bluuebunny/crossref_metadata_2025 huggingface dataset:
Reduced Activity of Protein S in Plasma: A Risk Factor for Venous Thromboembolism in the Japanese Population
Authors: Jin Xiuri , Kinoshita Sachiko , Kuma Hiroyuki , Tsuda Tomohide , Yoshida Tatsusada , Kang Dongchon , Hamasaki Naotaka
Published: July 2021

The quantitative assay of protein S can help in rapidly identifying carriers of abnormal protein S molecules through a simple procedure (by determining the total protein S mass, total protein S activity, and protein S-specific activity in blood), without genetic testing. To clarify the relationship between venous thromboembolism (VTE) and protein S-specific activity, and its role in the diagnosis of thrombosis in Japanese persons, the protein S-specific activity was measured and compared between patients with thrombosis and healthy individuals. The protein S-specific activity of each participant was calculated from the ratio of total protein S activity to total protein S antigen level. Plasma samples were collected from 133 healthy individuals, 57 patients with venous thrombosis, 118 patients with arterial thrombosis, and 185 non-thrombotic patients. The protein S-specific activity of one-third of the patients with VTE was below the line of Y = 0.85X (−2 S.D.). Most protein S activities in the plasma of non-thrombotic patients were near the Y = X line, as observed in healthy individuals. In conclusion, it was clearly shown that monitoring protein S activity and protein S-specific activity in blood is useful for predicting the onset and preventing venous thrombosis in at least the Japanese population.
The Evolution of G-quadruplex Structure in mRNA Untranslated Region
Authors: Qi Ting , Xu Yuming , Zhou Tong , Gu Wanjun
Published: July 2021

The RNA G-quadruplex (rG4) is a kind of non-canonical high-order secondary structure with important biological functions and is enriched in untranslated regions (UTRs) of protein-coding genes. However, how rG4 structures evolve is largely unknown. Here, we systematically investigated the evolution of RNA sequences around UTR rG4 structures in 5 eukaryotic organisms. We found universal selection on UTR sequences, which facilitated rG4 formation in all the organisms that we analyzed. While G-rich sequences were preferred in the rG4 structural region, C-rich sequences were selectively not preferred. The selective pressure acting on rG4 structures in the UTRs of genes with higher G content was significantly smaller. Furthermore, we found that rG4 structures experienced smaller evolutionary selection near the translation initiation region in the 5′ UTR, near the polyadenylation signals in the 3′ UTR, and in regions flanking the miRNA targets in the 3′ UTR. These results suggest universal selection for rG4 formation in the UTRs of eukaryotic genomes and the selection may be related to the biological functions of rG4s.
Traditional Practitioners and Nurses’ Perspectives on Traditional Medicine Utilisation During Antenatal Care in Matabeleland South Province, Zimbabwe
Authors: Mudonhi Nicholas , Nunu Wilfred Njabulo
Published: July 2021

Background:

Traditional Health System has been reported to be the most accessible, affordable, and acceptable in resource-poor settings, particularly in Sub-Saharan Africa. It is utilised for different health needs, including pregnancy management. This study sought to explore traditional and Nurses’ perspectives on traditional medicine utilisation during antenatal care in Bulilima District, Plumtree, Zimbabwe.

Methods:

A qualitative survey was conducted on purposively selected nurses’ and snowballed traditional health practitioners who responded to unstructured interviews. Data were collected using a digital tape recorder, transcribed, and thematically analysed on Max Qualitative Data Analysis.

Results:

A total of 6 superordinate and 10 subordinate themes emerged from the collected and analysed data on both traditional practitioners and nurses. The superordinate themes associated with Traditional Medicine utilisation during pregnancy by women were: protective role, beliefs, shortening of labour, cleansing, accessibility, and collaboration between traditional practitioners and modern health practitioners. Nurses expressed their skepticism on the safety and efficacy of traditional medicine utilisation during pregnancy.

Conclusion:

Women utilise traditional medicines and remedies during pregnancy for different reasons, such as protection from evil spirits, foetus growth and shortening labour. There are concerns regarding their safety from the health service providers, although traditional practitioners share a different view. There is a need for investing in research that would ascertain the safety of these traditional medicines as this system has been a cheaper alternative for those who cannot afford or access modern health services.
Amplification and the limits of visibility: Complicating strategies of trans voice and representations on social media
Authors: Ciszek Erica , Haven Paxton , Logan Nneka
Published: July 2021

In this article, we explore how the concepts of listening and voice influence trans communication and how communicators give voice to their identities and lived experiences through the communication work they perform. We examine amplification as a strategy for elevating historically marginalized voices within institutional and mediated spaces. Through interviews with trans communicators, findings reveal gaps that strategies of visibility leave unfilled, drawing attention to symbolic and material resources that are needed for generating effective change. We find that visibility-based strategies, such as amplification, can be instrumental in producing an inequitable distribution of power and exacerbating the burden of representation that complicates transgender communicators’ ability to navigate organizational politics.
Exploring Ripple Waves in the Human Brain
Authors: Takagi Shunsuke
Published: July 2021

Ripples are brief (<150 ms) high-frequency oscillatory neural activities in the brain with a range of 140 to 200 Hz in rodents and 80 to 140 Hz in humans. Ripples are regarded as playing an essential role in several aspects of memory function, mainly in the hippocampus. This type of ripple generally occurs with sharp waves and is called a sharp-wave ripple (SPW-R). Extensive research of SPW-Rs in the rodent brain while actively awake has also linked the function of these SPW-Rs to navigation and decision making. Although many studies with rodents unveiled SPW-R function, research in humans on this subject is still sparse. Therefore, unveiling SPW-R function in the human hippocampus is warranted. A certain type of ripples may also be a biomarker of epilepsy. This type of ripple is called a pathological ripple (p-ripple). p-ripples have a wider range of frequency (80-500 Hz) than SPW-Rs, and the range of frequency is especially higher in brain regions that are intrinsically linked to epilepsy onset. Brain regions producing ripples are too small for scalp electrode recording, and intracranial recording is typically needed to detect ripples. In addition, SPW-Rs in the human hippocampus have been recorded from patients with epilepsy who may have p-ripples. Differentiating SPW-Rs and p-ripples is often not easy. We need to develop more sophisticated methods to record SPW-Rs to differentiate them from p-ripples. This paper reviews the general features and roles of ripple waves.
Bio-inspired cluster–based optimal target identification using multiple unmanned aerial vehicles in smart precision agriculture
Authors: Salam Abdu , Javaid Qaisar , Ahmad Masood
Published: July 2021

Farming is the major profession in several republics for centuries. However, due to the immigration of individuals from rural to urban, there is prevention in farming. The use of modern technology in the precision agriculture field increases productivity and also improves the exports of a country. The productivity may suffer due to different environmental factors, diseases and insects attacks on the crops, especially tomatoes. The target area (i.e. the affected crops area due to environmental factors) identification and delivery of timely information about diseases in the crops to the ground station are mandatory to make the precautionary measurements. In flying sensor networks, the localization and clustering of multiple unmanned aerial vehicles for target areas identification is a challenging task due to energy constraints, communication range, frequent change in topology, link expiration and high mobility. In this article, we proposed the localization and clustering of multiple unmanned aerial vehicles for the identification of affected target areas in the tomato crop field. The localization of unmanned aerial vehicles depends on the weights of environmental factors, that is, relative humidity, soil moisture, temperature, light intensity, NPK (nitrogen (n), phosphorus (p) and potassium (k)) and power of hydrogen (pH). A honey bee optimization approach is used for the localization and formation of multiple unmanned aerial vehicles’ cluster to accurately identify the target areas. The performance of our bio-inspired approach is compared in terms of communication overhead, packet delivery ratio, mean end-to-end delay and energy consumption with the existing swarm intelligence–based schemes and validated via a simulation. The simulation result shows that the bio-inspired approach performs better among the selected approaches.
Atmospheric circulation and mortality by unintentional drowning in Spain: from 1999 to 2018
Authors: Real Á del , Sanchez-Lorenzo A , Lopez-Bustins J-A , Zarrabeitia MT , Santurtún A
Published: July 2021

Aims:

Drowning deaths are a leading cause of unintentional deaths worldwide. Few studies have analysed the role of meteorology in drowning, and with inconclusive results. The aim of this work is to analyse the temporal and geographical distribution of deaths by accidental drowning and submersion in Spain over 20 years, and to assess the relationship between accidental drowning and main atmospheric circulation patterns.

Methods:

An ecological study was performed, in which drowning and submersion mortality data from 1999 to 2018, considering demographic variables, were analysed. To study the association with atmospheric circulation we used an ERA5 reanalysis product over the whole European continent and the Climatic Research Unit Time Series (CRU TS) data set.

Results:

The annual average rate of deaths by accidental drownings was 11.86 deaths per million of habitants in Spain. The incidence in males was four times higher than in females, and when comparing age groups, the rate in the eldest group was the highest. Unintentional drowning deaths were not equally distributed around the country; the provinces with the highest registered standardized drowning death rates were touristic waterfront provinces either in Eastern Spain or in one of the archipelagos. There was a significant relationship between accidental drowning and meteorological variables during summer months, and drowning deaths were spatially correlated with sea-level pressure over the Mediterranean basin.

Conclusion:

Although the mortality rate registered a statistically significant decreasing tendency over the studied period, our results must be taken into consideration to improve the prevention strategies in the country since most of these deaths are avoidable.
Etiology of Cartilage Lesions Does Not Affect Clinical Outcomes of Patellofemoral Autologous Chondrocyte Implantation
Authors: Mestriner Alexandre Barbieri , Ackermann Jakob , Merkely Gergo , Galvão Pedro Henrique Schmidt Alves Ferreira , Ambra Luiz Felipe Morlin , Gomoll Andreas H.
Published: July 2021

Objective

To determine the relationship between cartilage lesion etiology and clinical outcomes after second-generation autologous chondrocyte implantation (ACI) in the patellofemoral joint (PFJ) with a minimum of 2 years’ follow-up.

Methods

A retrospective review of all patients that underwent ACI in the PFJ by a single surgeon was performed. Seventy-two patients with a mean follow-up of 4.2 ± 2.0 years were enrolled in this study and were stratified into 3 groups based on the etiology of PFJ cartilage lesions: patellar dislocation (group 1; n = 23); nontraumatic lesions, including chondromalacia, osteochondritis dissecans, and degenerative defects (group 2; n = 28); and other posttraumatic lesions besides patellar dislocations (group 3; n = 21). Patient’s mean age was 29.6 ± 8.7 years. Patients in group 1 were significantly younger (25.4 ± 7.9 years) than group 2 (31.7 ± 9.6 years; P = 0.025) and group 3 (31.5 ± 6.6 years; P = 0.05). Body mass index averaged 26.2 ± 4.3 kg/m2, with a significant difference between group 1 (24.4 ± 3.2 kg/m2) and group 3 (28.7 ± 4.5 kg/m2; P = 0.005). A clinical comparison was established between groups based on patient-reported outcome measures (PROMs) and failure rates.

Results

Neither pre- nor postoperative PROMs differed between groups ( P > 0.05). No difference was seen in survivorship between groups (95.7% vs. 82.2% vs. 90.5%, P > 0.05).

Conclusion

Cartilage lesion etiology did not influence clinical outcome in this retrospective study after second generation ACI in the PFJ.

Level of Evidence

Level III, retrospective comparative study.
Medical Students and Patients Benefit from Virtual Non-Medical Interactions Due to COVID-19
Authors: Coe Taylor M , McBroom Trevor J , Brownlee Sarah A , Regan Karen , Bartels Stephen , Saillant Noelle , Yeh Heidi , Petrusa Emil , Dageforde Leigh Anne
Published: July 2021

Background:

Patient care restrictions created by the COVID-19 pandemic constrained medical students’ ability to interact directly with patients. Additionally, organ transplant recipients faced increasing isolation due to the rise of telemedicine, the importance of social distancing and their immunosuppressed state. We created a pilot program to pair students with transplant patients for structured, virtual encounters and studied its impact on medical students and patients.

Methods:

In May 2020, medical students conducted virtual visits with patients via telephone or video conferencing. Patients and students were surveyed regarding their experiences and independent focus groups were conducted. The survey responses and focus group discussions were deidentified, transcribed, and analyzed for themes.

Results:

Ten participating students were in their first, second, or final year of medical school. The 14 patients were liver or kidney transplant recipients or kidney donors. All interactions lasted longer than 30 minutes, with 56% greater than 1 hour. Three themes emerged related to the student experience: improvement of their clinical communication skills, development of knowledge and attitudes related to organ transplantation and donation, and independent management of a patient encounter. Three themes related to the patient experience: appreciation of the opportunity to share their personal patient experience to help educate future physicians, a cathartic and personally illuminating experience and an opportunity to share the message of donation.

Conclusions:

This pilot program provided a novel opportunity for virtual student-patient interactions that was feasible, well-received, and mutually beneficial. The use of virtual non-medical patient experiences allowed for experiential learning during which students learned about both clinical medicine and enhanced their communication skills directly from patients. Additionally, patients were able to engage with medical students in a new way, as teachers of clinical interactions, and reported a high level of satisfaction in addition to deriving personal benefit.
Defining Learning Outcomes as a Prerequisite of Implementing a Longitudinal and Transdisciplinary Curriculum with Regard to Digital Competencies at Hannover Medical School
Authors: Foadi Nilufar , Koop Christian , Mikuteit Marie , Paulmann Volker , Steffens Sandra , Behrends Marianne
Published: July 2021

Background:

Worldwide educational programs face the challenge how to define and integrate digital competencies in medical education. This article describes the implementation of learning outcomes with respect to digital competencies in the compulsory curriculum at Hannover Medical School (MHH).

Methods:

An interdisciplinary MHH project group was constituted consisting of physicians and experts in medical informatics and in curriculum development. Over the course of 7 work sessions the group compared different international and national frameworks dealing with digital competencies for physicians. By a consensus driven approach the working group drew up a collection of learning outcomes which were regarded relevant to be incorporated in the curriculum at MHH.

Results:

The analysis of different frameworks indicated that data literacy is a central domain within all viewed preexisting catalogs. During the course of the project group analysis, 57 learning outcomes with respect to digital competencies were identified as necessary to be integrated in the compulsory curriculum. They were divided in 5 main categories: “handling of medical data,” “the digital infrastructure of the health system,” “scope of application: usage in patient care and in the field of preventive medicine,” “medico-legal and ethical basics,” and “transformation processes in medicine due to digitalization.”

Conclusions:

The MHH project group concluded that medical students should be taught digital competencies that enable an understanding of underlying functional principles of digital systems rather than their correct utilization. The presented project indicates that a close interdisciplinary collaboration of physicians and medical informaticians can be a promising approach to incorporate digital competencies in the undergraduate medical curriculum.
Synthesis and optimization of a montmorillonite-tolerant zwitterionic polycarboxylate superplasticizer via Box-Behnken design
Authors: Ren Jun , Luo Shuqiong , Shi Shi , Tan Hongbo , Wang Xianfeng , Liu Min , Li Xiangguo
Published: July 2021

Polycarboxylate superplasticizer (PCE) is sensitive to the clay present in concrete aggregates. In particular, Montmorillonite (Mnt), an impurity inevitably contained in the aggregate, can significantly influence the performance of concrete. In an effort to improve the compatibility of PCE, a zwitterionic PCE with cationic amide groups and shorter side-chain lengths was synthesized via free radical copolymerization. The optimal synthesis condition was verified via Box-Behnken design. In addition to characterizing the PCE, the performance of PCE in cement pastes with or without Na-Mnt was examined and the underlying mechanism was explored. The results show that, compared with commercially available PCE, the required dosage of PCE for cements containing Na-Mnt decreased. Unlike commercially available PCE, no intercalation occured on the newly manufactured clay-tolerant PCE within the layers of Mnt, resulting in a greater sorption thickness and improved dispersion of the cements containing Na-Mnt.
On the use of gravity data in delineating geologic features of interest for geothermal exploration in the Geneva Basin (Switzerland): prospects and limitations
Authors: Guglielmetti L. , Moscariello A.
Published: July 2021

Gravity data retrieved from the Bureau Gravimétrique International and the Gravimetric Atlas of Switzerland have been used to evaluate their applicability as a subsurface investigation tool to assess key geological features in support of the geothermal exploration in the Geneva Basin (GB). In this context, the application of an effective processing workflow able to produce reliable residual gravity anomalies was implemented as a crucial first step to investigate whether and to what level gravity anomalies can be correlated to geologic sources of geothermal interest. This study focusses on the processing workflow applied to publicly available gravity data, including the quantification of the uncertainty. This was then also used for first-order 2D forward gravity modelling. The resulting residual anomalies demonstrate the potential use of gravity investigations for geothermal exploration in sedimentary basins, and also reveal areas of significant, irreparable misfit, which calls for the use of complementary data and 3D subsurface structural knowledge. The results of such investigations will be presented in subsequent studies.
A rare case of male sex reversal syndrome (46, XX) with negative SRY gene: a disorder of sexual differentiation (DSD)
Authors: Abd El Salam Mohamed Ahmed , Ibrahim Noha Hassan , Eskarous Nehad Nabil
Published: July 2021

Background

Male sex reversal syndrome is a rare genetic cause of male infertility with an overall incidence of 1/20,000–1/100,000 males. There is mismatching between the genetic make-up and the apparent clinical features. The clinical presentation of such cases is variable ranging from ambiguous genitalia at birth, failed puberty, up to normal male phenotype with infertility and hypogonadism. The exact molecular and genetic bases of this syndrome are still unclear. Most of the recorded cases were SRY positive (i.e. representing 80–90% of all cases), and they showed translocated SRY gene on the Y chromosome. Moreover, fewer cases of male sex reversal (46, XX) were SRY negative.

Case presentation

Herby, we report a rare case of a 35-year-old infertile male patient who presented with azoospermia, hypergonadotropic hypogonadism, and abnormal classical (46, XX) karyotype, as well as negative FISH for SRY gene. He had a previous negative biopsy and was asking for redoing micro-TESE, whoever he was discouraged as chances to find sperm is eventually nil, and instead, he was prescribed testosterone replacement therapy to correct hypogonadism.

Conclusion

Therefore, any case of non-obstructive azoospermia should be offered genetic testing trying to exclude non-treatable cases and for genetic counseling.
Disease ontologies for knowledge graphs
Authors: Kurbatova Natalja , Swiers Rowan
Published: July 2021

Background

Data integration to build a biomedical knowledge graph is a challenging task. There are multiple disease ontologies used in data sources and publications, each having its hierarchy. A common task is to map between ontologies, find disease clusters and finally build a representation of the chosen disease area. There is a shortage of published resources and tools to facilitate interactive, efficient and flexible cross-referencing and analysis of multiple disease ontologies commonly found in data sources and research.

Results

Our results are represented as a knowledge graph solution that uses disease ontology cross-references and facilitates switching between ontology hierarchies for data integration and other tasks.

Conclusions

Grakn core with pre-installed “Disease ontologies for knowledge graphs” facilitates the biomedical knowledge graph build and provides an elegant solution for the multiple disease ontologies problem.
Weight shapes the intestinal microbiome in preterm infants: results of a prospective observational study
Authors: Heida Fardou H. , Kooi Elisabeth M. W. , Wagner Josef , Nguyen Thi-Yen , Hulscher Jan B. F. , van Zoonen Anne G. J. F. , Bos Arend F. , Harmsen Hermie J. M. , de Goffau Marcus C.
Published: July 2021

Background

The intestinal microbiome in preterm infants differs markedly from term infants. It is unclear whether the microbiome develops over time according to infant specific factors.

Methods

We analysed (clinical) metadata - to identify the main factors influencing the microbiome composition development - and the first meconium and faecal samples til the 4th week via 16 S rRNA amplican sequencing.

Results

We included 41 infants (gestational age 25–30 weeks; birth weight 430-990 g. Birth via Caesarean section (CS) was associated with placental insufficiency during pregnancy and lower BW. In meconium samples and in samples from weeks 2 and 3 the abundance of Escherichia and Bacteroides (maternal faecal representatives) were associated with vaginal delivery while Staphylococcus (skin microbiome representative) was associated with CS. Secondly, irrespective of the week of sampling or the mode of birth, a transition was observed as children children gradually increased in weight from a microbiome dominated by Staphylococcus (Bacilli) towards a microbiome dominated by Enterobacteriaceae (Gammaproteobacteria).

Conclusions

Our data show that the mode of delivery affects the meconium microbiome composition. They also suggest that the weight of the infant at the time of sampling is a better predictor for the stage of progression of the intestinal microbiome development/maturation than postconceptional age as it less confounded by various infant-specific factors.
Comparison of laryngeal mask airway and endotracheal tube in preterm neonates receiving general anesthesia for inguinal hernia surgery: a retrospective study
Authors: Su Miao-Pei , Hu Ping-Yang , Lin Jao-Yu , Yang Shu-Ting , Cheng Kuang-I , Lin Chia-Heng
Published: July 2021

Background

Preterm neonates are at higher risk of developing inguinal hernia, and have an increased risk of perioperative adverse events. Laryngeal mask airway (LMA) is claimed to be associated to decreasing perioperative respiratory complications compared to endotracheal tube (ETT) in infants under one year of age receiving minor surgery; thus, we conducted a retrospective survey in former preterm neonates below 5000 g to compare the respiratory complications between LMA and ETT in general anesthesia for inguinal hernia surgeries.

Methods

The inclusion criteria were: gestational age at birth under 37 weeks, body weight at surgery below 5000 g, and receiving scheduled inguinal hernia repair under general anesthesia with LMA or ETT. Infants who were dependent on mechanical ventilation preoperatively were excluded. The postoperative respiratory complications including delayed extubation, re-intubation, and apnea within postoperative 24 h were compared between groups.

Results

From July 2014 to December 2017, 72 neonates were enrolled into final analysis. There were 57 neonates managed with LMA, and only 15 neonates intubated with ETT during the study period. The gestational age at birth and post-menstrual age at surgery showed no significant difference between groups, although in the ETT group, the body weight at birth and at surgery were lower, and more infants had history of severe respiratory distress syndrome and had received oxygen therapy within two weeks prior to surgery. Surprisingly, none one of the infants developed delayed extubation, re-intubation, or postoperative apnea in the LMA group. In the ETT group, 40 percent of the neonates could not be successfully extubated in the operation theater.

Conclusion

In preterm neonates, even in those younger than 52 weeks post-menstrual age who undergoing inguinal hernia repair in their early infancy, LMA appears feasible and safe as the airway device during general anesthesia in specific patient group. However, anesthesiologist might prefer ETT rather than LMA in some complex situation. In neonates with lower body weight at birth and at surgery, and with a history of severe RDS and oxygen-dependence, further prospective study is required.
Renoprotective effects of sodium glucose cotransporter 2 inhibitors in type 2 diabetes patients with decompensated heart failure
Authors: Nakagaito Masaki , Imamura Teruhiko , Joho Shuji , Ushijima Ryuichi , Nakamura Makiko , Kinugawa Koichiro
Published: July 2021

Background

Sodium-glucose cotransporter 2 inhibitor (SGLT2i) reduces the risk of the composite renal endpoint and weakens the progressive decline in renal function in patients with chronic heart failure (HF). However, a detailed mechanism of SGLT2i on renal function and outcome remains uninvestigated.

Methods

We prospectively included 40 type 2 diabetic mellitus (T2DM) patients (median 68 years old, 29 male) who were hospitalized for decompensated HF and received SGLT2i during the index hospitalization. Of them, 24 patients had increases in estimated glomerular filtration rate (eGFR) at 12-month follow-up and 16 had decreases in eGFR. We investigated the baseline factors associating with the improvement in renal function.

Results

Lower plasma B-type natriuretic peptide (BNP) level and the use of renin-angiotensin system inhibitor (RASI) were independently associated with increases in eGFR during the follow-up period (p < 0.05 for both). Patients with both low plasma BNP levels and uses of RASI achieved significant increases in eGFR irrespective of the baseline HbA1c levels.

Conclusions

Lower plasma BNP level and the use of RASI at baseline were the key factors contributing to the renoprotective effects of SGLT2i among patients with decompensated HF and T2DM.
A first-aid fast track channel for rescuing critically ill children with airway foreign bodies: our clinical experience
Authors: Chen Yong-chao , Xian Zhi-xiong , Han Sai-hong , Li Lan , Teng Yi-shu
Published: July 2021

Objective

To explore the role of a first-aid fast track channel in rescuing children with airway foreign bodies and to analyse and summarize the experience and lessons of the first-aid fast track channel in rescuing airway foreign bodies from patients in critical condition.

Methods

We retrospectively reviewed the medical records of children with airway foreign bodies rescued by first-aid fast track channels admitted to our hospital from January 2017 to December 2020. The corresponding clinical features, treatments, and prognoses were summarized.

Results

Clinical data from 21 cases of first-aid fast track channel patients were retrospectively collected, including 12 males and 9 females aged 9–18 months. Cough was the most frequently exhibited symptom (100.0%), followed by III inspiratory dyspnoea (71.4%). Regarding the location of foreign bodies, 5 cases (23.8%) had glottic foreign bodies, 10 cases (47.6%) had tracheal foreign bodies, and 6 cases (28.6%) had bilateral bronchial foreign bodies. The most common type of FB was organic. FB removal was performed by rigid bronchoscopy in every case, and there were no complications of laryngeal oedema, subcutaneous emphysema, or pneumothorax. No tracheotomy was performed in any of the children.

Conclusion

The first-aid fast track channel for airway foreign bodies saves a valuable time for rescue, highlights the purpose of rescue, improves the success rate of rescue and the quality of life of children, and is of great value for the treatment of critical tracheal foreign bodies. It is necessary to regularly summarize the experience of the first-aid fast track channel of airway foreign bodies and further optimize the setting of the first-aid fast track channel.
Health care staff support for mothers in NICU: a focused ethnography study
Authors: Negarandeh Reza , Hassankhani Hadi , Jabraeili Mahnaz , Abbaszadeh Mohammad , Best Amy
Published: July 2021

Background

Mothers of premature newborns in the neonatal intensive care unit (NICU) have complex needs and require a significant amount of support during the NICU admission. However, little is known about mothers' support needs in the NICU. This study aimed to explore health care staff and mothers' experiences of meeting the mothers support needs in the NICU.

This study aimed to explore health care staff and mothers' experiences of meeting the mothers' support needs in the NICU.

Methods

A focused ethnographic approach was adopted. Observations and interviews with 21 mothers, 18 nurses, and five physicians were undertaken over a seven months period. Qualitative data analysis was conducted using the Roper and Shapira (2000) five-step framework.

Result

Two main themes of “insufficient provision of the mothers' support needs” (subthemes: inadequate accompany of the mothers in care, assigning monitoring and care to the mothers, inadequate sharing of medical the information) and “supporting the mothers in certain circumstances” (subthemes: reassuring the mothers, supporting the mothers with reduced functional capacity, providing information) were obtained.

Conclusion

The mothers experienced a gap between expected and actual support provided by health care staff. Although, the health care staff believed that mothers' support was a necessity, it was not their main concerns, and they considered workload as a barrier for the mothers support in the NICU.
An assessment of the role of socio-economic, maternal and service utilization factors in increasing self-reported maternal complications in India
Authors: Kumar Pradeep , Srivastava Shobhit , Maurya Chanda , Dhillon Preeti
Published: July 2021

Background

Self-reported maternal complications are associated with maternal morbidity, deliveries by C-section, postpartum depression, and maternal death. Thus, it is necessary to examine the contribution of socio-demographic and maternal characteristics, as well as service utilization in the rising self-reporting of maternal complications (difficulty with daylight vision, convulsions, swelling of the legs, body or face, heavy vaginal bleeding or high fever) in India. The study aimed at examining the factors that have influenced the increasing prevalence of maternal complications between 2005–06 and 2015–16 in India.

Methods

Data from the two most recent rounds of the National Family Health Survey, which covered a sample of 36,850 and 190,898 women respectively who delivered in the last five years preceding the survey has been used. Logistic regression analysis was performed to carve out the factors which significantly contributed to maternal complications among women aged 15 – 49 years in India. With the help of the Fairlie decomposition technique, the study quantified the contribution of factors which influenced the changes in maternal complications in the period from 2005–06 to 2015–16.

Results

A significant increase was seen in the prevalence of maternal complications — from 43.6% to 53.7% between the years 2005–06 and 2015–16. About 21% of the increase could be explained by certain maternal, households level factors, service utilization and birth outcomes. For example, service utilization, in which 13% was attributed to the place of delivery and 6% to postnatal care, was the major contributor to the increase in maternal complications from 2005–06 to 2015–16). This was followed by individual-level factors like education (2%), body mass index (4%) and tobacco use,. It was also found that household-level factors like standard of living (-3.7%) and region (-1.4%), and birth weight contributed to the reduction of complications during the period.

Conclusion

The increase in the prevalence of maternal complications in India could be attributed mainly attributed to increase in reporting behavior, an outcome of increased utilization of maternal healthcare services, and increase in BMI. However, reduced prevalence of maternal complications can be attributed to the decrease in the prevalence of low-birth-weight babies and tobacco use among women in India.
miR-29a-3p inhibits endometrial cancer cell proliferation, migration and invasion by targeting VEGFA/CD C42/PAK1
Authors: Geng Aizhi , Luo Lin , Ren Fengyun , Zhang Ling , Zhou Haiying , Gao Xue
Published: July 2021

Background

This study aimed to investigate the mechanism of miR-29a-3p in regulating endometrial cancer (EC) progression.

Methods

A total of 72 EC patients were enrolled. EC cells were transfected. Cells proliferation, cloning ability, migration and invasion were researched by MTT assay, colony formation experiment, cell scratch test and Transwell experiment respectively. Dual-luciferase reporter assay was performed. Xenograft experiment was conducted using nude mice. miR-29a-3p, VEGFA, CDC42, PAK1 and p-PAK1 expression in cells/tissues was investigated by qRT-PCR and Western blot.

Results

miR-29a-3p expression was aberrantly reduced in EC patients, which was associated with poor outcome. miR-29a-3p inhibited EC cells proliferation, cloning formation, migration and invasion (P <  0.05 or P <  0.01 or P <  0.001). miR-29a-3p inhibited CDC42/PAK1 signaling pathway activity in EC cells (P <  0.01). VEGFA expression was directly inhibited by miR-29a-3p. miR-29a-3p suppressed EC cells malignant phenotype in vitro and growth in vivo by targeting VEGFA/CDC42/PAK1 signaling pathway (P < 0.05 or P < 0.01).

Conclusion

miR-29a-3p inhibits EC cells proliferation, migration and invasion by targeting VEGFA/CDC42/PAK1 signaling pathway.
Growth and tolerance of healthy, term infants fed lower protein extensively hydrolyzed or amino acid-based formula: double-blind, randomized, controlled trial
Authors: Adams Craig B. , Johnston William H. , Deulofeut Harold , Leader Joseph , Rhodes Robbie , Yeiser Michael , Harris Cheryl L. , Wampler Jennifer L. , Hill Rebecca J. , Cooper Timothy
Published: July 2021

Background

Optimal protein level in hypoallergenic infant formulas is an area of ongoing investigation. The aim was to evaluate growth of healthy term infants who received extensively hydrolyzed (EH) or amino acid (AA)-based formulas with reduced protein.

Methods

In this prospective, multi-center, double-blind, controlled, parallel group study, infants were randomized to receive a marketed EH casein infant formula at 2.8 g protein/100 kcal (Control) or one of two investigational formulas: EH casein formula at 2.4 g protein/100 kcal (EHF) or AA-based formula at 2.4 g total protein equivalents/100 kcal (AAF). Control and EHF each had 2 × 107 CFU Lactobacillus rhamnosus GG/100 kcal. Anthropometrics were measured and recall of formula intake, tolerance, and stool characteristics was collected at 14, 30, 60, 90, 120 days of age. Primary outcome was weight growth rate (g/day) between 14 and 120 days of age (analyzed by ANOVA). Medically confirmed adverse events were recorded throughout the study.

Results

No group differences in weight or length growth rate from 14 to 120 days were detected. With the exception of significant differences at several study time points for males, no group differences were detected in mean head circumference growth rates. However, mean achieved weight, length, and head circumference demonstrated normal growth throughout the study period. No group differences in achieved weight or length (males and females) and head circumference (females) were detected and means were within the WHO growth 25th and 75th percentiles from 14 to 120 days of age. With the exception of Day 90, there were no statistically significant group differences in achieved head circumference for males; means remained between the WHO 50th and 75th percentiles for growth at Days 14, 30, and 60 and continued along the 75th percentile through Day 120. No differences in study discontinuation due to formula were detected. The number of participants for whom at least one adverse event was reported was similar among groups.

Conclusions

This study demonstrated hypoallergenic infant formulas at 2.4 g protein/100 kcal were safe, well-tolerated, and associated with appropriate growth in healthy term infants from 14 to 120 days of age.

Trial registration

ClinicalTrials.gov, ClinicalTrials.gov Identifier: NCT01354366. Registered 13 May 2011.
Neonatal mortality prediction with routinely collected data: a machine learning approach
Authors: Batista André F. M. , Diniz Carmen S. G. , Bonilha Eliana A. , Kawachi Ichiro , Chiavegatto Filho Alexandre D. P.
Published: July 2021

Background

Recent decreases in neonatal mortality have been slower than expected for most countries. This study aims to predict the risk of neonatal mortality using only data routinely available from birth records in the largest city of the Americas.

Methods

A probabilistic linkage of every birth record occurring in the municipality of São Paulo, Brazil, between 2012 e 2017 was performed with the death records from 2012 to 2018 (1,202,843 births and 447,687 deaths), and a total of 7282 neonatal deaths were identified (a neonatal mortality rate of 6.46 per 1000 live births). Births from 2012 and 2016 (N = 941,308; or 83.44% of the total) were used to train five different machine learning algorithms, while births occurring in 2017 (N = 186,854; or 16.56% of the total) were used to test their predictive performance on new unseen data.

Results

The best performance was obtained by the extreme gradient boosting trees (XGBoost) algorithm, with a very high AUC of 0.97 and F1-score of 0.55. The 5% births with the highest predicted risk of neonatal death included more than 90% of the actual neonatal deaths. On the other hand, there were no deaths among the 5% births with the lowest predicted risk. There were no significant differences in predictive performance for vulnerable subgroups. The use of a smaller number of variables (WHO’s five minimum perinatal indicators) decreased overall performance but the results still remained high (AUC of 0.91). With the addition of only three more variables, we achieved the same predictive performance (AUC of 0.97) as using all the 23 variables originally available from the Brazilian birth records.

Conclusion

Machine learning algorithms were able to identify with very high predictive performance the neonatal mortality risk of newborns using only routinely collected data.
Delaying sexual onset: outcome of a comprehensive sexuality education initiative for adolescents in public schools
Authors: Ramírez-Villalobos Dolores , Monterubio-Flores Eric Alejandro , Gonzalez-Vazquez Tonatiuh Tomás , Molina-Rodríguez Juan Francisco , Ruelas-González Ma. Guadalupe , Alcalde-Rabanal Jacqueline Elizabeth
Published: July 2021

Background

A common risk behavior in adolescence is the early initiation of unprotected sex that exposes adolescents to an unplanned pregnancy or sexually transmitted infections. Schools are an ideal place to strengthen adolescents’ sexual knowledge and modify their behavior, guiding them to exercise responsible sexuality. The purpose of this article was to evaluate the knowledge of public secondary school teachers who received training in comprehensive education in sexuality (CES) and estimate the counseling’s effect on students’ sexual behavior.

Methods

Seventy-five public school teachers were trained in participatory and innovative techniques for CES. The change in teacher knowledge (n = 75) was assessed before and after the training using t-tests, Wilcoxon ranks tests and a Generalized Estimate Equation model. The students’ sexual and reproductive behavior was evaluated in intervention (n = 650) and comparison schools (n = 555). We fit a logistic regression model using the students’ sexual debut as a dependent variable.

Results

Teachers increased their knowledge of sexuality after training from 5.3 to 6.1 (p < 0.01). 83.3% of students in the intervention school reported using a contraceptive method in their last sexual relation, while 58.3% did so in the comparison schools. The students in comparison schools were 4.7 (p < 0.01) times more likely to start sexual initiation than students in the intervention schools.

Conclusion

Training in CES improved teachers’ knowledge about sexual and reproductive health. Students who received counseling from teachers who were trained in participatory and innovative techniques for CES used more contraceptive protection and delayed sexual debut.
A cross-sectional survey assessing the influence of theoretically informed behavioural factors on hand hygiene across seven countries during the COVID-19 pandemic
Authors: Schmidtke K. A. , Drinkwater K. G.
Published: July 2021

Background

Human hygiene behaviours influence the transmission of infectious diseases. Changing maladaptive hygiene habits has the potential to improve public health. Parents and teachers can play an important role in disinfecting surface areas and in helping children develop healthful handwashing habits. The current study aims to inform a future intervention that will help parents and teachers take up this role using a theoretically and empirically informed behaviour change model called the Capabilities-Opportunities-Motivations-Behaviour (COM-B) model.

Methods

A cross-sectional online survey was designed to measure participants’ capabilities, opportunities, and motivations to [1] increase their children’s handwashing with soap and [2] increase their cleaning of surface areas. Additional items captured how often participants believed their children washed their hands. The final survey was administered early in the coronavirus pandemic (May and June 2020) to 3975 participants from Australia, China, India, Indonesia, Saudi Arabia, South Africa, and the United Kingdom. Participants self-identified as mums, dads, or teachers of children 5 to 10 years old. ANOVAs analyses were used to compare participant capabilities, opportunities, and motivations across countries for handwashing and surface disinfecting. Multiple regressions analyses were conducted for each country to assess the predictive relationship between the COM-B components and children’s handwashing.

Results

The ANOVA analyses revealed that India had the lowest levels of capability, opportunity, and motivation, for both hand hygiene and surface cleaning. The regression analyses revealed that for Australia, Indonesia, and South Africa, the capability component was the only significant predictor of children’s handwashing. For India, capability and opportunity were significant. For the United Kingdom, capability and motivation were significant. Lastly, for Saudi Arabia all components were significant.

Conclusions

The discussion explores how the Behaviour Change Wheel methodology could be used to guide further intervention development with community stakeholders in each country. Of the countries assessed, India offers the greatest room for improvement, and behaviour change techniques that influence people’s capability and opportunities should be prioritised there.
Environmental assessment of pediatric Lead exposure in Tehran; a prospective cross-sectional study
Authors: Ahangar Hedieh , Karimdoost Afsoon , Salimi Amir , Akhgari Maryam , Phillips Scott , Zamani Nasim , Hassanpour Nasibeh , Kolahi Ali-Asghar , Krieger Gary R. , Hassanian-Moghaddam Hossein
Published: July 2021

Background

Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities.

Methods

In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 μg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places.

Results

Thirty of 56 parents/guardians with BLL > 5 μg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p < 0.001) and interior windowsill dust lead level (median = 291, p = 0.011) were both significantly higher than the environmental protection agency (EPA) standards of 40 μg/ft2, 250 μg/ft2. Interior windowsill dust lead concentrations were significantly higher in industrial areas (p = 0.026).

Conclusion

Children’s playing environment should be cleaned more often to reduce dust. Moreover, specific rules may need to be implemented for paint lead concentrations and air pollution, especially in industrial areas.