bluuebunny/crossref_metadata_2025 huggingface dataset:
Immediate postpartum intrauterine contraceptive device utilization and influencing factors in Addis Ababa public hospitals: a cross-sectional study
Authors: Geda Yohannes Fikadu , Nejaga Seid Mohammed , Belete Mesfin Abebe , Lemlem Semarya Berhe , Adamu Addishiwet Fantahun
Published: February 2021

Background

Postpartum intrauterine device (PPIUCD) utilization remains very low in Ethiopia beside high levels of unmet need for postpartum family planning even if nongovernmental organizations efforts to promote its use. This study investigates immediate PPIUCD utilization and influencing factors.

Methods

Institution based cross-sectional study was conducted on public hospitals of Addis Ababa city. All public hospitals which have PPIUCD service were included and systematic random sampling technique was used to select 286 participants. Data were entered using Epi Data and exported to SPSS for analysis. Bivariate and multivariate logistic regression analysis was used to determine the effect of independent variables on immediate PPIUCD utilization. Variables which have P-value< 0.2 on bivariate analysis were candidate for multivariate analysis. Variables which have P-value ≤0.05 on multivariate analysis was considered as statistically significant.

Results

Utilization of immediate PPIUCD among participants who gave birth in Addis Ababa public hospitals was 26.6% (95%CI: 21.3, 31.8). Eighty one percent respondents occupation was housewife were (AOR = 0.19, 95%CI: 0.06, 0.67) less likely to utilize PPIUCD compared to those who have personal job. In the other hand respondents who have discuss about PPFP with their partner were 1.21times (AOR = 1.21, 95%CI: 1.14, 25.67) more likely to utilize PPIUCD compared to those who never discuss. Contrarily 81% of respondents who need partner approval were (AOR = 0.19, 95%CI: 0.05, 0.79) less likely to utilize PPIUCD compared to those who doesn’t need approval. Respondents who have been counseled about PPIUCD were 1.13 times (AOR = 1.13, 95%CI: 1.10, 2.21) more likely to utilize PPIUCD compared to those who were not counseled. Similarly respondents who have good knowledge about PPIUCD were 7.50 times (AOR = 7.50, 95%CI: 4.06, 9.31) more likely to utilize PPIUCD compared to those who have poor knowledge.

Conclusion

This study verifies that immediate PPIUCD utilization is high compared to other studies. Having a housewife occupation and necessity of partner approval to utilize PPIUCD have negative influences, whereas spousal discussion about PPIUCD, counseled during pregnancy and having good knowledge have positive influences on PPIUCD utilization. Therefor empowering women by the government and other organizations working on maternal health will advance immediate PPIUCD utilization.
Machine learning applied on chest x-ray can aid in the diagnosis of COVID-19: a first experience from Lombardy, Italy
Authors: Castiglioni Isabella , Ippolito Davide , Interlenghi Matteo , Monti Caterina Beatrice , Salvatore Christian , Schiaffino Simone , Polidori Annalisa , Gandola Davide , Messa Cristina , Sardanelli Francesco
Published: February 2021

Background

We aimed to train and test a deep learning classifier to support the diagnosis of coronavirus disease 2019 (COVID-19) using chest x-ray (CXR) on a cohort of subjects from two hospitals in Lombardy, Italy.

Methods

We used for training and validation an ensemble of ten convolutional neural networks (CNNs) with mainly bedside CXRs of 250 COVID-19 and 250 non-COVID-19 subjects from two hospitals (Centres 1 and 2). We then tested such system on bedside CXRs of an independent group of 110 patients (74 COVID-19, 36 non-COVID-19) from one of the two hospitals. A retrospective reading was performed by two radiologists in the absence of any clinical information, with the aim to differentiate COVID-19 from non-COVID-19 patients. Real-time polymerase chain reaction served as the reference standard.

Results

At 10-fold cross-validation, our deep learning model classified COVID-19 and non-COVID-19 patients with 0.78 sensitivity (95% confidence interval [CI] 0.74–0.81), 0.82 specificity (95% CI 0.78–0.85), and 0.89 area under the curve (AUC) (95% CI 0.86–0.91). For the independent dataset, deep learning showed 0.80 sensitivity (95% CI 0.72–0.86) (59/74), 0.81 specificity (29/36) (95% CI 0.73–0.87), and 0.81 AUC (95% CI 0.73–0.87). Radiologists’ reading obtained 0.63 sensitivity (95% CI 0.52–0.74) and 0.78 specificity (95% CI 0.61–0.90) in Centre 1 and 0.64 sensitivity (95% CI 0.52–0.74) and 0.86 specificity (95% CI 0.71–0.95) in Centre 2.

Conclusions

This preliminary experience based on ten CNNs trained on a limited training dataset shows an interesting potential of deep learning for COVID-19 diagnosis. Such tool is in training with new CXRs to further increase its performance.
Dynamic structural neuroplasticity during and after epileptogenesis in a pilocarpine rat model of epilepsy
Authors: Heysieattalab Soomaayeh , Sadeghi Leila
Published: February 2021

Background

The role of neuroplasticity in epilepsy has been widely studied in experimental models and human brain samples. However, the results are contradictory and it remains unclear if neuroplasticity is more related to the cause or the consequence of epileptic seizures. Clarifying this issue can provide insights into epilepsy therapies that target the disease mechanism and etiology rather than symptoms. Therefore, this study was aimed to investigate the dynamic changes of structural plasticity in a pilocarpine rat model of epilepsy.

Methods

A single acute dose of pilocarpine (380 mg/kg, i.p.) was injected into adult male Wistar rats to induce status epilepticus (SE). Animal behavior was monitored for 2 h. Immunohistochemical staining was performed to evaluate neurogenesis in the CA3 and dentate gyrus (DG) regions of hippocampus using biomarkers Ki67 and doublecortin (DCX). The Golgi-Cox method was performed to analyze dendritic length and complexity. All experiments were performed in control rats (baseline), at 24 h after SE, on day 20 after SE (latent phase), after the first and 10th spontaneous recurrent seizures (SRS; chronic phase), and in non-epileptic rats (which did not manifest SRS 36 days after pilocarpine injection).

Results

SE significantly increased the number of Ki67 and DCX-positive cells, suggesting neurogenesis during the latent phase. The dendritic complexity monitoring showed that plasticity was altered differently during epilepsy and epileptogenesis, suggesting that the two processes are completely separate at molecular and physiological levels. The numbers of spines and mushroom-type spines were increased in the latent phase. However, the dendritogenesis and spine numbers did not increase in rats that were unable to manifest spontaneous seizures after SE.

Conclusion

All parameters of structural plasticity that increase during epileptogenesis, are reduced by spontaneous seizure occurrence, which suggests that the development of epilepsy involves maladaptive plastic changes. Therefore, the maladaptive plasticity biomarkers can be used to predict epilepsy before development of SRS in the cases of serious brain injury.
Cholesteatoma surgery by open technique with reconstruction together with same session ossiculoplasty
Authors: Hasaballah Mohammed Saad , Milad Peter , Mady Ossama Mustafa , Teaima Ahmed Abdelmoneim
Published: February 2021

Background

This study was designed to evaluate the effect of mastoid cavity obliteration with bone chips and reconstruction of canal wall with tragal cartilage after canal wall down tympanomastoidectomy with cartilage ossiculoplasty in the same session. Sixty-three patients with cholesteatoma underwent the technique mentioned above; patients were followed for 1 year postoperative.

Results

No cavity problems, median preoperative air bone gap was 32.86 ± 6.24 db, while the median postoperative air bone gap was 21.67 ± 5.99 db.

Conclusions

Canal wall down mastoidectomy with obliteration of mastoid cavity is an effective option for the complete removal of cholesteatoma and same session cartilage ossiculoplasty is a viable option.
Seismic detection and characterization of a man-made karst analog — A feasibility study
Authors: Gritto Roland , Elnaiem Ali Elobaid , Mohamed Fateh Alrahman , Sadooni Fadhil
Published: February 2021

At the site of a water drainage shaft on the campus of Qatar University that serves as a man-made karst analog, two seismic imaging techniques were adapted to use resonant scattered waves recorded during active-source seismic surveys and during passive ambient-noise surveys. Data acquisition included two seismic transmission surveys that encompassed the shaft and a passive ambient-noise survey that extended across the top of the shaft. Seismic imaging of band-pass-filtered resonance waves correctly estimated the location and dimension of the shaft. Furthermore, the method detected the presence and the location of a horizontal drainage pipe and gravel bed connecting neighboring water shafts. Ambient-noise data were analyzed by computing amplitude values of the seismic records in spectral passbands. The results indicated an amplification of seismic amplitudes above the shaft for low-frequency passbands and a sharp decrease in amplitude values for high-frequency passbands. The high- and low-amplitude values displayed as a function of the receiver position allowed for accurate detection and location of the shaft in space. Ground truthing of the imaging results confirmed the accuracy of the seismic techniques, whereas numerical modeling supported the interpretation of the ambient-noise data. The techniques used do not require knowledge of the seismic velocities in the subsurface, but they depend on a priori information about the approximate location of the target.
Field measurements of fracture characteristics on a wave-cut platform
Authors: Loriaux Thomas , Verdon James , Kendall J.-Michael , Baird Alan , Wookey James
Published: February 2021

We have used seismic refraction surveys of a wave-cut platform from a field site in South West England to characterize the impact of natural fracture networks on seismic velocities and anisotropy. Time-lapse surveys were performed as the high tide ebbed to investigate the seismic effects of the water draining from the rock. We also deployed a drone to map the fracture sets from the air. Azimuthal variations in the P- and S-wave velocities reflect the orientation of the main east–west-oriented joint set. Seismic velocities increased as the water drained, an effect attributed to a reduction in the effective density of the medium. The ratio of fracture normal ([Formula: see text]) to tangential ([Formula: see text]) compliance ([Formula: see text]), which can be used as a proxy for fracture saturation and permeability, was observed to increase from [Formula: see text] to [Formula: see text], primarily driven by a drop in [Formula: see text]. These variations are attributed to a decrease in the water content of the main fracture set as the tide retreats.
Quantitative analysis of coal-bed methane components by downhole laser Raman spectroscopy
Authors: Wang Heng , Zhou Lifa , Yuxia Wang
Published: February 2021

Laser Raman spectroscopy can be used to acquire the unique fingerprint of a specific molecule, and it is widely used to identify substances and to study the spectral line characteristics of molecular structures. The measurement of coalbed methane (CBM) content is essential in the exploration and development of CBM fields for optimizing the fracture design. For this purpose, laser Raman spectroscopy can be extremely beneficial because it detects the gas content rapidly and accurately. Moreover, conventional gas content testing methods are laborious, time-intensive, and expensive, and they yield inaccurate results. Therefore, we have integrated a laser Raman spectroscopy system with coiled tubing (CT) equipment for downhole deployment in gas wells to accurately determine the CBM content in situ. The developed system can directly determine the CBM content at a specific location in the target layer. The trace test characteristics enable this system to rapidly detect downhole gas components and contents. The real-time detection data are transmitted via a cable to a computer on the surface and are processed using a baseline correction algorithm and a data enhancement algorithm. The Fourier transform and the wavelet transform are used to identify the Raman spectral lines, whereas analysis of Raman spectra is used to determine the CBM content. By using this equipment, we can shorten the cycle of depressurization, drainage, and recovery processes from multiple days to just a few hours. Furthermore, the integrated laser Raman spectroscopy-CT system enables a flexible operation and possesses strong site operability, making it suitable for complex and high-risk wells.
Characterizing complex slope channel reservoirs applying extended elastic impedance, Saffron gas field, offshore Nile Delta, Egypt
Authors: Othman Adel , Ali Ahmed , Fathi Mohamed , Metwally Farouk
Published: February 2021

In a complex reservoir with a significant degree of heterogeneity, it is a challenge to characterize the reservoir using different seismic attributes based on available data within certain time constraints. Prestack seismic inversion and amplitude variation with offset are among the techniques that give excellent results, particularly for gas-bearing clastic reservoir delineation because of the remarkable contrast between the latter and the surrounding rocks. Challenges arise when a shortage of seismic or well data presents an obstacle in applying these techniques. A further challenge arises if it is necessary to predict water saturation (Sw) using the seismic data because of the independent nonlinear relationship between Sw and seismic attributes and inversion products. Prediction of Sw is necessary not only for characterizing pay from nonpay reservoirs but also for economic reasons. Therefore, extended elastic impedance has been performed to produce a 3D volume of Sw over the reservoir interval. Then, a 3D sweetness volume and spectral decomposition volumes were used to grasp the geometry of the sand bodies that have been charged with gas in addition to their connectivity. This could help illustrate the different stages in the evolution of the Saffron channel system and the sand bodies distribution, both vertically and spatially, and consequently increase production and decrease development risk.
Dana-Farber Cancer Institute/Mass General Brigham Fellowship Response to the COVID-19 Pandemic
Authors: Stern Robert M. , Michaelson M. Dror , Mayer Erica L. , Parnes Aric D. , Fogerty Annemarie E. , LaCasce Ann S. , Nipp Ryan D.
Published: February 2021

The coronavirus disease (COVID)-19 pandemic has affected graduate medical education training programs, including hematology-oncology fellowship programs, both across the United States and abroad. Within the Dana-Farber Cancer Institute/Mass General Brigham hematology-oncology fellowship program, fellowship leadership had to quickly reorganize the program's clinical, educational, and research structure to minimize the risk of COVID-19 spread to our patients and staff, allow fellows to assist in the care of patients with COVID-19, maintain formal didactics despite physical distancing, and ensure the mental and physical well-being of fellows. Following the first wave of patients with COVID-19, we anonymously surveyed the Dana-Farber Cancer Institute/Mass General Brigham first-year fellows to explore their perceptions regarding what the program did well and what could have been improved in the COVID-19 response. In this article, we present the feedback from our fellows and the lessons we learned as a program from this feedback. To our knowledge, this represents the first effort in the hematology-oncology literature to directly assess a hematology-oncology program's overall response to COVID-19 through direct feedback from fellows.
Ascending Growth is Associated with Offspring Adiposity in Pregnancies Complicated with Obesity or Gestational Diabetes
Authors: Huvinen Emilia , Tuomaala Anna-Kaisa , Bergman Paula H , Meinilä Jelena , Tammelin Tuija , Kulmala Janne , Engberg Elina , Koivusalo Saila B
Published: February 2021

Context

Early growth is associated with childhood adiposity, but the influence of lifestyle remains unknown.

Objective

This work aimed to investigate the association of growth profiles from high-risk pregnancies with adiposity at age 5 years, taking into account lifestyle and several antenatal/postnatal exposures.

Methods

This prospective cohort study

included

609 children born during the Finnish Gestational Diabetes Prevention Study (RADIEL), recruiting women with body mass index (BMI) greater than or equal to 30 and/or prior gestational diabetes mellitus (GDM) (2008-2013). Altogether 332 children attended the 5-year follow-up (2014-2017). Main outcome measures included growth profiles based on ponderal index (PI = weight/height3), investigated using latent class mixed models. Adiposity was assessed with anthropometrics and body composition (InBody720).

Results

We identified 3 growth profiles: ascending (n = 82), intermediate (n = 351), and descending (n = 149). Children with ascending growth had a higher body fat percentage, ISO-BMI, and waist circumference (P < .05) at age 5 years. Ascending (β 4.09; CI, 1.60-6.58) and intermediate (β 2.27; CI, 0.50-4.03) profiles were associated with higher fat percentage, even after adjustment for age, sex, gestational age, diet, physical activity, education, and prepregnancy BMI. Similar associations existed with ISO-BMI. After adjusting for age and education, ascending growth was associated with prepregnancy BMI (odds ratio [OR] 1.06; CI, 1.01-1.12), primiparity (OR 3.07; CI, 1.68-5.62), cesarean delivery (OR 2.23; CI, 1.18-4.21), and lifestyle intervention (OR 2.56; CI, 1.44-4.57). However, meeting the intervention goals and exclusive breastfeeding for 3 months or more were associated with lower odds of ascending growth.

Conclusion

Accelerated early growth was associated with higher adiposity in 5-year-old children from high-risk pregnancies, even when adjusted for lifestyle. Reducing cesarean deliveries and promoting breastfeeding may be beneficial for postnatal growth.
Hes1 overexpression leads to expansion of embryonic neural stem cell pool and stem cell reservoir in the postnatal brain
Authors: Ohtsuka Toshiyuki , Kageyama Ryoichiro
Published: February 2021

Neural stem cells (NSCs) gradually alter their characteristics during mammalian neocortical development, resulting in the production of various neurons and glial cells, and remain in the postnatal brain as a source of adult neurogenesis. Notch-Hes signaling is a key regulator of stem cell properties in the developing and postnatal brain, and Hes1 is a major effector that strongly inhibits neuronal differentiation and maintains NSCs. To manipulate Hes1 expression levels in NSCs, we generated transgenic (Tg) mice using the Tet-On system. In Hes1-overexpressing Tg mice, NSCs were maintained in both embryonic and postnatal brains, and generation of later-born neurons was prolonged until later stages in the Tg neocortex. Hes1 overexpression inhibited the production of Tbr2+ intermediate progenitor cells but instead promoted the generation of basal radial glia-like cells in the subventricular zone (SVZ) at late embryonic stages. Furthermore, Hes1-overexpressing Tg mice exhibited the expansion of NSCs and enhanced neurogenesis in the SVZ of adult brain. These results indicate that Hes1 overexpression expanded the embryonic NSC pool and led to the expansion of the NSC reservoir in the postnatal and adult brain.
Retinoic acid production, regulation and containment through Zic1, Pitx2c and Cyp26c1 control cranial placode specification
Authors: Dubey Aditi , Yu Jianshi , Liu Tian , Kane Maureen A. , Saint-Jeannet Jean-Pierre
Published: February 2021

All paired sensory organs arise from a common precursor domain called the pre-placodal region (PPR). In Xenopus, Zic1 non-cell autonomously regulates PPR formation by activating retinoic acid (RA) production. Here, we have identified two Zic1 targets, the RA catabolizing enzyme Cyp26c1 and the transcription factor Pitx2c, expressed in the vicinity of the PPR as being crucially required for maintaining low RA levels in a spatially restricted, PPR-adjacent domain. Morpholino- or CRISPR/Cas9-mediated Cyp26c1 knockdown abrogated PPR gene expression, yielding defective cranial placodes. Direct measurement of RA levels revealed that this is mediated by a mechanism involving excess RA accumulation. Furthermore, we show that pitx2c is activated by RA and required for Cyp26c1 expression in a domain-specific manner through induction of FGF8. We propose that Zic1 anteriorly establishes a program of RA containment and regulation through activation of Cyp26c1 and Pitx2c that cooperates to promote PPR specification in a spatially restricted domain.
Can Successful Schools Replicate? Scaling Up Boston’s Charter School Sector
Authors: Cohodes Sarah R. , Setren Elizabeth M. , Walters Christopher R.
Published: February 2021

Can schools that boost student outcomes reproduce their success at new campuses? We study a policy reform that allowed effective charter schools in Boston, Massachusetts to replicate their school models at new locations. Estimates based on randomized admission lotteries show that replication charter schools generate large achievement gains on par with those produced by their parent campuses. The average effectiveness of Boston’s charter middle school sector increased after the reform despite a doubling of charter market share. An exploration of mechanisms shows that Boston charter schools compress the distribution of teacher effectiveness and may reduce the returns to teacher experience, suggesting the highly standardized practices in place at charter schools may facilitate replicability. (JEL H75, I21, I28)
Climate Change and Agriculture: Subsistence Farmers’ Response to Extreme Heat
Authors: Aragón Fernando M. , Oteiza Francisco , Rud Juan Pablo
Published: February 2021

This paper examines how subsistence farmers respond to extreme heat. Using microdata from Peruvian households, we find that high temperatures reduce agricultural productivity, increase area planted, and change crop mix. These findings are consistent with farmers using input adjustments as a short-term mechanism to attenuate the effect of extreme heat on output. This response seems to complement other coping strategies, such as selling livestock, but exacerbates the drop in yields, a standard measure of agricultural productivity. Using our estimates, we show that accounting for land adjustments is important to quantify damages associated with climate change. (JEL O12, O13, Q11, Q12, Q15, Q54)
Improving Police Performance in Rajasthan, India: Experimental Evidence on Incentives, Managerial Autonomy, and Training
Authors: Banerjee Abhijit , Chattopadhyay Raghabendra , Duflo Esther , Keniston Daniel , Singh Nina
Published: February 2021

Management matters for firms, but what practices are optimal in hierarchical government organizations? And can skilled managers identify them? A large-scale randomized trial conducted with the police of Rajasthan, India, tested four interventions recommended by senior police officers: limitations of transfers, rotation of duties and days off, increased community involvement, and on-duty training. Field experience motivated a fifth intervention: “decoy” visits by enumerators to register cases, incentivizing staff to improve service. Only training and decoy visits had robust impacts; others were poorly implemented and ineffective. Management reforms can improve policing, but even skilled leaders struggle to identify the optimal interventions. (JEL H76, J24, J45, K42, M53, O17)
Case Report: Voriconazole induced refractory hyperkalemia and adrenal insufficiency
Authors: Tariq Ezza Fatima , Irshad Yusra , Khan Usman A. , Shoaib Muhammad , Asif Hajra
Published: February 2021

Voriconazole, an azole drug, inhibits cytochrome P450 dependent lanosterol 14-alpha-demethylase. It is a potent anti-fungal agent. Adverse effects include neurotoxicity, cardiac arrhythmias, electrolyte disturbances and adrenal insufficiency. Hyperkalemia is a rare adverse effect that has been described, but is not well reported, in the literature.

We present a case of intractable hyperkalemia resulting from voriconazole use. A 47-year-old male presented with worsening shortness of breath, requiring mechanical ventilation within 24 hours of presentation. Diagnosis of acute respiratory distress syndrome was made. Empirical treatment with broad-spectrum antibacterial coverage resulted in no improvement. Voriconazole was added for anti-fungal coverage, causing treatment resistant hyperkalemia necessitating continuous renal replacement therapy (CRRT). Renal function remained normal. Stopping voriconazole restored normal potassium levels. CRRT was discontinued.

Hyperkalemia caused by voriconazole occurs in less than 2% of cases. It is a potentially life-threatening side effect. Physicians should be aware of this association and seek alternative treatment when necessary.
Whole-exome sequencing of de novo genetic variants in a Chinese family with a sporadic case of congenital nonsyndromic hearing loss
Authors: Hu Sijing , Zhang Hao , Liu Yunqiang , Liu Mohan , Li Jingjing , Liao Shunyao
Published: February 2021

Background: We examined the genetic variants of a Chinese family with a 22-month-old infant with sporadic non-syndromic sensorineural hearing loss (NSHL).

Methods: The whole-exome sequence data in the family, especially the de novo variants presented in the patient, were analyzed and the effect of the disease-causing genetic variants on the protein expression level and cellular localization were examined by cell-based functional assay.

Results: The infant had no known NSHL-causing variants, except two compound heterozygous variants in connexin26 gene GJB2; one was the c.79G>A, c.341A>G haplotype from the asymptomatic mother which was benign, and the other was a de novo pathogenic c.262G>C (p.A88P). In vitro, GJB2 with c.262G>C was weakly expressed and displayed a punctate distribution in the cytoplasm and cytomembrane, while wild type GJB2 was robustly expressed in the cytomembrane. We deduced that the de novo pathogenic GJB2 c.262G>C exacerbated loss-of-function in the context of leaky variants c.79G>A, c.341A>G in the patient. Interestingly, further analysis of exome sequences revealed that the occurrence of de novo pathogenic variants in the infant was frequent. Among the total~47,000 variants, 143 were de novo in the patient, whereas among all 74 variants predicted to be pathogenic/likely pathogenic, 21 were heterozygous and two were homozygous de novo. The occurrence rate of de novo deleterious variants was much higher (31.1%, 23/74) than that in total (0.34%, 143/47,000). It is notable that most genes with de novo deleterious variants were environment-sensitive, such as GJB2, MNK1, MNK2, MUC4, RAD21 and DNA copy number variations.

Conclusions: The full picture of genetic variants in the exome might help us to interpret the NSHL-causing variants. More research is needed into the causes of de novo deleterious variants and gene-environment interactions in congenital NSHL.
The international Perinatal Outcomes in the Pandemic (iPOP) study: protocol
Authors: Stock Sarah J. , Zoega Helga , Brockway Meredith , Mulholland Rachel H. , Miller Jessica E. , Been Jasper V. , Wood Rachael , Abok Ishaya I. , Alshaikh Belal , Ayede Adejumoke I. , Bacchini Fabiana , Bhutta Zulfiqar A. , Brew Bronwyn K. , Brook Jeffrey , Calvert Clara , Campbell-Yeo Marsha , Chan Deborah , Chirombo James , Connor Kristin L. , Daly Mandy , Einarsdóttir Kristjana , Fantasia Ilaria , Franklin Meredith , Fraser Abigail , Håberg Siri Eldevik , Hui Lisa , Huicho Luis , Magnus Maria C. , Morris Andrew D. , Nagy-Bonnard Livia , Nassar Natasha , Nyadanu Sylvester Dodzi , Iyabode Olabisi Dedeke , Palmer Kirsten R. , Pedersen Lars Henning , Pereira Gavin , Racine-Poon Amy , Ranger Manon , Rihs Tonia , Saner Christoph , Sheikh Aziz , Swift Emma M. , Tooke Lloyd , Urquia Marcelo L. , Whitehead Clare , Yilgwan Christopher , Rodriguez Natalie , Burgner David , Azad Meghan B. ,   iPOP Study Team
Published: February 2021

Preterm birth is the leading cause of infant death worldwide, but the causes of preterm birth are largely unknown. During the early COVID-19 lockdowns, dramatic reductions in preterm birth were reported; however, these trends may be offset by increases in stillbirth rates. It is important to study these trends globally as the pandemic continues, and to understand the underlying cause(s). Lockdowns have dramatically impacted maternal workload, access to healthcare, hygiene practices, and air pollution - all of which could impact perinatal outcomes and might affect pregnant women differently in different regions of the world.

In the international Perinatal Outcomes in the Pandemic (iPOP) Study, we will seize the unique opportunity offered by the COVID-19 pandemic to answer urgent questions about perinatal health. In the first two study phases, we will use population-based aggregate data and standardized outcome definitions to: 1) Determine rates of preterm birth, low birth weight, and stillbirth and describe changes during lockdowns; and assess if these changes are consistent globally, or differ by region and income setting, 2) Determine if the magnitude of changes in adverse perinatal outcomes during lockdown are modified by regional differences in COVID-19 infection rates, lockdown stringency, adherence to lockdown measures, air quality, or other social and economic markers, obtained from publicly available datasets. We will undertake an interrupted time series analysis covering births from January 2015 through July 2020.

The iPOP Study will involve at least 121 researchers in 37 countries, including obstetricians, neonatologists, epidemiologists, public health researchers, environmental scientists, and policymakers. We will leverage the most disruptive and widespread “natural experiment” of our lifetime to make rapid discoveries about preterm birth. Whether the COVID-19 pandemic is worsening or unexpectedly improving perinatal outcomes, our research will provide critical new information to shape prenatal care strategies throughout (and well beyond) the pandemic.
Individual-level variations in malaria susceptibility and acquisition of clinical protection
Authors: Valletta John Joseph , Addy John W.G. , Reid Adam J. , Ndungu Francis M. , Bediako Yaw , Mwacharo Jedida , Said Khadija , Musyoki Jennifer , Ngoi Joyce Mwongeli , Wambua Joshua , Otieno Edward , Berriman Matt , Bejon Philip , Marsh Kevin , Langhorne Jean , Newbold Chris I. , Recker Mario
Published: February 2021

After decades of research, our understanding of when and why individuals infected with Plasmodium falciparum develop clinical malaria is still limited. Correlates of immune protection are often sought through prospective cohort studies, where measured host factors are correlated against the incidence of clinical disease over a set period of time. However, robustly inferring individual-level protection from these population-level findings has proved difficult due to small effect sizes and high levels of variance underlying such data. In order to better understand the nature of these inter-individual variations, we analysed the long-term malaria epidemiology of children ≤12 years old growing up under seasonal exposure to the parasite in the sub-location of Junju, Kenya. Despite the cohort’s limited geographic expanse (ca. 3km x 10km), our data reveal a high degree of spatial and temporal variability in malaria prevalence and incidence rates, causing individuals to experience varying levels of exposure to the parasite at different times during their life. Analysing individual-level infection histories further reveal an unexpectedly high variability in the rate at which children experience clinical malaria episodes. Besides exposure to the parasite, measured as disease prevalence in the surrounding area, we find that the birth time of year has an independent effect on the individual’s risk of experiencing a clinical episode. Furthermore, our analyses reveal that those children with a history of an above average number of episodes are more likely to experience further episodes during the upcoming transmission season. These findings are indicative of phenotypic differences in the rates by which children acquire clinical protection to malaria and offer important insights into the natural variability underlying malaria epidemiology.
Critical Analysis of Methods for Assessing the Innovation Potential of an Enterprise
Authors: Podshivalova Mariya , Almrshed S.
Published: February 2021

The starting point of research on assessing the innovative capacity of an enterprise is the question of definitions. In this regard, authors initially turned to review of scientific literature on the subject of definitions variety for the term "enterprise innovative capacity". These data show that the wording of this term by both foreign and Russian researchers differs significantly. Authors propose a systematization of approaches to the definition and a corresponding graphical classification model, which highlights the evolutionary, resource, functional and process approaches. Further, a critical analysis of approaches to assessing enterprise innovative capacity is carried out. At the first stage, the content of modern assessment methods was studied, and at the second stage, the mathematical tools used were studied. Authors have formed a graphical representation of critical analysis results and based on it, they have concluded that among the approaches to assessing enterprise innovative capacity, the evolutionary approach should be recognized as promising, and among the methods of quantitative assessment – tools of economic statistics.
Problems of the Accumulation of Human Capital by Employed Workers in Modern Russia
Authors: Basovskaya Elena
Published: February 2021

The paper analyzes the accumulation of human capital by the employed popula-tion of modern Russia, depending on age, work experience and profession. The influ-ence of the age and seniority of workers on the amount of wages assessed as character-istics of the human capital of workers. For the analysis, we used Rosstat data on the amount of remuneration of workers of different professions, of different ages, with dif-ferent work experience for the period 2005-2019. It found that the nature of the age-related changes in wages during the period under review approached the nature of the age-related changes in wages in OECD countries, which demonstrates the resumption of growth in the wages of older workers. This indicates an increase in the efficiency of the human capital of older workers, which be explained the development of creative abilities based on the accumulated positive experience. This phenomenon is inherent, mainly, in managers and highly qualified specialists. The impact of experience on the accumulation of human capital in the period from 2005-2019 has been steadily decreasing, which indicates a low level of implementation of innovations in the economy and limited economic growth due to unfavorable institutional conditions.
Raising and escalating concerns about patient care: RCN guidance
Authors: Glasper Alan
Published: February 2021

Emeritus Professor Alan Glasper, from the University of Southampton, discusses guidance on raising concerns to help ensure that patient safety and the delivery of high-quality person-centred care is not compromised
From staff nurse to nurse consultant: Academic essays part 7: demonstrating depth of writing
Authors: Fowler John
Published: February 2021

John Fowler, Educational Consultant, explores academic writing
Approaches to common conditions of the gastrointestinal tract in pet hamsters
Authors: Baldrey Vicki
Published: February 2021

Hamsters are popular pets in the UK. The Syrian or Golden hamster (Mesocricetus auratus) is the best known species in the pet trade, with a variety of dwarf species also encountered. Gastrointestinal disease occurs frequently, and diarrhoea is a common presenting complaint. This is most often associated with bacterial or parasitic infection, but can also be related to neoplasia or the use of certain antibiotics. Initial stabilisation of the hamster with diarrhoea should include provision of a warm stress-free environment, fluid therapy, nutritional support with an appropriate critical care diet and analgesia. Following a full history and clinical examination, further diagnostic steps include faecal parasitology and microbiology, routine biochemistry and haematology, radiography with or without positive contrast, and abdominal ultrasound. Indications for surgery include evidence of intestinal obstruction or prolapsed intussusception. This article gives an overview of the most common gastrointestinal diseases encountered in hamster species and provides a guide of how to logically approach the investigation and treatment of these cases, achievable in general practice.
Understanding the pathogenesis of heart failure
Authors: Easa Jamshid , Chappell Jacob , Warriner David
Published: February 2021

Heart failure is a complex clinical syndrome. Jamshid Easa, Jacob Chappell and David Warriner explain the pathogenesis behind the most common form of this condition

Heart failure a complex clinical syndrome due to impairment of ventricular filling or contraction, resulting in a constellation of physical symptoms and signs, primarily due to salt and water retention. In this clinically focused review of the pathophysiology, we will summarise the main consequences of the most common type, left ventricular failure; knowledge of which is essential for those working in general practice due to the high prevalence of heart failure in the community and to aid understanding of the various pharmacotherapies that work to act on the pathological mechanisms.
Supporting people with dementia during the COVID-19 pandemic
Authors: Nazarko Linda
Published: February 2021

People with dementia have experienced great disruption to their lives due to the pandemic. Linda Nazarko highlights the way individuals have been affected and how the practice nurse can support them

People with dementia and their caregivers have been severely affected by the COVID-19 pandemic. Isolation, a reduction in formal and informal support, and disruption to routine have contributed to feelings of loneliness and anxiety in people with dementia and their caregivers. The pandemic has led to staff shortages in health and social care, changes of care workers and a reduction in the level of support provided. These changes have affected the physical and mental health of people with dementia and increased their reliance on primary care. Practice nurses have a key role to play in supporting affected individuals.
The integral role of BAME nurses in primary care
Authors: Pasta Yusra
Published: February 2021

Yusra Pasta highlights the role black, Asian and minority ethnic nurses can play in improving health outcomes for their communities
Fear: an unrecognised symptom of COVID-19
Authors: Duncan Debbie
Published: February 2021

Debbie Duncan describes her experiences of fighting COVID-19 with her family, and the unexpected symptoms she faced
A randomized clinical trial of low dose single antibiotic-loaded cement versus high dose dual antibiotic-loaded cement in patients receiving a hip hemiarthroplasty after fracture: A protocol for the WHiTE 8 COPAL study
Authors: Agni Nickil Ramesh , Costa Matthew L. , Achten Juul , O’Connor Heather , Png May Ee , Peckham Nicholas , Dutton Susan J. , Wallis Stephanie , Milca Svetlana , Reed Mike
Published: February 2021

Aims

Patients receiving cemented hemiarthroplasties after hip fracture have a significant risk of deep surgical site infection (SSI). Standard UK practice to minimize the risk of SSI includes the use of antibiotic-loaded bone cement with no consensus regarding type, dose, or antibiotic content of the cement. This is the protocol for a randomized clinical trial to investigate the clinical and cost-effectiveness of high dose dual antibiotic-loaded cement in comparison to low dose single antibiotic-loaded cement in patients 60 years and over receiving a cemented hemiarthroplasty for an intracapsular hip fracture.

Methods

The WHiTE 8 Copal Or Palacos Antibiotic Loaded bone cement trial (WHiTE 8 COPAL) is a multicentre, multi-surgeon, parallel, two-arm, randomized clinical trial. The pragmatic study will be embedded in the World Hip Trauma Evaluation (WHiTE) (ISRCTN 63982700). Participants, including those that lack capacity, will be allocated on a 1:1 basis stratified by recruitment centre to either a low dose single antibiotic-loaded bone cement or a high dose dual antibiotic-loaded bone cement. The primary analysis will compare the differences in deep SSI rate as defined by the Centers for Disease Control and Prevention within 90 days of surgery via medical record review and patient self-reported questionnaires. Secondary outcomes include UK Core Outcome Set for hip fractures, complications, rate of antibiotic prescription, resistance patterns of deep SSI, and resource use (more specifically, cost-effectiveness) up to four months post-randomization. A minimum of 4,920 patients will be recruited to obtain 90% power to detect an absolute difference of 1.5% in the rate of deep SSI at 90 days for the expected 3% deep SSI rate in the control group.

Conclusion

The results of this trial will provide evidence regarding clinical and cost-effectiveness between low dose single and high dose dual antibiotic-loaded bone cement, which will inform policy and practice guidelines such as the National Institute for Health and Care Excellence guidance on management of hip fractures. Cite this article: Bone Jt Open 2021;2(2):72–78.
Como en el principio - El balbuceo del lenguaje poético
Authors: Pellejero Eduardo
Published: February 2021

Todos los escritores buscan algo, incluso cuando no siempre sepan lo que buscan. De sus obras siempre esperamos y retenemos algunos hallazgos, pero sobre todo estimamos la perseverancia en el ejercicio de nombrar y renombrar el mundo, que es prerrogativa de nuestra libertad. Nacimiento continuado, la literatura sacude o hace tartamudear la lengua, desconociendo el ascendiente de sus orígenes y exponiendo el lenguaje al riesgo de su suspensión - y quizás también a la posibilidad del recomienzo. El presente trabajo pretende explorar algunas de las singularidades del lenguaje poético en cuanto expresión creadora, a partir de un diálogo con las obras de Maurice Merleau-Ponty, Michel Foucault y Gilles Deleuze.
1.3  GHz E-O bandwidth GaN-based micro-LED for multi-gigabit visible light communication
Authors: Wang Lei , Wei Zixian , Chen Chien-Ju , Wang Lai , Fu H. Y. , Zhang Li , Chen Kai-Chia , Wu Meng-Chyi , Dong Yuhan , Hao Zhibiao , Luo Yi
Published: February 2021

The data rate of a visible light communication (VLC) system is basically determined by the electrical-to-optical (E-O) bandwidth of its light-emitting diode (LED) source. In order to break through the intrinsic limitation of the carrier recombination rate on E-O bandwidth in conventional c-plane LEDs based on InGaN quantum wells, a blue micro-LED with an active region of nano-structured InGaN wetting layer is designed, fabricated, and packaged to realize a high-speed VLC system. The E-O bandwidth of the micro-LED can reach up to 1.3 GHz. Based on this high-speed micro-LED, we demonstrated a data rate of 2 Gbps with a bit error rate (BER) of

1.2
×

10

−
3

with simple on-off keying signal for a 3-m real-time VLC. In addition, a 4-Gbps VLC system using quadrature phase shift keying-orthogonal frequency-division multiplexing with a BER of

3.2
×

10

−
3

is also achieved for the same scenario. Among all the point-to-point VLC systems based on a single-pixel LED, this work has the highest distance-bandwidth product of 3 GHz·m and the highest distance-rate product of 12 Gbps·m.
Real-time deep learning design tool for far-field radiation profile
Authors: Qie Jinran , Khoram Erfan , Liu Dianjing , Zhou Ming , Gao Li
Published: February 2021

The connection between Maxwell’s equations and artificial neural networks has revolutionized the capability and efficiency of nanophotonic design. Such a machine learning tool can help designers avoid iterative, time-consuming electromagnetic simulations and even allows long-desired inverse design. However, when we move from conventional design methods to machine-learning-based tools, there is a steep learning curve that is not as user-friendly as commercial simulation software. Here, we introduce a real-time, web-based design tool that uses a trained deep neural network (DNN) for accurate far-field radiation prediction, which shows great potential and convenience for antenna and metasurface designs. We believe our approach provides a user-friendly, readily accessible deep learning design tool, with significantly reduced difficulty and greatly enhanced efficiency. The web-based tool paves the way to present complicated machine learning results in an intuitive way. It also can be extended to other nanophotonic designs based on DNNs and replace conventional full-wave simulations with a much simpler interface.
Observation of transition between multimode Q-switching and spatiotemporal mode locking
Authors: Liu Kewei , Xiao Xiaosheng , Yang Changxi
Published: February 2021

We report experimental observation of multimode

Q

-switching and spatiotemporal mode locking in a multimode fiber laser. A typical steady

Q

-switching state is achieved with a 1.88 μs pulse duration, a 70.14 kHz repetition rate, and a 215.8 mW output power, corresponding to the single pulse energy of 3.08 μJ. We find weak spatial filtering is essential to obtain stable

Q

-switched pulses, in contrast to the relatively stronger spatial filtering for spatiotemporal mode locking. Furthermore, a reversible transition process, as well as a critical bistable state, between multimode

Q

-switching and spatiotemporal mode locking, is achieved with specific spatial coupling and waveplates sets. We believe the results will not only contribute to understanding the complicated nonlinear dynamics in multimode, fiber-based platforms, but also benefit the development of promising high-pulse energy lasers.
High-speed silicon photonic Mach–Zehnder modulator at 2 μm
Authors: Wang Xi , Shen Weihong , Li Wenxiang , Liu Yingjie , Yao Yong , Du Jiangbing , Song Qinghai , Xu Ke
Published: February 2021

Recently, 2-μm wave band has gained increasing interest due to its potential application for next-generation optical communication. But the development of 2-μm optical communications is substantially hampered by the modulation speed due to the device bandwidth constraints. Thus, a high-speed modulator is highly demanded at 2 μm. Motivated by this prospect, we demonstrate a high-speed silicon Mach–Zehnder modulator for a 2-μm wave band. The device is configured as a single-ended push–pull structure with waveguide electrorefraction via the free carrier plasma effect. The modulator was fabricated via a multiproject wafer shuttle run at a commercial silicon photonic foundry. The modulation efficiency of a single arm is measured to be

1.6
  
V
·
cm

. The high-speed characterization is also performed, and the modulation speed can reach 80 Gbit/s with 4-level pulse amplitude modulation (PAM-4) formats.