bluuebunny/crossref_metadata_2025 huggingface dataset:
This study aimed to explore women’s experiences of infant feeding in Ireland
Authors: Murphy R , Rohde D , Foley C , O'Carroll T , Flynn R
Published: October 2021

Background

While breastfeeding may be among the most effective ways to ensure child health and survival, breastfeeding rates in Ireland are consistently low. This study aimed to explore women's experiences of infant feeding in Ireland.

Methods

Thematic analysis of feeding-related free-text comments from the National Maternity Experience Survey 2020 was undertaken. The survey collected data on the experiences of women who were 16 years or older and gave birth in one of Ireland's 19 maternity hospitals or units or had a home birth.

Results

3,204 women participated in the survey (50% response rate). In the first few days after birth, 41.9% of women breastfed exclusively, 29.0% used formula and breast milk, and 29.1% bottle fed only. 824 comments related to feeding were received. A number of themes were identified, including support and encouragement from healthcare professionals, information and education regarding feeding, and pressure and respect for personal preferences. Women highlighted that while breastfeeding was encouraged in antenatal care, this was not always the case in the postnatal ward, where formula was readily available, with an apparent lack of resources for breastfeeding women. Some women described feeling pressured to use a feeding method that was not their first preference, with some feeling pushed to breastfeed when this may not have been their wish, while women who wished to breastfeed felt pressured to supplement with formula. Staffing shortages on postnatal wards, a lack of lactation consultants and contradictory advice from healthcare professionals exacerbated difficulties with both feeding methods.

Conclusions

Some women experience a lack of practical support with infant feeding, regardless of feeding method, and clear and concise information on feeding practices is needed. The addition of lactation consultants, home supports and further education and training could benefit mothers on their breastfeeding journey.

Key messages

Barriers to breastfeeding included a lack of support from healthcare professionals and conflicting information. It is important to support women regardless of their chosen feeding method.
Access to medicines for children
Authors: Vardanyan L , Kazaryan I , Sevikyan A
Published: October 2021

Background

Access to medicines for children remains a serious public health problem worldwide. The World Health Organization (WHO) has developed a Model List of Essential Medicines for Children (EMLc). However, many essential medicines are still not covered by National EMLc and not available in some countries. The objective of this work was to examine the current situation with access to essential medicines for children in Armenia and identify changes if compare with the situation in 2013.

Methods

The Armenian EMLc (AEMLc) of 2013 and 2018, the Lists of medicines authorized in Armenia (for 2013 and the current data), pricelists of main wholesalers and national clinical guidelines for children were analyzed.

Results

81.2% of all the active ingredients from WHO EMLc were included in the AEML, 61.5% were authorized and only 56.1% were available on the pharmaceutical market. In 2013, 74.1% of all the active ingredients from WHO EMLc were included in the AEML, 62.0% were authorized and only 56.1% were available on the pharmaceutical market. The results of comparing the new data with those received in 2013 showed that the percentage of essential medicines for children recommended by WHO, which were covered by AEML, has increased; however the percentage of those which are authorized in the country stayed almost unchanged. The percentage of medicines from WHO EMLc (with taking into account pharmaceutical form and dose recommended by WHO), which were included in the current AEML was 57.7%; and authorized in the country - 68.5%.

Conclusions

Essential medicines for children recommended by WHO, are covered by a medicines supply system for children in Armenia, yet not in full. Political will is important. Development and approval of Armenian EMLc can be considered to be the first step in improving access to medicines for children. Draft of Armenian EMLc is developed and will be submitted to the Ministry of Health together with appropriate recommendations.

Key messages

Access to essential medicines for children remains a serious problem in Armenia. There is an urgent need in improving the situation, and introducing a National EMLc would be an important strategy aimed to increase supply of essential medicines for children.
Parental supervision and sexual behaviour of adolescents in Brazil
Authors: Sousa M , Reis G , Felisbino-Mendes M
Published: October 2021

Background

Sexual risk behaviors make adolescents more vulnerable to the main diseases, affecting their sexual health. The adoption of such behaviors may be related to the modes of supervision performed by parents, which is a factor that could minimize the adoption of such risky behaviors.

Objective

To characterize parental supervision of Brazilian adolescents and estimate the prevalence of sexual risk behaviors in relation to the supervision received.

Methods

Cross-sectional study that analyzed data from 102,072 Brazilian adolescents who self-answered the National School Health Survey in 2015. We estimated the prevalence of parental supervision with their respective 95% confidence intervals, considering five indicators of parental supervision individually, and their simultaneity according to sex and sociodemographic characteristics. We also estimated the prevalence of sexual behaviours of adolescents: sex initiation, condom use at last intercourse, contraceptive use, mean age at first intercourse and number of partners, in relation to the supervision received.

Results

One in seven Brazilian adolescents presented intense parental supervision, with the highest proportion among males (52.0%; 95%CI 50.6-53.4). White adolescents of both sex (39.7%; 95%CI 38.8-40.6), who do not work (39.1%; 95%CI 38.4-39.8), living with both parents (42.3%; 95%CI 41.4-43.1) and residing in the Midwest and South (39.7%; 95%CI 38.5-41.0) regions, showed greater parental supervision in relation to the others, also presenting lower sexual initiation and greater condom use. Moreover, the greater the simultaneity of the supervision indicators, the greater the prevalence of consistent condom use, use of contraceptive methods and lower average number of partners.

Conclusions

We observed different patterns of parental supervision between boys and girls and according to sociodemographic characteristics. Moreover, the greater the supervision, the better the adolescents' sexual behaviors.

Key messages

The results obtained point to the fundamental role of the family in providing adolescents with conditions that encourage healthy and risk-free sexual behavior, through supervision. The results obtained reveal gender inequalities in relation to the supervision of girls and boys.
Taboos and Myths as a mediator of the Relationship between Menstrual Practices and Menstrual Health
Authors: Babbar K
Published: October 2021

Background

There is a piece of growing evidence that associates menstrual practices with menstrual health. But menstruation has always been accompanied by various taboos and myths. Findings from qualitative studies have highlighted that these taboos and myths impact the psychosocial outcomes of the menstruators, ultimately affecting their menstrual health. However, no quantitative study has explored this link between menstrual practices and menstrual health. Thus, as a part of this study, we try to understand the role of taboos and myths as a mediator in explaining the relationship between menstrual practices and menstrual health.

Methods

The study uses the data from a cross-sectional survey of 683 active menstruators from India. First, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was used to develop and validate a new scale on Menstrual Health. Next, structural equation modeling was used to test the hypothesized relationship between menstrual practice and menstrual health.

Results

A clean one-factor scale was observed for the Menstrual Health scale using EFA and CFA with the fit measures (CFI= 0.99; RMSEA=0.059; SRMR=0.017; GFI=0.994). Data analysis, performed using structural equation modeling (CFI= 0.952; RMSEA=0.044; SRMR=0.047; GFI=0.959), revealed that the taboos and myths fully mediate the relationship between Menstrual Practices and Menstrual Health. The indirect effect reveals menstruators with perceptions of taboos and myths are more likely to have poor menstrual health. The ratio of the indirect effect to the total overall effect is 0.506.

Conclusions

Taboos and Myths are detrimental to the menstrual health of the menstruators. Different bodies like the government, policymakers, and NGOs should address this issue by conducting education and awareness programs for the menstruators, specifically targeting the socio-cultural aspects of menstruation to improve the menstrual practices and dissolve the taboos and myths around menstruation.

Key messages

Menstrual practices and taboos and myths are significant determinants for menstrual health. Educational interventions must be done to promote awareness around the myths and best menstrual practices that society can adopt.
Pregnancy and epilepsy: a retrospective study of 100 pregrancies
Authors: Chahed S , Bannour B , Bannour I , Messaoudi A , Khairi H
Published: October 2021

Introduction

Epilepsy is a common neurological disorder in obstetric practice it's prevalence is estimated around 0.3 to 0.7%. Pregnant women with epilepsy are commonly considered to be at high risk for complications during pregnancy or delivery therefore requires targeted and appropriate management.

Objectives

This study evaluated obstetric and neonatal outcome in epileptic pregnant women and to assess targeted management of pregnancy and childbirth.

Methods

Across sectional study was conducted among 100 epileptic patients who gave birth between 2015 and 2019 at the Maternity and Neonatology departments of both Farhat Hached and Monastir University Hospitals.

Results

The mean age of our patients was 29.87 years and 33.7% were primiparous. Only 19% of patients had a planned pregnancy and 71% had at least the 5 recommended prenatal follow-up. Overall 86% of our patients were under and antiepileptic medication and 52% received Folic acid supplementation. The fetal complications were advanced term in (17.85%); premature birth (5.5%); fetal death in utero (2%), low birth weight (4.3%) and macrosomia (8.7%). A significant statistical association was found between poly-therapy, low birth weight (P = 0.01) and fetal death in utero (P = 0.025). A statistical association was found between the use of Larnotrigine and gestational diabetes (p = 0.002).

Conclusions

A significant association of epilepsy, exposure to antiepileptic drugs, and adverse outcomes exists in pregnancy. Management at early stage of pregnancy, or even preconception, seems necessary in view of planning the pregnancy, studying the risks and re-evaluating the effectiveness of the treatment previously used.

Key messages

Pregnant women with epilepsy are commonly considered to be at high risk for complications during pregnancy or delivery. health professionals must planthe pregnancy, studying the risks and re-evaluating the effectiveness of the treatment.
Knowledge about vaccination in Croatian high school population
Authors: Miskulin I , Hac D , Domacinovic T , Kovacevic J , Vukoja I , Miskulin M
Published: October 2021

Background

Knowledge about vaccination is one of the key determinants of vaccination uptake and it is shaped by different information sources. Future of the vaccination coverage depends on vaccination knowledge and uptake in young generations. The aim of this study was to investigate knowledge about vaccination and information sources of this knowledge among Croatian high school students.

Methods

This online cross-sectional questionnaire study was conducted during the January 2021 to April 2021 in convenient sample of high school students from north-western part of Croatia.

Results

The study sample consisted of 1012 subjects (29.2% males and 70.8% females). The median age of all subjects was 17.0 (interquartile range (IQR) 17.0 - 18.0) years. According to the knowledge there were 29.5% of students with poor, 53.9% of students with average and 16.6% of students with good knowledge about vaccination. Male students more frequently had poor knowledge about vaccination (P = 0.028). Information source of knowledge about vaccination in study population were internet (39.2%), family and friends (35.2%) and formal education (25.6%). Students who displayed poor knowledge about vaccination more frequently stated internet as dominant source of knowledge about vaccination while students who displayed good knowledge about vaccination more frequently stated formal education as dominant source (P = 0.002).

Conclusions

The study showed that large proportion of Croatian high school students has poor knowledge about vaccination. Furthermore, study revealed that internet was dominant source of information regarding vaccination in study population. Additional education is needed to improve observed situation regarding vaccination knowledge and its sources among Croatian high school students.

Key messages

Improvement of general knowledge regarding vaccination in younger population subgroups is necessary precondition for insuring adequate vaccination coverage in future. Enhancement of the formal education about vaccination in younger population subgroups is crucial element of successful vaccination programs.
Screening for schistosomiasis among Eritrean refugees: a public health priority
Authors: Durieux-Paillard S , Ibañez AM
Published: October 2021

Issue

From 2014 to 2020, 24 422 Eritrean refugees arrived in Switzerland. After they applied for asylum in a federal centre, asylum seekers are allocated to the 26 Swiss cantons, among them Geneva. In the University hospitals of Geneva, the Programme Santé Migrants (PSM) is dedicated to ambulatory care for refugees.

Problem

30% of the PSM outpatients are Eritrean. After their arrival in Geneva, asylum seekers get a medical evaluation. We noticed that the Eritrean's health status was poor, due to their long and hazardous migratory journey. Some had a hypereosinophilia and their helminthiasis serologies were positive for schistosomiasis (Schs). We decided to implement a protocol to screen and treat Eritrean patients for Schs. Highlighting this infection among this population was important because: it is a chronic disease which can lead to severe consequences if untreated; 42% of the Swiss refugees are Eritreans; in Switzerland, Praziquantel (PZQ), the treatment of Schs, is not distributed and not refunded by medical insurances. However, our hospital's pharmacy can import PZQ. We analysed 158 medical records of Eritrean patients, to see if the screening protocol was applied.

Results

Among the 158 patients records 72 were women. Mean age 27. 118 (74.7%) of 158 got a Schs serology. 62 (52.5%) were positive or borderline (PB). 29.6% patients with PB had a hypereosinophilia (HE) > 0.5 G/l, and 59% had HE > 5%. None of the negative had HE > 0.5G/l. 44/62 PB had a stools examination and Schs eggs were present among 61% of the P and 18% of the B. 44 (71%) of the 62 PB got a PZQ treatment. Among not treated, 33% were pregnant women.

Lessons

25% of patients did not get the protocol. Electronic warning in the electronic files could help, especially in hospitals with large residents turn over. More than 50% of Eritrean patients had a positive or borderline Schs serology. The treatment (PZQ) is easy to take and effective, but not easily accessible and not free in Switzerland.

Key messages

Schistosomiasis is a frequent disease among Eritrean migrants. Systematic screening should be implemented among them with quality controls. If positive, they should have access to the treatment. European countries should adapt their drug licences and access to treatment to the diversity of the population, taking into account the epidemiology of diseases in the countries of origin.
Climate change, justice and public health
Authors:   Organised by: EuroHealthNet,   Moderator: Caroline Costongs (EuroHealthNet)
Published: October 2021

Recent events have put into sharp relief that the world is facing converging emergencies: health, rising inequalities, and climate change and environmental degradation.

Tackling these challenges requires actions by governments, businesses, communities, and individuals, and concerted strategies across health, environmental, and social sectors. Public health has an important role to play in promoting health in a rapidly changing world, and in ensuring a broad approach to health which considers socio-economic and environmental determinants. This is particularly crucial to ensure that we achieve a net zero carbon economy while simultaneously addressing the social crisis we are facing and improving health and wellbeing for all: achieving a green, healthy and just transition, leaving no one behind regardless of age, gender, ethnicity, and income and education levels.

On the closing day of the UN Climate Change Conference 2021 (COP26), this plenary will discuss the four COP26 goals of ‘Mitigation, Adaptation, Finance and Collaboration', exploring how health and equity can be further mainstreamed within these climate actions. It aims both to inform and to inspire, raising awareness about the interconnected challenges we are facing as well as discussing solutions and actions at different levels that we all can be a part of to ensure the transformational change that is needed.

Speakers:

Maria Neira Environmental and Social Determinants of Health, WHO Hans Bruyninckx European Environment Agency (EEA) Monica Scatasta Technical Assessment and Monitoring Directorate, Council of Europe Development Bank Karolina Fabianova Youth and Environment Europe
The changing culture of silviculture
Authors: Achim Alexis , Moreau Guillaume , Coops Nicholas C , Axelson Jodi N , Barrette Julie , Bédard Steve , Byrne Kenneth E , Caspersen John , Dick Adam R , D'Orangeville Loïc , Drolet Guillaume , Eskelson Bianca N I , Filipescu Cosmin N , Flamand-Hubert Maude , Goodbody Tristan R H , Griess Verena C , Hagerman Shannon M , Keys Kevin , Lafleur Benoit , Girona Miguel Montoro , Morris Dave M , Nock Charles A , Pinno Bradley D , Raymond Patricia , Roy Vincent , Schneider Robert , Soucy Michel , Stewart Bruce , Sylvain Jean-Daniel , Taylor Anthony R , Thiffault Evelyne , Thiffault Nelson , Vepakomma Udaya , White Joanne C
Published: October 2021

Changing climates are altering the structural and functional components of forest ecosystems at an unprecedented rate. Simultaneously, we are seeing a diversification of public expectations on the broader sustainable use of forest resources beyond timber production. As a result, the science and art of silviculture needs to adapt to these changing realities. In this piece, we argue that silviculturists are gradually shifting from the application of empirically derived silvicultural scenarios to new sets of approaches, methods and practices, a process that calls for broadening our conception of silviculture as a scientific discipline. We propose a holistic view of silviculture revolving around three key themes: observe, anticipate and adapt. In observe, we present how recent advances in remote sensing now enable silviculturists to observe forest structural, compositional and functional attributes in near-real-time, which in turn facilitates the deployment of efficient, targeted silvicultural measures in practice that are adapted to rapidly changing constraints. In anticipate, we highlight the importance of developing state-of-the-art models designed to take into account the effects of changing environmental conditions on forest growth and dynamics. In adapt, we discuss the need to provide spatially explicit guidance for the implementation of adaptive silvicultural actions that are efficient, cost-effective and socially acceptable. We conclude by presenting key steps towards the development of new tools and practical knowledge that will ensure meeting societal demands in rapidly changing environmental conditions. We classify these actions into three main categories: re-examining existing silvicultural trials to identify key stand attributes associated with the resistance and resilience of forests to multiple stressors, developing technological workflows and infrastructures to allow for continuous forest inventory updating frameworks, and implementing bold, innovative silvicultural trials in consultation with the relevant communities where a range of adaptive silvicultural strategies are tested. In this holistic perspective, silviculture can be defined as the science of observing forest condition and anticipating its development to apply tending and regeneration treatments adapted to a multiplicity of desired outcomes in rapidly changing realities.
The F-box protein Bard (CG14317) targets the Smaug RNA-binding protein for destruction during the Drosophila maternal-to-zygotic transition
Authors: Cao Wen Xi , Karaiskakis Angelo , Lin Sichun , Angers Stephane , Lipshitz Howard D
Published: October 2021

During the maternal-to-zygotic transition (MZT), which encompasses the earliest stages of animal embryogenesis, a subset of maternally supplied gene products is cleared, thus permitting activation of zygotic gene expression. In the Drosophila melanogaster embryo, the RNA-binding protein Smaug (SMG) plays an essential role in progression through the MZT by translationally repressing and destabilizing a large number of maternal mRNAs. The SMG protein itself is rapidly cleared at the end of the MZT by a Skp/Cullin/F-box (SCF) E3-ligase complex. Clearance of SMG requires zygotic transcription and is required for an orderly MZT. Here, we show that an F-box protein, which we name Bard (encoded by CG14317), is required for degradation of SMG. Bard is expressed zygotically and physically interacts with SMG at the end of the MZT, coincident with binding of the maternal SCF proteins, SkpA and Cullin1, and with degradation of SMG. shRNA-mediated knock-down of Bard or deletion of the bard gene in the early embryo results in stabilization of SMG protein, a phenotype that is rescued by transgenes expressing Bard. Bard thus times the clearance of SMG at the end of the MZT.
Regional wall stress differences on tricuspid aortic valve-associated ascending aortic aneurysms
Authors: Gomez Axel , Wang Zhongjie , Xuan Yue , Hope Michael D , Saloner David A , Guccione Julius M , Ge Liang , Tseng Elaine E
Published: October 2021

OBJECTIVES

Ascending thoracic aortic aneurysms (aTAAs) carry a risk of acute type A dissection. Elective repair guidelines are based on diameter, but complications often occur below diameter threshold. Biomechanically, dissection can occur when wall stress exceeds wall strength. Aneurysm wall stresses may better capture dissection risk. Our aim was to investigate patient-specific aTAA wall stresses associated with a tricuspid aortic valve (TAV) by anatomic region.

METHODS

Patients with aneurysm diameter ≥4.0 cm underwent computed tomography angiography. Aneurysm geometries were reconstructed and loaded to systemic pressure while taking prestress into account. Finite element analyses were conducted to obtain wall stress distributions. The 99th percentile longitudinal and circumferential stresses were determined at systole. Wall stresses between regions were compared using one-way analysis of variance with post hoc Tukey HSD for pairwise comparisons.

RESULTS

Peak longitudinal wall stresses on aneurysms (n = 204) were 326 [standard deviation (SD): 61.7], 246 (SD: 63.4) and 195 (SD: 38.7) kPa in sinuses of Valsalva, sinotubular junction (STJ) and ascending aorta (AscAo), respectively, with significant differences between AscAo and both sinuses (P < 0.001) and STJ (P < 0.001). Peak circumferential wall stresses were 416 (SD: 85.1), 501 (SD: 119) and 340 (SD: 57.6) kPa for sinuses, STJ and AscAo, respectively, with significant differences between AscAo and both sinuses (P < 0.001) and STJ (P < 0.001).

CONCLUSIONS

Circumferential and longitudinal wall stresses were greater in the aortic root than AscAo on aneurysm patients with a TAV. Aneurysm wall stress magnitudes and distribution relative to respective regional wall strength could improve understanding of aortic regions at greater risk of dissection in a particular patient.
Using three-dimensional visualization as an optimal tool to plan and validate an aortopexy in a congenital heart disease patient with severe tracheal stenosis
Authors: Kehl Torben , van Rüth Victoria , Weinrich Julius Matthias , Hübler Michael
Published: October 2021

We present a patient with severe tracheal stenosis resulting from a compression by the innominate artery 6 months after an arterial switch operation in a dextro-transposition of the great arteries. Segmentation and three-dimensional (3D) visualization were derived from a contrast-enhanced dual-source computed tomography and post-processing was performed using a dedicated open-source platform (3D Slicer). Post-processing allowed a comprehensible visualization of the relationship of the innominate artery to the trachea when compared to standard computer tomography reformations. Finally, the surgical approach to move the innominate artery anteriorly in order to relieve the tracheal obstruction was emphasized based on the improved 3D visualization of the actual pathology. An effective aortopexy could be performed and the postoperative result was confirmed by a second 3D visualization. About 3 months of follow-up, the patient is completely asymptomatic. Three-dimensional visualization offers excellent opportunities for diagnosis, treatment planning and follow-up in patients with a vascular-related tracheal stenosis in the context of congenital heart disease.
Alterations of Stress-Related Glucocorticoids and Endocannabinoids in Hair of Chronic Cocaine Users
Authors: Voegel Clarissa D , Kroll Sara L , Schmid Marc W , Kexel Ann-Kathrin , Baumgartner Markus R , Kraemer Thomas , Binz Tina M , Quednow Boris B
Published: October 2021

Background

Previous research in animals and humans has demonstrated a potential role of stress regulatory systems, such as the hypothalamic-pituitary-adrenal (HPA) axis and the endocannabinoid (eCB) system, in the development of substance use disorders. We thus investigated alterations of HPA and eCB markers in individuals with chronic cocaine use disorder by using an advanced hair analysis technique.

Methods

We compared hair concentrations of glucocorticoids (cortisone, cortisol) and the eCBs 2-arachidonylglycerol, anandamide (AEA), oleoylethanolamide (OEA), and palmitoylethanolamide (PEA) between 48 recreational cocaine users (RCU), 25 dependent cocaine users (DCU), and 67 stimulant-naïve controls. Self-reported substance use and hair concentrations of substances were also assessed.

Results

Significantly higher concentrations of hair cortisone were found in RCU and DCU compared with controls. Hair concentrations of OEA and PEA were significantly lower in DCU compared with RCU and controls. Additionally, within cocaine users, elevated cocaine hair concentration was a significant predictor for increased glucocorticoid and decreased OEA hair levels. Moreover, higher 3,4-methyl​enedioxymethamphetamine hair concentration was correlated with elevated cortisone and AEA, OEA, and PEA levels in hair within cocaine users, whereas more self-reported cannabis use was associated with lower eCBs levels in hair across the total sample.

Conclusion

Our findings support the hypothesis that the HPA axis and eCB system might be important regulators for substance use disorders. The mechanistic understanding of changes in glucocorticoid and eCB levels in future research might be a promising pharmacological target to reduce stress-induced craving and relapse specifically in cocaine use disorder.
Delivering universal eye health coverage: a call for more and better eye health funding
Authors: Jones Iain
Published: October 2021

Additional resources are urgently needed to tackle the increasing burden of vision impairment, to support the delivery of the Sustainable Development Goals, and to live up to the promise to leave no one behind. This commentary reflects on eye health funding in developing economies and calls for a step change in delivering more and better financing and the integration of eye health into universal health coverage. The transformation in funding will need to be done carefully, creatively and collaboratively to ensure that funding results in faster and more sustainable delivery of high quality, affordable eye healthcare for all.
Contesting Legitimacy of Global Governance Institutions: The Case of the World Health Organization During the Coronavirus Pandemic
Authors: Yang Hai
Published: October 2021

This article examines the (de)legitimation of a global governance institution (GGI) in the throes of a full-blown legitimacy crisis: the World Health Organization (WHO) during the coronavirus pandemic. Substantively, it fleshes out systematically the discursive (de)legitimating practices of six (types of) actors: the Trump administration, US allies, US quality press, global health-scientific community, the WHO, and the Chinese government. To that end, it synthesizes elements from the rich literature on legitimacy and elaborates a conceptual apparatus bolstered by operational sources of legitimacy. Empirically, it is grounded in a qualitative content analysis of a purpose-built data corpus of 458 texts that contain justifications for (de)legitimation. In so doing, this study not only presents a holistic and yet granular view of discursive (de)legitimation by some pivotal actors surrounding the WHO and its pandemic response, but offers general insights on legitimacy and (de)legitimation of GGIs during times of crisis.
Determination, Isolation, and Identification of Related Impurities in Erdosteine Bulk Drug
Authors: Liu Heying , Xiong Xin , Wang Jie , Pei Kun , Zhong Zhenhua , Zhou Zhiqiang , Cheng Qizhen
Published: October 2021

Background

Erdosteine is a mucolytic drug and has antioxidant activity.

Objective

The study aimed to develop an HPLC method for determination of erdosteine and its impurities in erdosteine bulk drug and to identify the main impurities to help improve the quality of erdosteine bulk drug.

Method

The chromatographic separations were performed on a CAPCELL PAK C18 column (250 mm × 4.6 mm id, 5 μm). Acetonitrile–0.01 mol/L citric acid solution (13 + 87, by volume) pumped at a flow rate of 1.0 mL/min was used as the mobile phase. The detection wavelength was 254 nm. Two main impurities in erdosteine bulk drug were enriched by an ODS column chromatography and oxidative degradation, respectively, and then both were purified by semipreparative HPLC. Finally, their structures were identified by a variety of spectral data (MS, 1H NMR and 13C NMR).

Results

Good separations of erdosteine and its related impurities were observed. A new impurity was confirmed as ethyl ({2-oxo-2-[(2-oxotetrahydro-3-thiophenyl) amino] ethyl} sulfanyl)acetate, which was erdosteine ethyl ester, and was produced in the refining process of erdosteine bulk drug when using ethanol as a refining solvent. Another impurity was confirmed as ({2-oxo-2-[(2-oxotetrahydro-3-thiophenyl)amino]ethyl}sulfinyl) acetic acid, which was an erdosteine oxide.

Conclusions

An HPLC method for determination of erdosteine and its related impurities was developed and validated. Two main impurities in erdosteine bulk drug were isolated and identified. Avoiding ethanol as the refining solvent can improve the purity of erdosteine bulk drug.

Highlights

A new process-related impurity and an oxidative degradation impurity in erdosteine bulk drug were isolated and identified.
Mid- to late-gestational maternal nutrient restriction followed by realimentation alters development and lipid composition of liver and skeletal muscles in ovine fetuses
Authors: Smith Brandon I , Liefeld Amanda , Vásquez-Hidalgo Manuel A , Vonnahme Kimberly A , Grazul-Bilska Anna T , Swanson Kendall C , Mishra Neha , Reed Sarah A , Zinn Steven A , Govoni Kristen E
Published: October 2021

Maternal nutrient restriction during gestation adversely affects offspring growth and development of liver and skeletal muscle tissues. Realimentation following nutrient restriction may alleviate these negative impacts on development but may alter metabolism and tissue composition. Forty-eight ewes, pregnant with singletons, were fed to meet 100% National Research Council (NRC) recommendations starting at the beginning of gestation. On day 50 of gestation, seven ewes were euthanized (BASE), and fetal liver, skeletal muscles, and blood samples were collected. The remaining animals were fed either 100% of NRC recommendations (CON) or 60% NRC recommendations (RES), a subset were euthanized at day 90 of gestation (n = 7/treatment), and fetal samples were collected. Remaining ewes were maintained on the current diet (CON-CON, n = 6; RES-RES, n = 7) or switched to the alternate diet (CON-RES, RES-CON; n = 7/treatment). On day 130 of gestation, the remaining ewes were euthanized, and fetal samples were collected. At day 130 of gestation, maternal nutrient restriction during late-gestation (RES-RES and CON-RES) decreased fetal liver weight (P < 0.01) and cross-sectional area in triceps brachii (P = 0.01; TB), longissimus dorsi (P = 0.02; LM), and semitendinosus (P = 0.05; STN) muscles. Maternal nutrient restriction during mid-gestation increased hepatocyte vacuole size at day 130 of gestation. Late-gestational maternal nutrient restriction increased mRNA expression of insulin-like growth factor (IGF) binding protein-1 (P < 0.01), glycogen synthase 2 (P = 0.01; GYS2), and pyruvate dehydrogenase kinase 1 (P < 0.01; PDHK1) in the liver and IGF receptor 1 (P = 0.05) in the LM. Lipid concentration in the LM was decreased by late-gestational nutrient restriction (P = 0.01) and increased by mid-gestational nutrient restriction in STN (P = 0.03) and TB (P < 0.01). Principal component analysis of lipidomics data demonstrated clustering of principal components by day of gestation and elastic net regression identified 50, 44, and 29 lipids that classified the treatments in the fetal liver, LM, and blood, respectively. In conclusion, restricting maternal nutrition impacts fetal liver and muscle morphology, gene expression, and lipid metabolism, whereas realimentation attenuated some of these effects. Therefore, realimentation may be a viable strategy to reduce the impacts of nutrient restriction, but can lead to alterations in lipid metabolism in sheep.
Pediatric Burns Unique Characteristics Among Ultra-Orthodox Jewish Minority—Retrospective Study
Authors: Yahal Orr , Eshel Ron , Manor Uri , Lennon Joshua M , Stern Michal , Geller Dan , Pessach Itai M
Published: October 2021

Burn injuries are a significant cause of morbidity among children. Ultra-Orthodox Jewish children are at higher risk for burn injuries. The goal of this study was to examine the clinical characteristics of moderate to severe burns in this population in comparison to the general population in Israel. This retrospective cohort study included all pediatric patients 0 to 18 years of age admitted with burn injuries from January 1, 2015 through December 31, 2018. Data were collected regarding demography, etiology, and clinical characteristics. Of 778 burns injuries presented to our tertiary center, 385 (49.5%) were hospitalized. Of those 212 (55%) were non-ultra-Orthodox Jews, 135 (35%) were ultra-Orthodox Jews, and 38 (10%) were non-Jewish patients. The total body surface area percentage (TBSA%) of scald-type burns was larger in ultra-Orthodox compared to non-ultra-Orthodox children (median TBSA% of 7% vs 5%, respectively, P < .05). Among the ultra-Orthodox group, the median TBSA% during weekdays was 6%, and for weekends, the TBSA% was 7.5% (P < .05). Females demonstrated the greatest diversity between subgroups. On weekends, ultra-Orthodox female’s median TBSA% was 10%, and non-ultra-Orthodox female’s TBSA% was 4.5% (P < .05). Ultra-Orthodox children and especially girls had a significantly higher median TBSA% than non-ultra-Orthodox children for burns occurring during weekends. This may be the result of the unique cultural norms of the ultra-Orthodox Jewish community, in particular, their lifestyle and observation of the Sabbath. These findings provide a focus for better intervention and prevention of pediatric burns among this unique population.
Addition of Ammonium Acetate to Protein-Borax Baited Traps Does Not Improve Attraction ofAnastrepha obliquaorAnastrepha serpentina(Diptera: Tephritidae)
Authors: Lasa Rodrigo , Williams Trevor
Published: October 2021

Ammonia is considered a key component in the attraction of tephritid flies to protein-based lures. The addition of ammonium acetate to improve hydrolyzed protein-borax mixtures used to monitor tephritids has not been evaluated, although it has improved attraction to toxic baits. The presence of ammonium acetate crystals in a ventilated tube inside a trap containing hydrolyzed protein + borax, did not improve the capture of Anastrepha obliqua or Anastrepha serpentina flies in field experiments when compared with hydrolyzed protein + borax alone. In contrast, the addition of 1% ammonium acetate into the drowning solution of a hydrolyzed protein + borax mixture resulted in significantly reduced captures of both pests. Laboratory tests indicated that the emission of ammonia gas was increased 1.6–4.5-fold from traps that included ammonium acetate. These results confirm the hypothesis that a higher release of ammonia does not improve the attraction of tephritids when protein-derived odors are also present.
A New Tail-Based Correlation Measure and Its Application in Global Equity Markets
Authors: Liu Jinjing
Published: October 2021

Many studies have found that large negative returns tend to occur together. This article develops a correlation measure focusing on tails using the expected shortfall (ES), referred to as the ES-implied correlation. The new correlation measure provides closer estimates to the true correlation than does the existing value at risk-implied correlation measure in the simulations. In addition, the new correlation measure performs as well as the linear correlation measure when correlation is constant but captures changes in correlations when correlations are not constant. A series of test statistics are developed to measure and test correlation asymmetries. The empirical analysis shows that correlations among international equity markets increase significantly when returns are low.
Task Discretion, Labor-market Frictions, and Entrepreneurship
Authors: Canidio Andrea , Legros Patrick
Published: October 2021

An agent can perform a job in several ways, which we call tasks. Choosing agents’ tasks is the prerogative of management within firms, and of agents themselves if they are entrepreneurs. While agents’ comparative advantage at different tasks is unknown, it can be learned by observing their performance. However, tasks that generate more information could lead to lower short-term profits. Hence, firms will allocate workers to more informative tasks only if agents cannot easily move to other firms. When, instead, workers can easily move to other firms, agents may prefer to become entrepreneurs and acquire task discretion, even if their short-term payoff is lower than employees. Our model generates novel predictions with respect to, for example, how the wage dynamics of agents who switch between entrepreneurship and employment are affected by labor and contracting frictions. (JEL D83, J24, J62, J63, L26, M13).
High Prevalence of Rickettsia bellii in Mosquitoes From Eastern China
Authors: Li Feng , Tian Junhua , Wang Lin , Yang Zhengpei , Lu Miao , Qin Xincheng , Zhao Hongqing , Chen Jintao , Li Kun
Published: October 2021

Mosquitoes are the most important vectors carrying significant numbers of human pathogens. Recent studies implicated that mosquitoes play an important role in circulation and transmission of multiple Rickettsia species. In this study, Rickettsia bellii was identified in four mosquito species (Culex pipiens, C. tritaeniorhynchus, Aedes albopictus, and Anopheles sinensis) collected from three Eastern China provinces during 2019–2020. Rickettsia bellii was detected in 37.50 and 26.32% of the C. pipiens pools from Beijing and Jiangsu province, respectively. In C. tritaeniorhynchus and An. sinensis from Shandong, the infection rate is 20.00 and 6.25%, respectively. Additionally, three Ae. albopictus pools (3/42, 7.14%) from Beijing were also detected positive for R. bellii. Genetic and phylogenetic analysis on 16S, gltA, and groEL genes indicates that sequences from all these strains are highly homologous and closely related to other R. bellii strains. This is the first report that Ae. albopictus and C. tritaeniorhynchus harbor R. bellii. The wide host range and high infection rate in certain areas may dramatically increase the exposure of R. bellii to human and other vertebrates. The role of mosquitoes in transmission of rickettsiosis and its potential risk to public health should be further considered.
Reconciling Regulation with Scientific Autonomy in Dual-Use Research
Authors: Evans Nicholas G , Selgelid Michael J , Simpson Robert Mark
Published: October 2021

In debates over the regulation of communication related to dual-use research, the risks that such communication creates must be weighed against against the value of scientific autonomy. The censorship of such communication seems justifiable in certain cases, given the potentially catastrophic applications of some dual-use research. This conclusion however, gives rise to another kind of danger: that regulators will use overly simplistic cost-benefit analysis to rationalize excessive regulation of scientific research. In response to this, we show how institutional design principles and normative frameworks from free speech theory can be used to help extend the argument for regulating dangerous dual-use research beyond overly simplistic cost-benefit reasoning, but without reverting to an implausibly absolutist view of scientific autonomy.
Thermally driven winds in ultraluminous X-ray sources
Authors: Middleton Matthew J , Higginbottom Nick , Knigge Christian , Khan Norman , Wiktorowicz Grzegorz
Published: October 2021

The presence of radiatively driven outflows is well established in ultraluminous X-ray sources (ULXs). These outflows are optically thick and can reprocess a significant fraction of the accretion luminosity. Assuming isotropic emission, escaping radiation from the outflow’s photosphere has the potential to irradiate the outer disc. Here, we explore how the atmosphere of the outer disc would respond to such irradiation, and specifically whether unstable heating may lead to significant mass loss via thermally driven winds. We find that, for a range of physically relevant system parameters, this mass loss may actually switch off the inflow entirely and potentially drive limit-cycle behaviour (likely modulated on the time-scale of the outer disc). In ULXs harbouring neutron stars, magnetic fields tend to have a slight destabilizing effect; for the strongest magnetic fields and highest accretion rates, this can push otherwise stable systems into the unstable regime. We explore the prevalence of the instability in a simulated sample of ULXs obtained from a binary population synthesis calculation. We find that almost all neutron star and black hole ULXs with Eddington-scaled accretion rates of $\dot{m}_0 \lt 100$ should be able to drive powerful outflows from their outer discs. Several known ULXs are expected to lie in this regime; the persistence of accretion in these sources implies the irradiation may be anisotropic which can be reconciled with the inferred reprocessed (optical) emission if some of this originates in the wind photosphere or irradiation of the secondary star.
On the intrinsic AGN emission in the far-infrared/sub-mm
Authors: Symeonidis M
Published: October 2021

Far-infrared (far-IR)/sub-mm emission linked to AGN-heated dust has been a topic of contention for many years. Results have been diverse and various views have been presented. The empirical AGN SED derived by Symeonidis et al. (2016, hereafter S16) has more far-IR/sub-mm emission than other SEDs in the literature, and thus it is contested by other works which argue that its luminosity in that part of the spectrum is overestimated. Here, I investigate this topic and the concerns raised over the S16 AGN SED. I also examine the differences between the S16 AGN SED and other commonly used empirical AGN SEDs. My findings show that the reasons proposed by other works as to why the S16 AGN SED is not a reasonable representation of AGN emission in the far-IR/sub-mm, do not hold.
The impact of stellar clustering on the observed multiplicity of super-earth systems: outside–in cascade of orbital misalignments initiated by stellar flybys
Authors: Rodet Laetitia , Lai Dong
Published: October 2021

A recent study suggests that the observed multiplicity of super-Earth (SE) systems is correlated with stellar overdensities: field stars in high phase-space density environments have an excess of single-planet systems compared to stars in low-density fields. This correlation is puzzling as stellar clustering is expected to influence mostly the outer part of planetary systems. Here, we examine the possibility that stellar flybys indirectly excite the mutual inclinations of initially coplanar SEs, breaking their co-transiting geometry. We propose that flybys excite the inclinations of exterior substellar companions, which then propagate the perturbation to the inner SEs. Using analytical calculations of the secular coupling between SEs and companions, together with numerical simulations of stellar encounters, we estimate the expected number of ‘effective’ flybys per planetary system that lead to the destruction of the SE co-transiting geometry. Our analytical results can be rescaled easily for various SE and companion properties (masses and semimajor axes) and stellar cluster parameters (density, velocity dispersion, and lifetime). We show that for a given SE system, there exists an optimal companion architecture that leads to the maximum number of effective flybys; this results from the trade-off between the flyby cross-section and the companion’s impact on the inner system. Subject to uncertainties in the cluster parameters, we conclude that this mechanism is inefficient if the SE system has a single exterior companion, but may play an important role in ‘SE + two companions’ systems that were born in dense stellar clusters. Whether this effect causes the observed correlation between planet multiplicity and stellar overdensities remains to be confirmed.
Constraints on magnetic field and particle content in blazar jets through optical circular polarization
Authors: Liodakis I , Blinov D , Potter S B , Rieger F M
Published: October 2021

Polarization offers a unique view in the physical processes of astrophysical jets. We report on optical circular polarization (CP) observations of two famous blazars, namely 3C 279 and PKS 1510−089, at high linearly polarized states. This is the first time PKS 1510−089 is observed in optical CP. While only upper limits can be extracted from our observing campaign, the non-detection of optical CP allows us to provide meaningful constraints on their magnetic field strength and jet composition. We find that high-energy emission models requiring high magnetic field strength and a low positron fraction can be excluded.