bluuebunny/crossref_metadata_2025 huggingface dataset:
0957 The Association Between Sleep and Sustained Attention Differs in Children vs. Adolescents With ADHD
Authors: Gagnon K , Theoret R , Rudd E , Lepage C , Chirica A , Godbout R
Published: May 2020

Introduction

Sleep disturbance in children with attention-deficit/hyperactivity disorder (ADHD) is frequent, and lead to shorter sleep duration which has been associated with lower performance on sustained attention tasks. However, no study has investigated this association in adolescents with ADHD. We sought to explore whether the association between sleep and sustained attention performance of children with ADHD is similar in adolescents with ADHD given that sleep patterns are different.

Methods

Parents of 32 children (mean age = 8.0; SD = 1.3) and 10 adolescents (mean = 15.2; SD = 1.3) with ADHD completed a developmental questionnaire including sleep questions. Children and adolescents were medication free and underwent a comprehensive neuropsychological evaluation. Three sleep variables were extracted from the questionnaire, namely the duration of the sleep period during week nights and weekends as well as the difference between the two (“weekend shift”). The Continuous Performance Test was used to measure sustained attention (omission, commission, hit reaction time). Pearson correlations between sleep variables and sustained attention measures were calculated.

Results

Children showed a positive correlation between hit reaction time and the duration of the sleep period during week nights (r = 0.37; p =0.04), weekends (r = 0.51; p = 0.004) and the weekend shift (r = 0.37; p =0.04). No significant correlations were found in the adolescent group.

Conclusion

The fact that no significant associations were found in the adolescent group suggest an improvement of the arousal system through brain development in ADHD, or that other mechanisms could be involved in the etiology of ADHD in adolescents.

Support

Centre d’apprentissage aux 1001 astuces; Fonds de recherche du Québec - Santé
0969 Early Life Sleep Disturbance Among Children With Autism Spectrum Disorders: A Questionnaire-based Retrospective Study
Authors: Gupta A , Shukla G , Poornima S , Mohd A , Katoch J , Taneja D , Singhal N
Published: May 2020

Introduction

Autism spectrum disorders(ASD) and sleep has hand to hand relationship and few recently published studies have shown that, disturbed infant sleep is associated with Attention deficit hyperactive disorder and Autism. The aim of the study is to evaluate the sleep disturbance in first year of life among the children with ASD.

Methods

In this case control study, pre-diagnosed ASD children between 3-12 year of age (group 1) and controls; sibling of autistic children and community dwelling children(group 2), were enrolled in between June 2014 to November 2017. After giving consent every child underwent, Detailed Clinical [Childhood Autism rating scale-2(CARS-2)] and Sleep evaluation [Brief Infant sleep Questionnaire (BISQ) - Retrospectively, Child sleep habits questionnaire (CSHQ)].

Results

Sixty children in group1 and 60 in group 2 were enrolled and both groups were age [Median 7(2.5-12) vs. 8.5 (2.5-12), p = 0.14] and sex [53(88.33%) vs. 45(75.00 %), p=0.15] matched. On CHSQ poor sleepers are more common among the group 1[40(66.66%) vs. 20(33.33%), p=.003, respectively]. On BISQ children had severe sleep problems during infancy were significantly more among the group 1 [46(76.66%) vs. 6(10%), p=<.001, respectively]. Duration of nocturnal awakening was significantly correlated (r=0.87, p=.001) with the T score of the CARS-2.

Conclusion

Sleep is significantly disturbed since infancy among children with autism spectrum disorder and duration of nocturnal awakenings during infancy is strongly correlated with severity of autism.

Support

NA
0982 Content Analysis Of The Features And Claims Of Smartphone Applications For Children’s Sleep
Authors: Talker I , Kaar J L , Simon S L
Published: May 2020

Introduction

Empirically supported treatments for pediatric sleep problems exist but many families turn to other sources for help with their child’s sleep, such as smartphone applications (apps). Sleep apps are easy for families to access but little evidence exists regarding the validity of the services and information provided. The goal of this study was to examine the features and claims of sleep apps for children.

Methods

A search of the Apple iTunes store and Google Play Store was conducted using the terms “kids sleep” and “baby sleep”. 635 apps were initially identified. Apps were excluded if they were not specifically for children (n=163), not for sleep (n=152), or if they had <100,000 downloads (n=246). Content analyses were used to assess the apps functions, claims, and evidence base.

Results

A total of 74 apps were examined of which only 4% offered sleep improvement strategies. The majority were sound and light apps (77%) and 19% were bedtime games/stories. The apps were highly rated (average 4.4 out of 5) and most were free (54%); the price of paid apps ranged from $0.99 to $119.99 (annual subscription). Only 2 apps were identified as containing empirical evidence, and all of the apps featuring games and stories to be used as part of the bedtime routine are in opposition to the recommendation to avoid the melatonin-suppressing effect of electronics/bright light before bedtime. Despite this, many apps boasted claims that they will help children “fall asleep instantly,” “cry less and sleep better,” or improve child development.

Conclusion

A large variety of sleep applications exist aimed for use with children. Many boast claims that cannot be supported by empirical evidence, and indeed may be in opposition to research support. Collaboration between sleep researchers and technology developers may be beneficial for the creation of evidence-supported apps to help with children’s sleep.

Support

N/A
Machine learning-based prediction of activity and substrate specificity for OleA enzymes in the thiolase superfamily
Authors: Robinson Serina L , Smith Megan D , Richman Jack E , Aukema Kelly G , Wackett Lawrence P
Published: May 2020

Enzymes in the thiolase superfamily catalyze carbon–carbon bond formation for the biosynthesis of polyhydroxyalkanoate storage molecules, membrane lipids and bioactive secondary metabolites. Natural and engineered thiolases have applications in synthetic biology for the production of high-value compounds, including personal care products and therapeutics. A fundamental understanding of thiolase substrate specificity is lacking, particularly within the OleA protein family. The ability to predict substrates from sequence would advance (meta)genome mining efforts to identify active thiolases for the production of desired metabolites. To gain a deeper understanding of substrate scope within the OleA family, we measured the activity of 73 diverse bacterial thiolases with a library of 15 p-nitrophenyl ester substrates to build a training set of 1095 unique enzyme–substrate pairs. We then used machine learning to predict thiolase substrate specificity from physicochemical and structural features. The area under the receiver operating characteristic curve was 0.89 for random forest classification of enzyme activity, and our regression model had a test set root mean square error of 0.22 (R2 = 0.75) to quantitatively predict enzyme activity levels. Substrate aromaticity, oxygen content and molecular connectivity were the strongest predictors of enzyme–substrate pairing. Key amino acid residues A173, I284, V287, T292 and I316 in the Xanthomonas campestris OleA crystal structure lining the substrate binding pockets were important for thiolase substrate specificity and are attractive targets for future protein engineering studies. The predictive framework described here is generalizable and demonstrates how machine learning can be used to quantitatively understand and predict enzyme substrate specificity.
The role of glutamate receptors and their interactions with dopamine and other neurotransmitters in the development of tardive dyskinesia: preclinical and clinical results
Authors: Szota Anna Maria , Scheel-Krüger Jørgen
Published: May 2020

Tardive dyskinesia is a serious, disabling, movement disorder associated with the ongoing use of antipsychotic medication. Current evidence regarding the pathophysiology of tardive dyskinesia is mainly based on preclinical animal models and is still not completely understood. The leading preclinical hypothesis of tardive dyskinesia development includes dopaminergic imbalance in the direct and indirect pathways of the basal ganglia, cholinergic deficiency, serotonin receptor disturbances, neurotoxicity, oxidative stress, and changes in synaptic plasticity. Although, the role of the glutamatergic system has been confirmed in preclinical tardive dyskinesia models it seems to have been neglected in recent reviews. This review focuses on the role and interactions of glutamate receptors with dopamine, acetylcholine, and serotonin in the neuropathology of tardive dyskinesia development. Moreover, preclinical and clinical results of the differentiated effectiveness of N-methyl-d-aspartate (NMDA) receptor antagonists are discussed with a special focus on antagonists that bind with the GluN2B subunit of NMDA receptors. This review also presents new combinations of drugs that are worth considering in the treatment of tardive dyskinesia.
Comparative Case Analysis of the Role of Community Health Workers in Rural and Low-Income Populations of West Virginia and the United States
Authors: Schleiff Meike J. , Peters David H. , Surkan Pamela J.
Published: May 2020

The rural United States, including West Virginia, has decades of experience engaging communities and utilizing community health workers (CHWs). This study aims to inform policy and planning by comparing how 2 county-level CHW programs engage with communities. The analysis is based on in-depth interviews with 19 community representatives and 20 health workers and archival documents and published literature reviews. Results highlight the local contextual determinants for community engagement with CHW programs. Making CHW policies inclusive and adaptable to local realities will enable more community benefits. Making the value of CHW programs for communities explicit should guide resource allocation and policies.
Fitting Community-Centered Population Health (CCPH) Into the Existing Health Care Delivery Patchwork
Authors: Goldfield Norbert
Published: May 2020

The COVID-19 crisis has nakedly exposed the problems and huge holes in the health care system of the United States. For today, we need to address the current pandemic from the point of view of both control and suppression. But such efforts could also provide insights into a post-pandemic restructuring of health care. If one or several states succeed in addressing the COVID pandemic together with an associated modest economic resurgence, citizens could develop the trust in state leadership necessary to finally make fundamental changes in our health care system. Such change is a once in a century opportunity.
Recurrent 1q21.1 deletion syndrome: report on variable expression, nonpenetrance and review of literature
Authors: Upadhyai Priyanka , Amiri Eram Fatima , Guleria Vishal Singh , Bielas Stephanie L. , Girisha Katta Mohan , Shukla Anju
Published: May 2020

The clinical phenotype of 1q21.1 microdeletion syndrome is highly heterogeneous. It is characterized by dysmorphic facial features, microcephaly, and developmental delay. Several congenital defects, including cardiac, ocular, skeletal anomalies, and psychiatric or behavioural abnormalities, have also been described. Here, we report on two siblings with substantial intrafamilial phenotypic variability carrying a heterozygous deletion of the 1q21.1 region spanning a known critical genomic area (~1.35 Mb). The microdeletion was inherited from the unaffected father. Patients described here show a spectrum of clinical features, a portion of which overlap with those previously reported in patients with 1q21.1 microdeletions. In addition, we review the clinical reports of 66 individuals with this condition. These findings extend and substantiate the current clinical understanding of recurrent copy number variations in the 1q21.1 region.
Productivity Loss Among Parents of Children With Inflammatory Bowel Diseases in Relation to Disease Activity and Patient's Quality of Life
Authors: Stawowczyk Ewa , Kawalec Paweł , Kowalska‐Duplaga Kinga , Mossakowska Małgorzata
Published: May 2020

Objectives:

To assess the productivity losses among the parents of children with inflammatory bowel diseases (IBDs) in Poland and their relationship with disease activity and the patient's quality of life.

Methods:

A questionnaire‐based self‐reported Internet survey was conducted among the parents of patients (0‐‐17 years old) with a diagnosis of ulcerative colitis (UC) or Crohn disease (CD). Data on indirect and direct costs, general patient characteristics, disease activity, pharmacological treatment, and children's quality of life measured with the Pediatric Quality of Life Inventory (PedsQL) were collected.

Results:

A total of 113 completed questionnaires were obtained. Remission was reported in 58.6% of cases. Severe disease was more common in patients with UC (7.3% vs 2.9%). The mean reduction in parents’ daily activities was 40% (range: 0%–100%). The mean (SD) reduction of parents’ work productivity because of absenteeism was 21% (0.27), and the mean cost was €902.77 (1136.90) per year per parent. The mean (SD) productivity loss at paid work of a working parent (presenteeism) was 35% (0.31) and the mean (SD) cost was €1125.13 (1121.16) per year per parent. The PedsQL score was significantly higher among patients with inactive than with active disease.

Conclusions:

A significant difference between patients with inactive and active disease was observed for the total reduction of parent's work productivity and the PedsQL score. A negative correlation was observed for indirect costs and the PedsQL score for the whole study population; better health‐related quality of life among patients in remission was revealed.
Adult Donor Blood Products as Risk Factors for Central Venous Catheter–associated Thromboembolism in Neonates: A Retrospective Case-Control Study
Authors: Badur Chiara-Aiyleen , Bührer Christoph , Dame Christof
Published: May 2020

This study aimed to examine whether the transfusion of donor blood products, abnormal coagulation or inflammation increase the risk of venous thromboembolism (VTE) associated with central venous catheters (CVC) in neonates. A retrospective case-control study including 25 neonates with CVC-associated VTE and tightly matched controls with CVC, but without VTE was performed. The frequency of (i) abnormal coagulation screens, (ii) increased inflammatory marker proteins before catheter insertion, or (iii) catheter-associated blood stream infection did not differ between cases and controls. No difference was found in the number or type of transfusions within the last day before VTE. However, the total number of transfusions in the time period between catheter placement and VTE diagnosis (median 6.5 d) was significantly higher (P<0.001) in cases (44 red blood cell, 61 plasma, and 18 platelet transfusions) compared with an equal median time period of 7 days postcatheter insertion in controls (26/24/11). In conclusion, intensive transfusion treatment (through a peripheral line) after CVC insertion was associated with a higher risk of VTE (odds ratio 7.58; 95% confidence interval, 0.84-68.46), suggesting that transfusion of adult donor blood products into the cellular and plasmatic hemostatic system of the neonate increases the risk for CVC–associated VTE.
Social Media in the Pediatric Hematology/Oncology Clinical Space
Authors: Caruso Brown Amy E.
Published: May 2020

Parents and families of children with cancer and blood disorders increasingly turn to social media to connect with families facing similar challenges. These multidirectional interactions on social media are not only sources of psychosocial support but frequently sources of medical information. Consequently, such interactions have the potential to meaningfully impact the relationships between parents, children, and pediatric hematology/oncology providers. The 3 case studies analyzed here illustrate the spectrum of ethical and communication issues that arise when families’ use of social media enters the pediatric clinical space, including questions related to trust and mistrust, misinformation, patient privacy and confidentiality, and allocation of resources, including time. Ideal approaches to resolving dilemmas related to parental social media use are those that maintain respect, build trust, and acknowledge the changing culture. Social media use is now the norm. Promoting transparent discussions of its use between families and health professionals is, therefore, the key to optimizing health outcomes for children whose parents turn to social media. Mutual respect, collaboration, and long-term relationships are also potential antidotes to the spread of misinformation and mistrust through social media.
Targeted Rhythmic Auditory Cueing During Treadmill and Overground Gait for Individuals With Parkinson Disease: A Case Series
Authors: Sherron Margaret A. , Stevenson Sarah A. , Browner Nina M. , Lewek Michael D.
Published: May 2020

Background and Purpose:

Rhythmic auditory cueing and treadmill walking can improve spatiotemporal gait parameters through entrainment of movement patterns. Careful selection of cue frequencies is necessary if treadmill walking is to be employed, because cadence and step length are differentially affected by walking on a treadmill and overground. The purpose of this study was to describe the treatment of gait impairments for individuals with Parkinson disease, using strategically selected rhythmic auditory cue frequencies on both a treadmill and overground.

Case Description:

Three individuals with Hoehn & Yahr stage 2 Parkinson disease participated in this case series.

Intervention:

All participants completed 6 weeks of gait training, in which each session employed rhythmic auditory cueing during treadmill-based gait training followed by overground gait training. We provided targeted rhythmic auditory cueing with a metronome set to 85% and 115% of their self-selected cadence for treadmill and overground training, respectively. We performed clinical tests of gait and balance prior to, midway, and following training, and at a 3-month follow-up.

Outcomes:

All participants improved overground gait speed (participant 1: +0.27 m/s; participant 2: +0.20 m/s; and participant 3: +0.18 m/s) and stride length (15.7 ± 4.17 cm) with small changes to cadence. Likewise, there were only small changes in balance.

Discussion:

We hypothesize that the large improvements in gait speed are due to the concomitant increases in stride length. Further research is needed to test the effect of targeted rhythmic auditory cueing during treadmill and overground gait.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A309).
The 2019 International Society of Urological Pathology (ISUP) Consensus Conference on Grading of Prostatic Carcinoma
Authors: van Leenders Geert J.L.H. , van der Kwast Theodorus H. , Grignon David J. , Evans Andrew J. , Kristiansen Glen , Kweldam Charlotte F. , Litjens Geert , McKenney Jesse K. , Melamed Jonathan , Mottet Nicholas , Paner Gladell P. , Samaratunga Hemamali , Schoots Ivo G. , Simko Jeffry P. , Tsuzuki Toyonori , Varma Murali , Warren Anne Y. , Wheeler Thomas M. , Williamson Sean R. , Iczkowski Kenneth A.
Published: May 2020

Five years after the last prostatic carcinoma grading consensus conference of the International Society of Urological Pathology (ISUP), accrual of new data and modification of clinical practice require an update of current pathologic grading guidelines. This manuscript summarizes the proceedings of the ISUP consensus meeting for grading of prostatic carcinoma held in September 2019, in Nice, France. Topics brought to consensus included the following: (1) approaches to reporting of Gleason patterns 4 and 5 quantities, and minor/tertiary patterns, (2) an agreement to report the presence of invasive cribriform carcinoma, (3) an agreement to incorporate intraductal carcinoma into grading, and (4) individual versus aggregate grading of systematic and multiparametric magnetic resonance imaging–targeted biopsies. Finally, developments in the field of artificial intelligence in the grading of prostatic carcinoma and future research perspectives were discussed.
A Quality Improvement Project to Improve Documentation and Awareness of Limitations of Life-Sustaining Therapies
Authors: Jones Amy H. , Heneghan Julia A. , Brooks Bonnie , Maamari Mia , Ahmad Ali , October Tessie W. , Corriveau Christiane
Published: May 2020

Purpose:

Poor documentation and understanding of the limitations of life-sustaining therapies upon admission to the pediatric intensive care unit (PICU) can result in moral distress for both providers and families. Limitations of life-sustaining treatments are often not documented and/or understood by members of the health care team.

Methods:

We performed a quality improvement initiative to improve the care teams’ understanding and paper documentation of the limitations of life-sustaining therapies in the PICU of a quaternary children’s hospital from January 2018 to March 2019. We implemented a series of plan-do-study-act cycles, including initiation of an updated rounding tool that included limitations of interventions, in-person and electronic information sessions, and implementation of a visual bedside tool to remind providers when limitations were present. Pre- and postintervention surveys were administered.

Results:

Nursing paper documentation of limitations of life-sustaining therapies increased sequentially from 0% to 88% during plan-do-study-act cycles. Creating a specific area to document limitations on the nursing sheet resulted in the most significant increase in documentation (36.6 points). Nurses reported that they “always” document limitations, which increased from 10% to 38%. The percentage of nurses who understood patients’ intervention limitations increased from 28% to 33%.

Conclusions:

Limitations of life-sustaining therapies in the PICU are nuanced and involve multiple stakeholders. Nursing education and designation of a section of intervention limitations in nursing daily goal paper documentation can increase comfort with therapeutic limitations in the PICU. Future studies should explore impacts on patient care and serve as a framework for the ultimate goal of improving documentation of care limitations and code status in the electronic medical record.
Consequences of Trocar Dynamics on Mental Nerve in Transoral Thyroidectomy
Authors: Zhang Daqi , Li Shijie , Dionigi Gianlorenzo , Wang Tie , Zhang Jiao , Xue Gaofeng , Sun Hui
Published: May 2020

Background:

Mental nerve (MN) injuries are reported during transoral endoscopic thyroidectomy vestibular approach. Effect of trocar insertion and position on MN are examined in the present study.

Materials and Methods:

Ten millimeter incision was made at the center of the lower lip oral vestibule. Two 5 mm lateral incisions of the lower lip oral vestibule were made at the junction between the incisor and the canine. These 2 lateral incisions were high, just below the edge of lower lip. Nine pigs (18 MN) were randomly divided into 3 groups and MN dissection was performed. The angle between the lateral ports and median line were changed between 15 and 45 degrees among 3 groups and effect on MN was examined.

Results:

During dissection when insertion and other ports are in neutral position visual inspection of MNs did not reveal any compression bilaterally. The distance between MN and the ports was 18.2±2.1 mm (16.3 to 21.2 mm). In group I and group II, MNs have no compression by the lateral trocars. In group III (45 degrees), left MNs were all compressed. Two MNs (66.7%) were compressed on the right side. The MN was compressed at its ramification.

Conclusions:

The results of the present experimental study, endorse the suggested medial and lateral vestibular incisions for transoral endoscopic thyroidectomy vestibular approach. However, during dynamic modification of the lateral port position/angle, MN compression was observed when the angle was >45 degrees.
Emergence of azole resistant-Aspergillus fumigatus infections during STAT3-deficiency
Authors: Danion François , Duréault Amélie , Gautier Cécile , Senechal Agathe , Persat Florence , Bougnoux Marie-Elisabeth , Givel Claire , Couderc Louis-Jean , Lortholary Olivier , Garcia-Hermoso Dea , Lanternier Fanny
Published: May 2020

Introduction. Signal transducer and activator of transcription 3 (STAT3) deficiency is a rare primary immunodeficiency associated with increased susceptibility to bacterial and fungal infections, notably pulmonary aspergillosis.

Aim. We describe the emergence of azole-resistant Aspergillus fumigatus infections in STAT3-deficient patients.

Methodology. During a retrospective study of 13 pulmonary aspergillosis cases in STAT3-deficient patients conducted in France, we identified patients infected with azole-resistant A. fumigatus isolates.

Results. Two out of the 13 STAT3-deficient patients with aspergillosis had azole-resistant A. fumigatus infection, indicating an unexpectedly high prevalence of resistance. The first patient with STAT3 deficiency presented several flares of allergic bronchopulmonary aspergillosis-like episodes. He was chronically infected with two azole-resistant A. fumigatus isolates (TR34/L98). Despite prolonged antifungal treatment, including caspofungin and amphotericin B, the patient was not able to clear the azole-resistant A. fumigatus. The second patient had chronic cavitary pulmonary aspergillosis (CCPA). The A. fumigatus isolate was initially azole susceptible but harboured three F46Y, M172V and E427K point mutations. Despite prolonged antifungal therapies, lesions worsened and the isolate became resistant to all azoles. Surgery and caspofungin treatments were then required to cure CCPA. Resistance was probably acquired from the environment (TR34/L98) in the first case whereas resistance developed under antifungal treatments in the second case. These infections required long-term antifungal treatments and surgery.

Conclusions. The emergence of azole-resistant A. fumigatus infections in STAT3-deficiency dramatically impacts both curative and prophylactic antifungal strategies. Physicians following patients with primary immune-deficiencies should be aware of this emerging problem as it complicates management of the patient.
The association of UV with rates of COVID-19 transmission and deaths in Mexico: the possible mediating role of vitamin D
Authors: Skutsch M , Dobler C , McCall M.B.B , Ghilardi A , Salinas M , McCall M.K , Fenner Sanchez G
Published: May 2020

The first COVID-19 case in Mexico was confirmed on 26 February 2020 and by May 3 the number of registered cases had risen to 30,927. However the rate of transmission varied greatly from city to city. We used data on temperature, humidity and ultraviolet radiation (UV) from 45 cities all over the country to explore whether there was an association between these variables and rates of transmission and rates of accumulation of COVID-19 ascribed deaths. The advantage of an in-country study of this kind is that many of the variables that can confound international studies are held constant (e.g. public health policies, methods of reporting, cultural, behavioural and genetic factors). Although the official statistics undoubtedly greatly underestimate the situation in Mexico due to lack of testing, they are underestimated in all cities so this should not introduce bias across the sample. We found that temperature and humidity had no discernible association with transmission rates but that UV during the transmission period was negatively correlated with rates of transmission, suggesting a sterilizing effect. UV in the January preceding the epidemic had a slightly higher association with transmission rates than UV during the transmission period itself. We also found negative associations of UV in the transmission period and in January with rate of cumulative deaths, but at lower levels of statistical significance. We conclude that in addition to a sterilizing effect during the transmission period, UV may have a physiological effect in reducing transmission and deaths due to COVID-19, most likely through the medium of vitamin D production in the body. This follows the growing body of medical evidence that vitamin D deficiency is associated with severity of COVID-19. However, we also found a negative correlation between altitude and rates of COVID-19 transmission, distinct and independent of the UV effect, which may indicate that other physiological processes are also present. In a multiple regression, altitude and UV together accounted for 18% of the variation in transmission rates between cities.
Relation between rich-club organization versus brain functions and functional recovery after acute ischemic stroke
Authors: Wang Lu , Lau Kui Kai , Li Leonard SW , Wong Yuen Kwun , Yau Christina , Mak Henry KF , Hui Edward S
Published: May 2020

Studies have shown that rich-club may underlie brain function and be associated with many brain disorders. In this study, we aimed to investigate the relation between poststroke brain functions and functional recovery versus the rich-club organization of the structural brain network of patients after first-time acute ischemic stroke. A cohort of 16 first-time acute ischemic stroke patients (11 males; 5 females) was recruited. Structural brain networks were measured using diffusion tensor imaging within 1 week and at 1, 3 and 6 months after stroke. Motor impairment was assessed using the Upper-Extremity Fugl-Meyer motor scale and activities of daily living using the Barthel Index at the same time points as MRI. The rich-club regions that were stable over the course of stroke recovery included the bilateral dorsolateral superior frontal gyri, right supplementary motor area, and left median cingulate and paracingulate gyri. The network properties that correlated with poststroke brain functions were mainly the ratio between communication cost ratio and density ratio of rich-club, feeder and local connections. The recovery of both motor functions and activities of daily living were correlated with higher normalized rich club coefficients and shorter length of local connections within a week after stroke. The communication cost ratio of feeder connections, the length of rich-club and local connections, and normalized rich club coefficients were found to be potential prognostic indicators of stroke recovery. Our results provide additional support to the notion that different types of network connections play different roles in brain functions as well as functional recovery.
Mobility-Guided Modeling of the COVID-19 Pandemic in Metro Manila
Authors: Egwolf Bernhard , Nicanor Austriaco O.P.
Published: May 2020

COVID-19 is a novel respiratory disease first identified in Wuhan, China, that is caused by the novel coronavirus, SARS-CoV-2. To better understand the dynamics of the COVID-19 pandemic in the Philippines, we have used real-time mobility data to modify the DELPHI Epidemiological Model recently developed at M.I.T., and to simulate the pandemic in Metro Manila. We have chosen to focus on the National Capital Region, not only because it is the nation’s demographic heart where over a tenth of the country’s population live, but also because it has been the epidemiological epicenter of the Philippine pandemic. Our UST CoV-2 model suggests that the government-imposed enhanced community quarantine (ECQ) has successfully limited the spread of the pandemic. It is clear that the initial wave of the pandemic is flattening, though suppression of viral spread has been delayed by the local pandemics in the City of Manila and Quezon City. Our data also reveals that replacing the ECQ with a General Community Quarantine (GCQ) will increase the forecasted number of deaths in the nation’s capital unless rigorous tracing and testing can be implemented to prevent a second wave of the pandemic.
To isolate, or not to isolate: a theoretical framework for disease control via contact tracing
Authors: Lunz Davin , Batt Gregory , Ruess Jakob
Published: May 2020

Contact tracing is an essential tool in the public health battle for epidemiological control of infectious diseases. Contact tracing via case-by-case interviews is effective when contacts are known and outbreaks are small. Smartphone applications that keep track of contacts between users offer the possibility to scale contact tracing to larger outbreaks with minimal notification delays. While the benefits of reduced delays are widely recognised, it is less well understood how to best implement the tracing and notification protocol. The application will detect a multitude of contacts encountering an individual who later tests positive. Which of these contacts should be advised to self-isolate? The resolution hinges on an inherent trade-off: the more contacts notified, the greater the disease control, at the cost of more healthy individuals being instructed to self-isolate. In this study, based on a compartmental model tailored to the COVID-19 pandemic, we develop a framework to incorporate testing with limited resources coupled with a mechanistic description of digital contact tracing. Specifically, we employ a family of distributions characterising contact exposure and infection risk, and introduce a notification threshold that controls which level of exposure triggers notification. We detail how contact tracing can prevent disease outbreak, as a function of adoption rate, testing limitations, and other intervention methods such as social distancing and lockdown measures. We find an optimal notification threshold that balances the trade-off by minimising the number of healthy individuals instructed to self-isolate while preventing disease outbreak.
Exposing the need for a training programme in paediatric and adolescent gynaecology for paediatric and GP trainees
Authors: Cosgrave EJ , Geraghty JM , Geoghegan AR
Published: May 2020

Objective

As paediatric and adolescent gynaecology (PAG) falls within the remit of paediatrics and gynaecology, training in both specialties is underdeveloped. There is a paucity of research investigating trainee knowledge of PAG, while postgraduate paediatric training demonstrates little focus in the field. Compounding this, a finite number of PAG specialists means clinical training is limited. We hypothesize that knowledge deficits exist among paediatric and GP trainees and that this has future implications for increased morbidity in girls.

Design, Setting and Participants

A structured questionnaire assessing PAG was distributed to forty paediatric and GP trainees in October 2019 in a tertiary paediatric hospital.

Results

60% (24) incorrectly identified vulvovaginitis as candidal infection. 80% (32) were unable to identify labial adhesions. 62% (25) were unable to define menorrhagia. 100% (9) of GP trainees said they would prescribe the OCP compared with 51% (16) of paediatric trainees. 52% (21) did not consider STI screening when appropriate. 75% (30) believed genital warts invariably warrant referral to child sexual assault clinic. 70% (28) could not identify female genital mutilation. 60% (24) did not consider imperforate hymen as a cause of primary amenorrhoea. 67% (27) misdiagnosed lichen sclerosis.

Conclusions

A knowledge deficit among trainees was evident in relation to PAG conditions. Misdiagnosis and delayed treatment could lead to considerable increased morbidity for girls and we postulate that a key intervention which may prove effective in improving trainee competency in PAG lies in the introduction of a structured training curriculum for all clinicians involved in PAG practice.
Burden of COVID-19 pandemic in India: Perspectives from Health Infrastructure
Authors: Sahoo Harihar , Mandal Chaitali , Mishra Suyash , Banerjee Snigdha
Published: May 2020

The coronavirus (COVID-19) is spreading rapidly across the country but India’s testing regime is far from the global standards. It is important to identify the states where testing needs expansion and the magnitudes of active COVID cases are higher focusing on current health infrastructure to meet the pandemic. The data on COVID-19 was extracted from the Application Programming Interface. Test positive rate, test per confirmed case, recovery rate, case fatality rate, and percent distribution of active cases were computed. Availability of hospitals, hospital beds, intensive care unit and ventilators per lakh population was also computed by public and private sector. The result revealed that, Maharashtra constitutes more than one-third positive cases in the country. More than a quarter of the active cases in India belonged to the Mumbai district of Maharashtra, followed by the Chennai district (9.4%) and Ahmedabad district (9.1%). Further, about 40 percent of the active cases in India belonged to the 11 districts of Maharashtra. The increased test positive rate in Maharashtra and Gujarat to almost double in last one month is a concern. In order to bring the states and the country in right track, the test positive rate need to be brought down to below 2 percent. The procurement of higher number of high throughput machine, the Cobas 6800 testing machine, is need of the hour. Only few states have adequate health infrastructure. The priority should be the laid on expansion of more laboratories and hospitals, storage of PPE kit, testing kit, and indigenously developed vaccines.

Highlights

Maharashtra is having the highest number of positive cases followed by Gujarat and Tamil Nadu. Maharashtra constitutes more than one-third positive cases in the country, but the test per confirmed cases (8) is much lower than the other states.

More than a quarter of the active cases in India belonged to the Mumbai district (26.1%) of Maharashtra, followed by the Chennai district (9.4%) and Ahmedabad district (9.1%). Further, about 40 percent of the active cases in India belonged to the 11 districts of Maharashtra.

The test positive rate is higher in Maharashtra, Gujarat and Delhi is a concern.

The recovery rate in India increased substantially by 26.5 percent point from 11.9 percent on April 14 to 38.4 percent on May 17, 2020.

The case fatality rate of Covid-19 in India declined by 0.2 percent from 3.4 percent on April 14 to 3.2 percent on May 17 in India.

The number of Dedicated Covid Hospitals is not sufficient in India.

The available ventilators in the country will deficit in near future to cater to a growing number of active Covid-19 patients and the burden of other communicable and non-communicable diseases.

India has only 569 testing laboratories (396 govt. and 173 private) against its 1.35 billion population. The procurement of higher number of high throughput machine, the Cobas 6800 testing machine, is need of the hour.
Effects of surface undulations on asymmetric X-ray diffraction: a rocking-curve topography study
Authors: Macrander Albert , Pereira Nino , Huang Xianrong , Kasman Elina , Qian Jun , Wojcik Michael , Assoufid Lahsen
Published: May 2020

The results are reported of an X-ray diffraction study of an Si crystal designed and fabricated for very asymmetric diffraction from the 333 reflection for X-ray energies of 8.100 and 8.200 keV. A crystal with an asymmetry angle of 46 ± 0.1° between the surface and the (111) planes was studied. The grazing angles of incidence were near 1.08 and 0.33° for these two energies, respectively. Features arising from surface undulations were not observed at 8.100 keV, but were observed at 8.200 keV. The results at 8.100 keV allow an alternative explanation based on strain near the surface to be ruled out. Topographic images were obtained as a function of rocking angle, and in the case of 8.200 keV the surface morphology is evident. The results are found to be in agreement with dynamical X-ray diffraction calculations made with the Takagi–Taupin equations specialized to a surface having convex or concave features, as reported in the accompanying paper [Macrander (2020). J. Appl. Cryst.
53, 793–799].
Monitoring of regional labor markets and the main trends of labor underutilization in Russia
Authors: Sibirskaya Elena V. , Volkova Maria V. , Oveshnikova Lyudmila V. , Shchukina Natalia A. , Lula Paweł
Published: May 2020

Purpose

In the recent two decades, a model of the labor market formed in Russia; it differs from the model that is peculiar for most developed countries. Its specific feature consists in the fact that adaptation to the fluctuations of the economic situation takes place by means of changes in the labor price, not by means of changes in employment and unemployment.

Design/methodology/approach

Such model ensures high and stable level of employment and low level of unemployment with significant pro-cyclic fluctuations of wages. Changes that take place in the sphere of employment of population in labor markets and gradual implementation of collection of information in view of the forms of labor activities into the practices of different countries led to the necessity for reconsidering the previously adopted international standards.

Findings

This is due to the fact that the normative documents present the treatment of unemployment without the criterion “job search,” and new indicators of measuring potential labor force and incomplete employment were adopted. The authors analyze the situation of labor underutilization, which is important for characterizing a region of the Russian Federation by the indicator of unmet need for employment.

Originality/value

The offered information could be used for wider monitoring of the labor market, studying the volume and tendencies in the sphere of unemployment, evaluating the problems of integration in the labor market, studying the connection between employment and poverty and forecasting the tendencies.
Cape Town’s gay village: from “gaytrified” tourism Mecca to “heterosexualised” urban space
Authors: Hattingh Chris , Bruwer Juan-Pierré
Published: May 2020

Purpose

The purpose of this paper is to ascertain the factors that led to Cape Town’s gay village to transform from a “gaytrified” tourism mecca to a “heterosexualised” urban space, from a gay leisure space owner perspective.

Design/methodology/approach

Empirical observations of the six remaining gay leisure space owners in De Waterkant (population) are taken into account by using semi-structured interviews. All narratives are analysed in Altas.ti – qualitative data analysis software – to identify applicable factors, which participants believe are contributing to the “de-gaying” of Cape Town’s gay village.

Findings

From the conducted analyses, it becomes apparent that Western theorisation of the “de-gaying” of gay villages is not universally applicable as certain factors contributing to De Waterkant’s demise appear to be location-specific, suggesting that Western theory is insufficient to explain gay spatial realities in non-Western contexts such as South Africa. The identified factors responsible for the “de-gaying” of De Waterkant adversely affect Cape Town’s status as a gay capital and its ability to market this gay neighbourhood to attract the gay tourism market. This may result in lost socio-economic opportunities considering the financial contribution of gay travellers to the local tourist economy.

Originality/value

This study is the first of its kind to use first-hand narratives of the six remaining gay business owners in De Waterkant and marks the first attempt to investigate the factors, from a non-Western perspective, which led to the “de-gaying” of Africa’s only gay village. Taking into account the socio-economic value added by gay tourism, the findings provide the first non-Western perspective on the demise of Africa’s and South Africa’s only gay neighbourhood from a gay leisure space owner perspective, including the possible repercussions on Cape Town’s local tourist economy. Some tactical considerations and recommendations are suggested to ensure the continuation of gay tourism in the city.
IT strategy and business strategy mediate the effect of managing IT on firm performance: empirical analysis
Authors: Ilmudeen Aboobucker , Bao Yukun
Published: May 2020

Purpose

The multifaceted effect of IT in organizations has been widely examined. However, the intervening role of IT strategy and business strategy on the effect of managing IT on firm performance remains less strong. This study examines how managing information technology (MIT) effects on firm performance by looking at the mediating role of IT strategy and business strategy.

Design/methodology/approach

Drawing on the resource-based view of IT and contingency perspective, theoretical insights for managing IT and the mediating effect of IT strategy and business strategy on firm performance are established. The model is empirically tested by using hierarchical regression and structural equation modeling for the data collected through the survey of 194 senior IT and business managers in China.

Findings

The significant and impactful relationship found in the model for the proposed idea. The results show that both IT strategy and business strategy partially mediate the effect of managing IT on firm performance.

Research limitations/implications

The findings highlight that managing IT does not merely influence better firm performance; instead, the coherent amalgamation of IT strategy and business strategy can enrich firm performance. The theoretical and practical implications are also discussed.

Originality/value

In line with the call for rigorous research to integrate the managing IT and firm strategies, this study demonstrates the mediating role of business strategy and IT strategy between the managing IT and the firm performance relationship, hence contributing to the IS research literature.