsnip being a possible aetiologic agent.

Case presentation

Nine horses from three different stables in Berlin and Brandenburg, Germany, presented variable degrees of erythema, scaling, crusting and necrosis of unpigmented skin at the head and prepuce. Horses were of different breeds with a median age of 15 ± 5.9 years. A mild leukocytosis was diagnosed in 1/9 horses at admission. Analyzed liver enzymes were within the reference ranges in all horses. Ocular changes were diagnosed as follows: blepharitis (3/9), conjunctivitis (7/9), corneal edema without additional signs of keratitis and/or uveitis (2/9), corneal edema with signs of uveitis (1/9) and photophobia (4/9). One horse developed a fluorescein positive corneal erosion. Skin biopsy (1/9) revealed a moderate to severe acute, eosinophilic and lymphocytic dermatitis with dermal edema and vasculitis. All stables housing these patients fed hay from the same distributer. Analyzed hay samples showed high contents of wild parsnip (plants, seeds, roots). Wild parsnip is widespread in Europe and contains furocoumarins, a family of photodynamic pigments, which may cause primary photodermatitis, keratoconjunctivitis and uveitis. Horses were treated according to severity of clinical symptoms systemically with flunixine meglumine (1.1 mg/kg BW 1-2x/day) or prednisolone (1 mg/kg BW 1x/day). Topically, either gentamicin (3x/day), dexamethasone (2-3x/day) and/or atropine (1x/day) were used. Skin care was provided with almond oil or dexpanthenol (2x/day). All horses were kept in a dark environment or were treated with sunscreen and facemasks. Duration of treatment varied from 6–30 days (median 11.3 days).

Conclusion

Ingestion of wild parsnip (Pastinaca sativa) can induce primary photosensitization with dermatitis and ocular injury in horses. In times of extreme weather, hay may alter in botanical composition, resulting in high amounts of uncharacteristic plants causing novel problems.
Homozygous SPAG6 variants can induce nonsyndromic asthenoteratozoospermia with severe MMAF
Authors: Xu Chuan , Tang Dongdong , Shao Zhongmei , Geng Hao , Gao Yang , Li Kuokuo , Tan Qing , Wang Guanxiong , Wang Chao , Wu Huan , Li Guanjian , Lv Mingrong , He Xiaojin , Cao Yunxia
Published: March 2022

Background

Multiple morphological abnormalities of the sperm flagella (MMAF) is a subtype of severe asthenoteratozoospermia with poorly understood genetic etiology. SPAG6 is a core axonemal component that plays a critical role in the formation of cilia and sperm flagella. Previous studies have reported that mutations in SPAG6 cause primary ciliary dyskinesia (PCD), but the association between SPAG6 gene variants and the MMAF phenotype has not yet been described.

Methods

We performed whole-exome sequencing (WES) in two unrelated Han Chinese men with MMAF. Sanger sequencing was used to validate the candidate variants. Routine semen analysis was carried out according to the WHO guidelines (5th Edition). Sperm morphology was assessed using modified Papanicolaou staining. Scanning and transmission electron microscopy (S/TEM) was performed to observe the ultrastructural defects of the sperm flagella. Western blot analysis and immunofluorescence (IF) of spermatozoa were performed to examine the expression of SPAG6 protein. Assisted fertilization with intracytoplasmic sperm injection (ICSI) was applied.

Results

Two homozygous SPAG6 variants were identified by WES and Sanger validation in two patients with MMAF phenotype (F1 II-1: c.308C > A, p. A103D; F2 II-1: c. 585delA, p. K196Sfs*6). Semen analysis showed progressive rates of less than 1%, and most of the spermatozoa presented MMAF by Papanicolaou staining. TEM revealed that the overall axonemal ultrastructure was disrupted and primarily presented an abnormal “9 + 0” configuration. No other PCD-related symptoms were found on physical examination and medical consultations, as well as lung CT screening. The level of SPAG6 protein was significantly decreased in the spermatozoa, and IF analysis revealed that SPAG6 staining was extremely weak and discontinuous in the sperm flagella of the two patients. Notably, F1 II-1 and his wife conceived successfully after undergoing ICSI.

Conclusions

Our research provides new evidence for a potential correlation between SPAG6 variants and the MMAF phenotype.
Can humans perceive the metabolic benefit provided by augmentative exoskeletons?
Authors: Medrano Roberto Leo , Thomas Gray Cortright , Rouse Elliott J.
Published: February 2022

Background

The purpose of augmentative exoskeletons is to help people exceed the limitations of their human bodies, but this cannot be realized unless people choose to use these exciting technologies. Although human walking efficiency has been highly optimized over generations, exoskeletons have been able to consistently improve this efficiency by 10–15%. However, despite these measurable improvements, exoskeletons today remain confined to the laboratory. To achieve widespread adoption, exoskeletons must not only exceed the efficiency of human walking, but also provide a perceivable benefit to their wearers.

Methods

In this study, we quantify the perceptual threshold of the metabolic efficiency benefit provided during exoskeleton-assisted locomotion. Ten participants wore bilateral ankle exoskeletons during continuous walking. The assistance provided by the exoskeletons was varied in 2 min intervals while participants provided feedback on their metabolic rate. These data were aggregated and used to estimate the perceptual threshold.

Results

Participants were able to detect a change in their metabolic rate of 22.7% (SD: 17.0%) with 75% accuracy. This indicates that in the short term and on average, wearers cannot yet reliably perceive the metabolic benefits of today’s augmentative exoskeletons.

Conclusions

If wearers cannot perceive the benefits provided by these technologies, it will negatively affect their impact, including long-term adoption and product viability. Future exoskeleton researchers and designers can use these methods and results to inform the development of exoskeletons that reach their potential.
Open surgical treatment of subclavian artery pseudoaneurysm after endovascular repair: a case report
Authors: Lee Kyo Seon , Jung Yochun , Jeong In Seok , Song Sang Yun , Na Kook Joo , Oh Sang Gi
Published: February 2022

Background

Subclavian artery aneurysms are rare but may cause life-threatening complications. Surgical repair has been performed as a treatment of choice, but recently, with the development of endovascular treatment, many endovascular repairs have been performed to prevent surgical complications.

Case presentation

A patient undergoing endovascular repair with a subclavian artery aneurysm was diagnosed with a type II endoleak with an enlarged aneurysmal sac. Surgical repair was performed to remove the aneurysmal sac compressing the adjacent organs.

Conclusions

The highly mobile subclavian artery has abundant collaterals. Therefore, regular follow-up is essential for endovascular repair. Surgical repair is effective when adjacent organs are compressed by the aneurysm sac.
Cutaneous microvascular reactivity in Charcot neuroarthropathy: a systematic review and meta‐analysis
Authors: Lanting Sean Michael , Chan Tsz Long , Casey Sarah Louise , Peterson Benjamin John , Chuter Vivienne Helaine
Published: March 2022

Background

To systematically evaluate the literature investigating the relationship between cutaneous microvascular reactivity in the foot of adults with diabetes‐related Charcot neuroarthropathy compared to a non‐Charcot adult control group.

Methods

A systematic search was conducted to June 2021 using the biomedical databases EBSCO Megafile Ultimate, Cochrane Library and EMBASE. Original research conducting comparative investigation of cutaneous microvascular reactivity in the foot of adults with diabetes and any pattern of acute or chronic Charcot neuroarthropathy and any non‐Charcot adult control groups were included. A modified Critical Appraisal Skills Programme tool was used for quality appraisal. Cutaneous microvascular reactivity in diabetes‐related Charcot neuroarthropathy data were synthesised and meta‐analysis conducted where possible.

Results

The search strategy identified 1,684 articles, with seven eligible for inclusion. Included studies used various methodologies and equipment to assess cutaneous microvascular reactivity in 553 participants (162 with Charcot neuroarthropathy). Cutaneous microvascular reactivity in Charcot neuroarthropathy groups was impaired compared to uncomplicated diabetes groups. Meta‐analysis investigating the difference in response to thermal hyperaemia demonstrated a significant difference in cutaneous microvascular reactivity between Charcot neuroarthropathy and peripheral neuropathy with a large, pooled effect size (SMD 1.46 95% CI: 0.89–2.02) and low heterogeneity (I2 = 4%, T2 = 0.01) indicating that the cutaneous microvascular response is more impaired in peripheral neuropathy than in Charcot neuroarthropathy.

Conclusions

Charcot neuroarthropathy is associated with greater cutaneous microvascular reactivity in the periphery relative to diabetes cohorts with diabetes‐related peripheral neuropathy alone. It is unknown if this occurs prior to, or as a result of, Charcot neuroarthropathy.
Insight into the ecology of vaginal bacteria through integrative analyses of metagenomic and metatranscriptomic data
Authors: France Michael T. , Fu Li , Rutt Lindsay , Yang Hongqiu , Humphrys Michael S. , Narina Shilpa , Gajer Pawel M. , Ma Bing , Forney Larry J. , Ravel Jacques
Published: March 2022

Background

Vaginal bacterial communities dominated by Lactobacillus species are associated with a reduced risk of various adverse health outcomes. However, somewhat unexpectedly, many healthy women have microbiota that are not dominated by lactobacilli. To determine the factors that drive vaginal community composition we characterized the genetic composition and transcriptional activities of vaginal microbiota in healthy women.

Results

We demonstrate that the abundance of a species is not always indicative of its transcriptional activity and that impending changes in community composition can be predicted from metatranscriptomic data. Functional comparisons highlight differences in the metabolic activities of these communities, notably in their degradation of host produced mucin but not glycogen. Degradation of mucin by communities not dominated by Lactobacillus may play a role in their association with adverse health outcomes. Finally, we show that the transcriptional activities of L. crispatus, L. iners, and Gardnerella vaginalis vary with the taxonomic composition of the communities in which they reside. Notably, L. iners and G. vaginalis both demonstrate lower expression of their cholesterol-dependent cytolysins when co-resident with Lactobacillus spp. and higher expression when co-resident with other facultative and obligate anaerobes. The pathogenic potential of these species may depend on the communities in which they reside and thus could be modulated by interventional strategies.

Conclusions

Our results provide insight to the functional ecology of the vaginal microbiota, demonstrate the diagnostic potential of metatranscriptomic data, and reveal strategies for the management of these ecosystems.
The chromatin organization of a chlorarachniophyte nucleomorph genome
Authors: Marinov Georgi K. , Chen Xinyi , Wu Tong , He Chuan , Grossman Arthur R. , Kundaje Anshul , Greenleaf William James
Published: March 2022

Background

Nucleomorphs are remnants of secondary endosymbiotic events between two eukaryote cells wherein the endosymbiont has retained its eukaryotic nucleus. Nucleomorphs have evolved at least twice independently, in chlorarachniophytes and cryptophytes, yet they have converged on a remarkably similar genomic architecture, characterized by the most extreme compression and miniaturization among all known eukaryotic genomes. Previous computational studies have suggested that nucleomorph chromatin likely exhibits a number of divergent features.

Results

In this work, we provide the first maps of open chromatin, active transcription, and three-dimensional organization for the nucleomorph genome of the chlorarachniophyte Bigelowiella natans. We find that the B. natans nucleomorph genome exists in a highly accessible state, akin to that of ribosomal DNA in some other eukaryotes, and that it is highly transcribed over its entire length, with few signs of polymerase pausing at transcription start sites (TSSs). At the same time, most nucleomorph TSSs show very strong nucleosome positioning. Chromosome conformation (Hi-C) maps reveal that nucleomorph chromosomes interact with one other at their telomeric regions and show the relative contact frequencies between the multiple genomic compartments of distinct origin that B. natans cells contain.

Conclusions

We provide the first study of a nucleomorph genome using modern functional genomic tools, and derive numerous novel insights into the physical and functional organization of these unique genomes.
The effects of high-intensity functional training on cardiometabolic risk factors and exercise enjoyment in men and women with metabolic syndrome: study protocol for a randomized, 12-week, dose-response trial
Authors: Smith L. E. , Van Guilder G. P. , Dalleck L. C. , Harris N. K.
Published: March 2022

Background

Individuals with metabolic syndrome (MetS) are at a greater risk for developing atherosclerotic cardiovascular disease (ASCVD) than those without MetS, due to underlying endothelial dysfunction, dyslipidemia, and insulin resistance. Exercise is an effective primary and secondary prevention strategy for MetS; however, less than 25% of adults meet the minimum stated public recommendations. Barriers often identified are lack of enjoyment and lack of time. High-intensity functional training (HIFT), a time-efficient modality of exercise, has shown some potential to elicit positive affectivity and elicit increased fitness and improved glucose metabolism. However, the effects of HIFT on dyslipidemia and endothelial dysfunction have not been explored nor have the effects been explored in a population with MetS. Additionally, no studies have investigated the minimal dose of HIFT per week to see clinically meaningful changes in cardiometabolic health. The purpose of this study is to (1) determine the dose-response effect of HIFT on blood lipids, insulin resistance, and endothelial function and (2) determine the dose-response effect of HIFT on body composition, fitness, and perceived enjoyment and intention to continue the exercise.

Methods/design

In this randomized, dose-response trial, participants will undergo a 12-week HIFT intervention of either 1 day/week, 2 days/week, or 3 days/week of supervised, progressive exercise. Outcomes assessed at baseline and post-intervention will be multiple cardiometabolic markers, and fitness. Additionally, the participant’s affective response will be measured after the intervention.

Discussion

The findings of this research will provide evidence on the minimal dose of HIFT per week to see clinically meaningful improvements in the risk factors of MetS, as well as whether this modality is likely to mitigate the barriers to exercise. If an effective dose of HIFT per week is determined and if this modality is perceived positively, it may provide exercise specialists and health care providers a tool to prevent and treat MetS.

Trial registration

ClinicalTrials.gov NCT05001126. August 11, 2021.
Preferable outcome of Janus kinase inhibitors for a group of difficult-to-treat rheumatoid arthritis patients: from the FIRST Registry
Authors: Ochi Sae , Sonomoto Koshiro , Nakayamada Shingo , Tanaka Yoshiya
Published: March 2022

Backgrounds

Treatment of difficult-to-treat rheumatoid arthritis (D2T RA) is one of the greatest unmet needs in rheumatology. This study aims to find out preferable treatment options for a group of D2T RA patients who are refractory to multiple biologic and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs).

Methods

Data were obtained from patients enrolled in the FIRST Registry who started either TNF inhibitor (TNFi), interleukin-6 receptor inhibitor, cytotoxic T-lymphocyte–associated antigen-4 immunoglobulin, or Janus-kinase inhibitor (JAKi) in the period of August 2013 to December 2020. Those who failed to ≥ 2 and ≥ 3 b/tsDMARDs were categorised as D2T RA and very D2T RA (vD2T RA), respectively. Change in Clinical Disease Activity Index (CDAI) and Health Assessment Questionnaire Disability Index were compared among the groups using propensity-based inverse probability treatment weighted (IPTW) method.

Results

Of 2128 cases included, 353 were categorised as D2T RA. Among the D2T RA, 106 were identified as vD2T RA. JAKi showed a significant improvement in CDAI in the patients with D2T RA and vD2T RA, compared to IPTW-adjusted patients treated with the other 3 regimens. Latent class analysis of the trajectories of treatment response revealed that the proportion of a group of patients who showed poor response was lower among the JAKi subgroup than among those with other subgroups. This superiority of JAKi was more apparent among methotrexate- and glucocorticoid-free individuals. The hazard ratio of severe adverse events was comparable among the four treatment subgroups in both the D2T RA and b/tsDMARD-naïve groups.

Conclusions

This study compared responsiveness to different classes of b/tsDMARDs among D2T RA and vD2T RA patients who were refractory to multiple b/tsDMARDs. The results suggest JAKi is a preferable treatment choice for this type of D2T RA.
Plasma interleukin-23 and circulating IL-17A+IFNγ+ ex-Th17 cells predict opposing outcomes of anti-TNF therapy in rheumatoid arthritis
Authors: Millier Melanie J. , Fanning Niamh C. , Frampton Christopher , Stamp Lisa K. , Hessian Paul A.
Published: February 2022

Objectives

TNF-α inhibitors are widely used in rheumatoid arthritis (RA) with varying success. Response to TNF-α inhibition may reflect the evolution of rheumatoid inflammation through fluctuating stages of TNF-α dependence. Our aim was to assess plasma concentrations of Th-17-related cytokines and the presence of circulating effector T-cells to identify predictors of response to TNF-α inhibitors.

Methods

Ninety-three people with RA were seen prior to and 4–6 months after commencing etanercept or adalimumab. Plasma concentrations of Th17-related cytokines, circulating effector T-cells, their production of relevant transcription factors and intracellular cytokines were measured at baseline. EULAR response criteria were used to define poor (ΔDAS28 ≤ 1.2 and/or DAS28 > 3.2) and good (ΔDAS28 > 1.2 and DAS28 ≤ 3.2) responders. Multivariate logistic regression was used to identify predictors of response.

Results

Participants with plasma IL-23 present at baseline were more likely to be poor responders [15/20 (75%) of IL-23+ versus 36/73 (49.3%) of IL-23−; p = 0.041]. While frequencies of Th1, Th17, ex-Th17 and Treg cell populations were similar between good and poor responders to anti-TNF therapy, IL-17A+IFNγ+ ex-Th17 cells were more prevalent in good responders (0.83% of ex-TH17 cells) compared to poor responders (0.24% of ex-Th17 cells), p = 0.023. Both plasma IL-23 cytokine status (OR = 0.17 (95% CI 0.04–0.73)) and IL-17A+IFNγ+ ex-Th17 cell frequency (OR = 1.64 (95% CI 1.06 to 2.54)) were independently associated with a good response to anti-TNF therapy. Receiver operator characteristic (ROC) analysis, including both parameters, demonstrated an area under the ROC curve (AUC) of 0.70 (95% CI 0.60–0.82; p = 0.001).

Conclusions

Plasma IL-23 and circulating IL-17A+IFNγ+ ex-Th17 cells are independently associated with response to anti-TNF therapy. In combination, plasma IL-23 and circulating IL-17A+IFNγ+ ex-Th17 cells provide additive value to the prediction of response to anti-TNF therapy in RA.
Influence of probiotics on water quality in intensified Litopenaeus vannamei ponds under minimum-water exchange
Authors: Hassan Marwa A. , Fathallah Mustafa A. , Elzoghby Mohamed A. , Salem Mohamed G. , Helmy Mohamed S.
Published: February 2022

The effects of two probiotics on NH3degradation, as well as the magnetic field (21.56 m tesla) on the germination and proliferation ofBacillusspores, were studied in-vitro. Additionally, the effect of these probiotics on water quality maintenance inLitopenaeus vannameiholding ponds was investigated. For 180 min, NH3degradation was assessed as follows: Set 1: ammonia-free tap water with NH3; Probiotic A (5 × 1010viableBacillusspores/g) with NH3; Probiotic B (multi spp. 2 × 109 CFU/g) with NH3; and Set 2: same as set 1 with 30 mg L−1OM. The magnetic field was tested on Probiotic A (3.5 × 107CFU) for 36 h in triplicate. In the presence of organic matter, both probiotics degrade NH3. The viable Bacillus count increased within 6 h of being exposed to the magnetic field, reaching its peak after 36 h. Firstly, fifteen ponds (250,000 PL/acre) were investigated, then 360 water samples were collected from the same corresponding pond for 8 weeks, and subjected to T1: control; T2: Probiotic A (0.007 g/m3/2 weeks); T3: Probiotic B (0.03 g/m3/2 weeks). Both probiotics with TVC and NH3demonstrated a negative correlation, on the other hand, they showed a significant (P ≤ 0.01) improvement in DO and pH. Overall, both probiotics were able to degrade NH3and the magnetic field (21.56 m tesla) was efficient to improve the germination and proliferation ofBacillusspores in-vitro. Probiotics were also effective for reducing TVC and NH3levels by increasing dissolved oxygen and pH in pond water.
Evaluation of feasibility and user acceptance of lateral-flow self-testing for viral illness in a residential treatment rehabilitation facility
Authors: Sievers Benjamin L. , Klotzle James , Khan Tipu V.
Published: February 2022

Background

The role of rapid testing has proven vital in reducing infection incidence in communities through swift identification and isolation of infected individuals. The COVID-19 pandemic has been particularly catastrophic for residential carceral and rehabilitation facilities that are high-risk settings for transmission of contagious diseases. Centralized provider-based viral testing employing conventional diagnostic techniques is labor-intensive and time-consuming. There is a marked unmet need for quick, inexpensive, and simple viral testing strategies. We hypothesized that rehabilitation residents could successfully test themselves employing inexpensive, disposable, antigen-based influenza lateral-flow tests and would be willing to self-isolate and self-report to health authorities if positive.

Methods

We evaluated self-testing among 50 rehabilitation residents ages 18 and older in Pomona, California, where participants self-administered influenza lateral-flow diagnostic test (without specimen collection) with the goal of appropriately observing a control line and completed two brief written surveys on self-testing and COVID-19, one before self-administering the lateral-flow test and one after, to determine the overall feasibility of viral self-testing and to characterize attitudes comparing self-testing and provider-based testing.

Findings

A total of 50 rehabilitation residents were enrolled in this study and all 50 conducted a lateral-flow test and answered the provided surveys. Among the participants, 96% (48 of 50) achieved a positive-control line from their lateral-flow test. Most participants, 83% (34 of 41) indicated that they would prefer to perform their own rapid test instead of having a health care provider administer the test. Notably, 98% (49 of 50) indicated that they would self-isolate if the lateral-flow test returned a positive indicator suggesting the presence of a viral infection and 96% (48 of 50) would report positive results to their corresponding public health department.

Interpretation

Residents in a residential rehabilitation center were widely able to successfully self-administer standard lateral-flow antigen-based rapid diagnostic kits. Self-testing was strongly preferred over tests administered by a healthcare provider. Reassuringly, almost every resident indicated that they would report any positive test result to the health department and self-isolate accordingly. Self-testing offers a promising adjunct to centralized testing, potentially better enabling swift and effective management of life-threatening infectious outbreaks among those living in high-risk congregate living settings.
Pharmacists’ perspectives on traditional, complementary, and integrative medicine in Japan with special reference to Kampo medicines: an internet survey with preliminary interviews
Authors: Motoo Yoshiharu , Yukawa Keiko , Hisamura Kazuho , Arai Ichiro
Published: March 2022

Background

Pharmacists guide patients in their use of traditional, complementary, and integrative medicine (TCIM). The present study aimed to evaluate the opinions of Japanese pharmacists regarding TCIM, and to evaluate the usability of the evidence-based Japanese Integrative Medicine (eJIM) website from the pharmacists’ point of view.

Methods

We conducted a two-stage, mixed-method study using interviews and an internet-based survey. In-person interviews were conducted with 20 pharmacists working in hospitals, dispensing pharmacies, or retail pharmacies. We analyzed their perspectives on TCIM and the usability of the eJIM. Based on the interviews, questionnaires for an internet survey conducted in February 2019 were developed.

Results

In the interviews, 55% of pharmacists acknowledged TCIM as a supportive measure for modern medicine, and 45% responded that TCIM was efficacious. However, pharmacists’ evaluation levels of Kampo medicine were high, whereas pharmacists’ attitudes towards dietary supplements were primarily negative. There have been various proposals to improve the eJIM, such as highlighting important information and providing more specific information on TCIM in Japan. An internet survey of 365 pharmacists showed that 67.4% were consulted by patients regarding TCIM. Of these TCIM, pharmacists’ evaluation levels of Kampo medicines were high. Only 5% of the respondents had visited the eJIM website prior to the survey, and the overall usability score of each web page was high.

Conclusions

Kampo medicines and dietary supplements are common TCIMs that pharmacists use or advise on in Japan. Pharmacists’ evaluation levels of Kampo medicine were high, whereas pharmacists’ attitudes towards dietary supplements were generally negative.
Comparison of dietary acid load score between celiac patients and healthy population
Authors: Nikniaz Zeinab , Mahdavi Reza , Akhavan Sabbagh Mojgan , Nikniaz Leila , Shirmohammadi Masood
Published: March 2022

Background and aims

In the present study, we assessed the dietary acid load in adult celiac patients and compared it with that of the healthy population to provide more specific dietary recommendations for celiac patients.

Methods

This study was a cross-sectional study that included 130 celiac patients and 462 Non-celiac participants. The 80-item semi-quantitative food frequency questionnaire was used to obtain dietary data. Based on the dietary data, the dietary acid load (DAL), Potential renal net acid load (PRAL), and net endogenous acid production (NEAP) were calculated.

Results

The mean PRAL value is negative in the celiac group but positive in the general population. There was a significant difference in the PRAL score between celiac patients and the general population (p < 0.001). The mean NEAP and DAL score were significantly lower in the celiac group compared with the healthy population (P < 0.001). There were no significant differences between gluten-free diet adherents and non-adherents regarding the PRAL, NEAP, and DAL values (P > 0.05).

Conclusion

We showed that the patients with celiac disease had a significantly less acidogenic diet compared with that of the general population. So, following dies low in gluten may be associated with less acid production spacially in populations at risk of acid/base imbalance.
Reduction in Plasmodium falciparum Pfk13 and pfg377 allele diversity through time in southern Vietnam
Authors: Thieu Nguyen Quang , Chinh Vu Duc , Van Hanh Truong , Van Dung Nguyen , Takagi Hidekazu , Annoura Takeshi , Kawai Satoru , Masuda Gaku , Van Tuan Nguyen , Hung Vu Viet , Nakazawa Shusuke , Culleton Richard , Binh Nguyen Thi Huong , Maeno Yoshimasa
Published: March 2022

Background

Plasmodium falciparum has acquired resistance to artemisinin in Southeast Asia, with mutations in the P. falciparum Kelch-13 (Pfk13) gene associated with the resistance phenotype. The widespread use of Artemisinin-based combination therapy (ACT)s in Southeast Asia has led to the selection and spread of parasites carrying mutations in Pfk13. We characterised the allele diversity of Pfk13 and pfg377, an artemisinin-resistance neutral polymorphic gene, in parasite DNA extracted human blood from in southern Vietnam in 2003, 2012, 2015 and 2018.

Method

This study was conducted in Bu Gia Map commune, Binh Phuoc province, Vietnam, from May 2018 to January 2019. Twenty-four samples from 2018 to 2019, 30 from 2003, 24 from 2012 and 32 from 2015 were analysed. Malaria-infected human blood was collected by finger-prick and used for molecular analysis. A nested-PCR targeting the small subunit ribosomal RNA gene was used for Plasmodium species identification, followed by amplification and nucleotide sequencing of Pfk13 and region 3 of pfg377. Archived blood samples collected in the same region in 2012 and 2015 were also analysed as above for comparison.

Results

The genetic diversity of Pfk13 and pfg377 was lower in 2018–2019 compared to 2012 and 2015. The number of distinct Pfk13 mutants decreased from three in 2012 and 2015, P553L, V568G and C580Y, to one, C580Y in 2018–2019. In 2018–2019, the frequency of C580Y mutant strains was 71% (17/24 isolates). All samples were wild type in 2003. In 2012 and 2015, there were single-strain infections as well as co-infections with two mutant strains or with mutant and wild strains, whereas there were no co-infections in 2018. pfg377 allele diversity decreased from five alleles in 2012 to two alleles in 2018–2019.

Conclusion

The genetic diversity of P. falciparum was reduced at the two genetic loci surveyed in this study, Pfk13 and pfg377. In the case of the former gene, we observed an increase in the prevalence of parasites carrying the C580Y gene, known to confer reduced susceptibility to ACTs. The reduction in the diversity of pfg377 may be linked to the clonal expansion of parasite strains carrying the C580Y mutation, leading to an overall reduction in parasite genetic diversity across the population.
An immunogenetic perspective of ANCA-associated vasculitides
Authors: Kocaaga A. , Kocaaga M.
Published: March 2022

Background

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of small vessel vasculitides characterized by necrotizan vasculitis and inflammation. The phenotypes of AAV include microscopic polyangiitis (MPA), granulomatosis and polyangiitis (GPA), and eosinophilic granulomatosis and polyangiitis (EGPA). The pathogenesis of AAV is multifactorial, and it is suggested that both genetic and environmental factors can influence these disorders.

Main body

Several candidate gene studies and genome-wide association studies (GWAS) have been conducted to investigate the genetic associations with AAV in recent years. Numerous genes have been related to the pathogenesis of AAV, including the innate, adaptive immune system and coagulation systems.

Conclusion

This review summarizes the immunological mechanisms involved in the etiopathogenesis of AAV and recent advances in susceptibility genes.
Preserving Minors’ Data Protection in IoT-based Smart Homes According to GDPR Considering Cross-Border Issues
Authors:   Dept. of Applied Informatics, University of Macedonia, Thessaloniki, 54636, Greece, Rizou Stavroula , Alexandropoulou-Egyptiadou Eugenia , Ishibashi Yutaka , Psannis Kostas E.
Published: March 2022

Apart from the positive effects οf smart homes, such as economic, energy, and security enhancements, and the focus on their efficiency and reliability, it should also be paid attention to the legal, ethical and social impacts of these ICT systems. The field of children’s data protection is challenging, as they are likely more vulnerable to online risks, and as a result, their protection requires a specialized privacy-preserving scheme. This research work addresses the crucial issues of minors’ data protection, from a European law perspective, through IoT-based devices inside a smart home environment.
Estimating Indoor Population Density from Non-contact
Authors:   Institute of Management and Information Technologies, Chiba University, 1-33, Yayoi-cho, Inage-ku, Chiba, 263-8522 Japan, Komuro Nobuyoshi
Published: March 2022

With the spread of Covid-19, it is important to comprehend the indoor environment. It is also important to estimate indoor population density in order to avoid three Cs: Closed space, Crowded places, and Close-contact settings. This paper proposes a system for estimating indoor population density based on indoor environment data through Wireless Sensor Network (WSN). The proposed system collects indoor environment such as temperature, humidity, illuminace, CO2 concentration, and dust level. Then, the proposed system estimates indoor population density from collected environment data. The proposed system estimates the indoor population density from indoor environment data by machine learning. This study also investigates whether sensor data are adequate for estimating indoor population density. The experimental results show that the proposed system achieves about 80 % or more estimation accuracy by using multiple types of sensors, thereby demonstrating the effectiveness of the proposed system. The proposed system is expected to measure the closed space also estimate crowded rooms, which is a helpful finding for preventing the spread of COVID-19.
Editorial
Authors: Meyza Henryk
Published: March 2022

The Institute of Mediterranean and Oriental Cultures, Polish Academy of Sciences, represented by one of its legal predecessors, the Research Centre for Mediterranean Archaeology of the Academy, was from the beginning of Polish excavations in Cyprus in 1965 involved in study, publication of finds and storage as well as processing of documentation of Polish research in Cyprus until 2019. The excavations were initiated by the first Director of the Research Centre at the Academy and the Polish Centre of Mediterranean Archaeology of the University of Warsaw in Cairo (a foreign unit of the University), professor Kazimierz Michałowski.
A sense of coherence and styles of coping with stress of students of medical and non-medical universities
Authors: Jurczyszyn Anna , Zdziarski Krzysztof
Published: March 2022

The article relates to a sense of coherence and styles of coping with stress in a group of students of medical and non-medical universities. In the first part, a brief characteristics of the specifics of studies and future student work from both types of universities were presented. The issue of a sense of coherence and coping with stress in research was approximated closer. The study used a life orientation questionnaire (SOC-29) examining the sense of coherence and a questionnaire of coping in stressful situations (CISS). The level of a sense of coherence and strategies to deal with stress from students from medical and non-medical universities were compared. With the use of SOC-29 and CISS questionnaires, a group of 145 people were examined. Among the respondents there were 72 students from medical universities and 73 students from non-medical universities. In a group of students from medical universities, it has been shown that the level of sense of coherence is significantly different from the level of sense of coherence of non-medical students. The style focused on emotions was most often used in both student groups. There is a relationship between a style focused on emotions and a sense of coherence. In the study groups, no relationship was shown between the style concentrated on avoidance and the sense of coherence. The level of sense of coherence of students from medical universities is significantly different from the level of sense of coherence of students from non-medical universities. Students from both universities most often use the style concentrated on emotions, less often task style. The style focused on emotions correlates at a high level with a sense of coherence. The style focused on avoidance does not correlate with a sense of coherence. A relationship between an emotional style of coping with stress and a low sense of coherence is visible.
Find and Replace: R&D Investment Following the Erosion of Existing Products
Authors: Krieger Joshua L. , Li Xuelin , Thakor Richard T.
Published: March 2022

How do innovative firms react when existing products experience negative shocks? We explore this question with detailed project-level data from drug development firms. Using the Food and Drug Administration public health advisories as idiosyncratic negative shocks to approved drugs, we examine how drug makers react through investment decisions. Following these shocks, affected firms increase research and development (R&D) expenditures, driven by a higher likelihood of acquiring external innovations rather than developing novel projects internally. Such acquisition activities are concentrated in firms with weak research pipelines. We also find that competing developers move resources away from the affected therapeutic areas. Our results show how investments in specialized commercialization capital create path dependencies and alter the direction of R&D investments.

This paper was accepted by Ashish Arora, entrepreneurship and innovation.
An Examination of Velocity and Initial Coin Offerings
Authors: Holden Richard , Malani Anup
Published: March 2022

Blockchain technology offers firms a novel method of raising capital via so-called initial coin offerings (ICOs). In the most common form of an ICO, a firm creates digital assets called “utility tokens” that are tracked on a blockchain-based ledger, requires that its product be purchased only with those tokens, and then, raises capital by selling these tokens to investors prior to creating any saleable product. (Some nonfungible tokens (NFTs) may function in a similar fashion.) We model a fundamental paradox with the use of ICOs involving utility tokens and similar structures. To increase capital raised by an ICO, the firm may attempt to reduce blockchain operating costs, thus expanding the quantity of goods sold. However, because of the mechanics of miner compensation, doing so increases the number of utility token transactions that take place in any time interval (i.e., increases token velocity and thus, the effective supply of tokens). By Fisher’s equation, this lowers the dollar value of tokens and the amount investors are willing to pay for them. We show that this paradox limits the value of utility token ICOs as an alternative to traditional financing options. We discuss alternatives to and variations of utility tokens that can mitigate the conundrum and promote ICOs as a more viable form of financing.

This paper was accepted by Joshua Gans, business strategy.
Relationship Between Organizational Climate And Self-Concept With Effectiveness Of Interpersonal Communication
Authors: Muslicha Aria Nur Farida , Nurbianta Nurbianta , Herudiati Sri Endang
Published: March 2022

The research was conducted to determine whether there is a significant relationship between Organizational Climate and Self-Concept with the effectiveness of interpersonal communication at the Sekolah Tinggi Ilmu Tarbiyah Muhammadiyah Tanjung Redeb. This study was designed using a quantitative correlational approach through survey methods. The target population was all 45 educators and education staff at the Sekolah Tinggi Ilmu Tarbiyah Muhammadiyah Tanjung Redeb. The number of research samples is 30 teaching staff. Samples were purposive random sampling. This study indicates a significant relationship between organizational climate (X1) and head interpersonal communication (Y) effectiveness with the percentage contribution of variable X1 to Y of 40%. Then there is a significant relationship between Self-Concept (X2) and the Effectiveness of Head Interpersonal Communication (Y) with a correlation coefficient of ry2 = 0.628. The results then show that there is a significant relationship between Organizational Climate (X1) and Self-Concept (X2) with the Effectiveness of Leader Interpersonal Communication (Y) with a correlation coefficient of ry12 = 0.707 and the coefficient of determination r2y12 = 0.262 significant at 0.05. It shows that 50% of the leaders' interpersonal communication is determined jointly by organizational climate and self-concept. The research finding indicated a good atmosphere related to the organizational climate provides comfort for each individual to build a positive self-concept, which is related to the effective interpersonal communication of institutional leaders. Where there was never found in the previous research, the combination of organizational climate and self-concept influences the effectiveness of Interpersonal communication simultaneously.
Beneficence and non-maleficence: collaborative practice and harm mitigation
Authors: Bifarin Oladayo , Stonehouse David
Published: February 2022

This article is the third in a series of three, discussing and applying four ethical principles as identified by Beauchamp and Childress (2019) . This final article examines the two interrelated principles of beneficence and non-maleficence.

First, we will present definitions identifying the differences between the two. Then we will identify relevant and pertinent parts of the Nursing and Midwifery Council (NMC) (2018) code will be identified.

This will be followed by a discussion on how beneficence and non-maleficence can be demonstrated and practised within the clinical environment to patients, their families, your colleagues, and yourself.
Rare health conditions 55: Charcot-Marie-Tooth disease, Fraser syndrome, malignant atrophic papulosis and Jacob syndrome
Authors: Barber Chris
Published: February 2022

The purpose of this series is to highlight a range of rare health conditions. Rare health conditions are those that affect no more and usually fewer than one person in every 2000 and many healthcare assistants (HCAs) and nurses will encounter some of these conditions, given the high number of these conditions. This 55th article will explore four of these conditions: Charcot-Marie-Tooth disease, Fraser syndrome, malignant atrophic papulosis and Jacob syndrome.
Diagnostic, management and nursing challenges of less common dementias: Frontotemporal dementia, alcohol-related dementia, HIV dementia and prion diseases
Authors: Davis Laura , Karim Zarina , Dening Tom
Published: February 2022

Background:

Most cases of dementia are due to Alzheimer's disease or vascular dementia, but attention on these disorders means that other important causes of dementia may be relatively neglected. About 10–15% of people with dementia have other diagnoses, and there are numerous causes of the less common types of dementia.

Aims:

This paper provides information about the causes, symptoms, diagnosis and nursing management of some of the different types of less common dementias, with the aim of helping nurses to provide better care to patients and families affected.

Methods:

This is one of two connected papers and provides a narrative review of the literature on the clinical presentation of frontotemporal dementia, HIV dementia, prion dementias and alcohol-related dementia.

Findings:

Frontotemporal dementia has important clinical subtypes with distinct different presentations; for example, predominantly behavioural symptoms or progressive language dysfunction. Alcohol-related dementia is one of several types of alcohol-related brain damage. This is important as, with abstinence, its progression may be halted or even to some extent improved. HIV dementia has become less common since the introduction of effective antiretroviral therapy, but, nonetheless, the less severe picture of HIV-associated cognitive dysfunction remains prevalent despite treatment. Prion dementias encompass sporadic, familial and acquired Creutzfeldt-Jakob disease and are incurable, therefore requiring extensive palliative care.

Conclusions:

These forms of dementia all have different symptoms and courses from common types of dementia, such as Alzheimer's disease. It is important for nurses to be aware that dementia may have several causes and that people with different dementias will have different needs. Nonetheless, the general skills of nurses in supporting patients and families remain essential in order to develop appropriate care plans and to provide individualised, person-centred care.