bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived Gender and Client Satisfaction in Transgender Voice Work: Comparing Self and Listener Rating Scales across a Training Program
Authors: Quinn Sterling , Oates Jennifer , Dacakis Georgia
Published: November 2021

Background/Aim: Scales used to collect perceptual ratings related to a speaker’s gender are widely used in gender affirming voice training for trans individuals. Such scales may be used as outcome measures to gain insight into whether training has helped clients meet personal goals related to gender expression. These scales are also widely used in general research investigating the relationship between vocal characteristics and perceptions of speaker gender. However, past studies in these areas have varied in the terminology used to label rating scales and the impact of this variation is currently unknown. Additionally, research has not yet fully explored the relationship between self- and listener ratings of trans participant voices and trans participant satisfaction with voice, and whether or not these relationships change after trans participants undertake gender affirming voice training. This research paper aimed to explore these relationships and address these research gaps. Methods: A group of 34 trans participants were asked to rate their voices before and after participating in gender affirming voice training. Trans participant voice samples from before and after training were also presented to a group of 25 listeners for rating. Perceptual ratings were made on two visual analogue scales (VAS) with anchors “very feminine/very masculine” and “very female/very male.” Trans participants also rated their satisfaction with their current voice on a VAS with anchors “very satisfied/very unsatisfied.” Correlation coefficients were calculated to investigate the relationship between collected ratings. Results: Differences in scale labels were found to have minimal impact on ratings made by both trans participants and listeners. Trans participant self-ratings were found to correlate with listener ratings, but this correlation was not strong. Trans participant self-ratings had a consistently stronger relationship with their self-rated vocal satisfaction. The study contributed new findings that these differences may be more pronounced after trans participants have completed voice training. Discussion/Conclusion: This study suggests that results from past studies that have used differently labelled scales to collect ratings related to gender perception based on voice are suitable to compare. This study also discusses the implications reported differences between trans participant self-ratings and listener ratings may have for research and clinical practice.
АНАЛІЗ БІОЛОГІЧНОЇ АКТИВНОСТІ ВОДИ ТА ЇЇ ЕНЕРГОІНФОРМАЦІЙНИХ КОПІЙ ЗА ДАНИМИ КІРЛІАНОГРАМ
Authors: Мінцер О. П. , Краснобрижев В. Г. , Пісоцька Л. А. , Глухова Н. В. , Тепла Т. Д.
Published: November 2021

Встановлено критерії біологічно активної води та її енергоінформаційних копій за даними кірліанограм, для використання в практичній біології. З метою дослідження та класифікації води різних типів було вирішено завдання накопичення експериментальних вибірок зображень води з різними фізико-хімічними та біологічними властивостями, побудови бази даних зображень. На основі аналізу експериментальних даних було виявлено специфічні ознаки, на базі яких можливо побудувати систему автоматизованої програмної класифікації. Метод кірліанфотографії крапель води досить інформативний для оцінювання природних властивостей води та може використовуватись, як експрес-метод.
ОСВІТНЬО-НАУКОВА ПРОГРАМА ЗА СПЕЦІАЛЬНІСТЮ 091 «БІОЛОГІЯ»
Authors: Бабінцева Л. Ю. , Горовенко Н. Г. , Дзюблік І. В. , Кирик Д. Л. , Соловйов С. О. , Подольска С. В.
Published: November 2021

Біологія — напрям, котрий є трансдисциплінарною галуззю знань та розглядається як комплекс наукових дисциплін, що вивчають живі організми, їх будову, функціонування, поширення, походження та розвиток, а також природні співтовариства організмів, їх зв'язки один із одним, із неживою природою та людиною. Представлено сучасне бачення навчання майбутніх спеціалістів ступеня доктора філософії за спеціальністю 091 «Біологія» галузі знань 09 «Біологія». Сучасна біологія має декілька особливостей: вивчення взаємозв'язку біологічного та соціального розвитку людини; щільний зв'язок із низкою високотехнологічних напрямів, що включають молекулярну біологію, молекулярну генетику, системну біомедицину. Практично всі нові напрями та особливості пов'язані з використанням інформаційних технологій.
По завершенню навчання, здобувачі вищої освіти третього рівня мають оволодіти загальнонауковими компетентностями, здобути універсальні навики дослідника та мовні компетентності. Тематика курсів професійної підготовки розроблена з метою сприяння здатності інтегрувати знання та розв'язувати складні завдання в мультидисциплінарних і трансдисциплінарних контекстах. Отже, зміст запропонованої освітньо-наукової програми за спеціальністю 091 «Біологія» спрямовано на підготовку висококваліфікованих і конкурентоспроможних спеціалістів ступеня доктора філософії та здобуття ними в процесі навчання необхідних теоретичних знань, що носять мультидисциплЫарний характер, та комплексу практичних умінь, навиків і компетентностей для виконання інноваційних наукових досліджень та впровадження отриманих результатів у практичну охорону здоров'я.
Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack
Authors: Zhang Runhua , Xu Qin , Wang Anxin , Jiang Yong , Meng Xia , Zhou Maigeng , Wang Yongjun , Liu Gaifen
Published: November 2021

Background

Anemia or low hemoglobin can increase the risk of stroke. However, the association between hemoglobin and outcomes after stroke is uncertain. In this study, we aimed to investigate the association between hemoglobin and clinical outcomes, including mortality, poor functional outcome, stroke recurrence, and composite vascular events at 1 year.

Methods and Results

We included the patients diagnosed with acute ischemic stroke or transient ischemic attack from the Third China National Stroke Registry. We used the Cox model for mortality, stroke recurrence, and composite vascular events and the logistic model for the poor functional outcome to examine the relationship between hemoglobin and clinical outcomes. In addition, we used the restricted cubic spline to evaluate the nonlinear relationship. This study included 14 159 patients with acute ischemic stroke or transient ischemic attack. After adjusted for potential cofounders, both anemia and high hemoglobin were associated with the higher risk of mortality (hazard ratio [HR], 1.73; 95% CI, 1.39–2.15; HR, 2.71; 95% CI, 1.95–3.76) and poor functional outcome (odds ratio [OR], 1.36; 95% CI, 1.18–1.57; OR, 1.42; 95% CI, 1.07–1.87). High hemoglobin, but not anemia, increased the risk of stroke recurrence (HR, 1.37; 95% CI, 1.05–1.79) and composite vascular events (HR, 1.41; 95% CI, 1.08–1.83). There was a U‐shaped relationship between hemoglobin and mortality and poor functional outcome.

Conclusions

Abnormal hemoglobin was associated with a higher risk of all‐cause mortality, poor functional outcome, stroke recurrence, and composite vascular events. More well‐designed clinical studies are needed to confirm the relationship between hemoglobin and clinical outcomes after stroke.
Japan’s Diplomatic Proactive Stance towards Indochina and the Cambodian Problem (1970)
Authors: Frattolillo Oliviero
Published: November 2021

This article assesses the Japanese diplomatic contribution through the prism of the Indochinese political situation in the early 1970s. The traditional literature depicts Japan’s non-existent proactivism in postwar foreign politics, based on its alleged unconditional dependence on Washington’s political agenda. However, throughout the 1970s there were occasions in which the country showed how it was independently engaged at a diplomatic level. This has often been overlooked by the literature produced in the field, but it is an irrefutable conclusion from the historical evidence and the analysis of the archival sources. Japan’s diplomatic commitment in solving the problem of peace in Cambodia, its double effort as a diplomatic intermediary between the political actors involved in the Indochinese issue and, at the same time, through the ODA policy, may offer the missing elements for a no longer univocal interpretation of its postwar diplomatic history—which is the aim of this essay.
Technology as a Key Tool for the Prosecution of International Crimes: Lessons from Uganda
Authors: Kirabira Tonny Raymond
Published: November 2021

This article uses the context of Uganda to examine the role of technology in the prosecution of international crimes. It uses the International Criminal Court (icc)complementarity framework to analyse two cases — Dominic Ongwen and Thomas Kwoyelo, exploring a question — whether the use of technology enhances the icc’s positive complementarity approach? The article draws substantially from the review of empirical literature, qualitative interviews and the author’s work experiences at the two sites of justice - Uganda and The Hague. The article reveals a practical overlap between the two sites of justice in the use of digital evidence and witness protection. It is argued that use of technology enhances the criminal trial procedures, victims’ rights and the legitimacy of the courts. It is equally argued that the use of technology has the potential to enhance the icc’s complementarity approach. The article contributes to current debates about the role of technology in international criminal justice.
Conflict-Related Sexual Violence in Kosovo and Lessons to be Learned from the International Criminal Tribunal for the former Yugoslavia
Authors: Istrefi Remzije , Hajrullahu Arben
Published: November 2021

This article examines challenges in seeking justice for Conflict-Related Sexual Violence (crsv) survivors in Kosovo. It analyses the roles and responsibilities of international missions and how deficiencies impact the prosecution and adjudication of crsv by Kosovo’s justice system. A key question is why two decades after the 1998–1999 war in Kosovo survivors of crsv cannot find justice? The end of the international mandates, the large number of war crime cases transferred, unfinished files, and the necessity for specific expertise in handling the gender-based violence are some of the existing challenges which undermine the prosecution and adjudication of crsv in Kosovo. The International Criminal Tribunal for the former Yugoslavia (icty) established accountability for sexual violence in armed conflicts. This article seeks to scaffold the icty experience by developing an accurate and comprehensive understanding of the nature of crsv and by examining its impact on survivors and victims’ alike. This paper then explores how a contexualist interpretation of international and domestic criminal law provisions can prioritise the prosecution of crsv amid other pressing needs in Kosovo.
It’s a Trap! Re-Thinking Samuel Moyn’s Humane Beyond the North Atlantic
Authors: Gurmendi Dunkelberg Alonso
Published: November 2021

Samuel Moyn’s latest book, Humane: How the United States Abandoned Peace and Reinvented War, offers a compelling re-reading of the history of the laws of war not as the precursors of international humanitarian law, but as enablers of what he calls “inhumane war”. Instead of advancing the cause of humanization of war, Moyn argues in favour of pacificism and the abolition of war in its entirety. And yet, Moyn’s decision to tell his history through two interconnected but different parts – one on the broader history of the laws of war and another on the very recent present of US domestic politics – forces the book to embrace a North Atlantic, Anglo-American vision of international law that robs it of valuable insights from the Global South and its relationship to the same body of laws. In this review essay, I explore these missed connections seeking to offer a more global approach to the history of war and peace.
Cremastra saprophytica (Orchidaceae: Epidendroideae), a new leafless autonomously self-pollinating orchid species from Gifu Prefecture, Japan
Authors: SUETSUGU KENJI
Published: November 2021

A new species of Cremastra (Orchidaceae), C. saprophytica, is described from Gifu Prefecture, Japan. The new species is similar to C. aphylla in having a leafless and mycoheterotrophic habit. However, it is distinguishable from C. aphylla by its green stem, more closed perianth tube, smaller lateral lobes of lip, smaller callus of lip positioned at base of the midlobe and absence of a rostellum and viscidium. An illustration and ecological information on the new species are provided. A key to the Cremastra species is also provided.
Two new species of Monstera (Araceae: Monsteroideae) from the Pacific slope of the Andes in Colombia
Authors: ZULUAGA ALEJANDRO , CEDEÑO-FONSECA MARCO , MITTERMEIER MICHAEL
Published: November 2021

The genus Monstera is represented in Colombia by 20 species, 12 of them from the Pacific slope of the Andes. Fieldwork between 2017 and 2019 in this region and a thorough revision of the main Colombian herbaria allowed us to discover two undescribed species belonging to Monstera section Monstera. The two new species are described and illustrated using color photographs of vegetative and reproductive features from living material, and compared to Monstera oreophila, M. epipremnoides and M. dissecta from Central America.
A Noninferiority Analysis of 3‐ vs 2‐Incision Techniques for Hypoglossal Nerve Stimulator Implantation
Authors: Kent David T. , Chio Eugene G. , Weiner Jordan S. , Heiser Clemens , Suurna Maria V. , Weidenbecher Mark
Published: November 2021

Objective

The only hypoglossal nerve stimulation (HNS) device available for US clinical use is implanted through 3 incisions. A recently proposed 2‐incision modification moved the respiratory sensing lead from the fifth to the second intercostal space to eliminate the third lower chest incision. This study compared perioperative data and therapeutic outcomes between the techniques.

Study Design

Noninferiority cohort analysis of a retrospective and prospective registry study.

Setting

Tertiary care and community surgical centers.

Methods

Patients with obstructive sleep apnea underwent HNS implantation via a modified 2‐incision technique (I2). A cohort previously implanted via the standard 3‐incision technique (I3) were 1:1 propensity score matched for a noninferiority analysis of postoperative outcomes.

Results

There were 404 I3 patients and 223 I2 patients across 6 participating centers. Operative time decreased from 128.7 minutes (95% CI, 124.5‐132.9) in I3 patients to 86.6 minutes (95% CI, 83.7‐97.6) in I2 patients (P <. 001). Postoperative sleep study data were available for 76 I2 patients who were matched to I3 patients. The change in apnea‐hypopnea index between the cohorts was statistically noninferior (a priori noninferiority margin: 7.5 events/h; mean difference, 1.51 [97.5% CI upper bound, 5.86]). There were no significant differences between the cohorts for baseline characteristics, perioperative adverse event rates, or change in Epworth Sleepiness Score (P >. 05).

Conclusion

In a multicenter registry, a 2‐incision implant technique for a commercially available HNS device had a statistically noninferior therapeutic efficacy profile when compared with the standard 3‐incision approach. The 2‐incision technique is safe and effective for HNS implantation.
Employment and the distribution of intra-household financial satisfaction
Authors: Kalsi Jaslin K , Austen Siobhan , Mavisakalyan Astghik
Published: November 2021

This study applies a methodology used by De Henau and Himmelweit (2013) to study resource allocation in Australian mixed-sex couple households. Using 18 waves of data from the Household, Income and Labour Dynamics in Australia survey and by means of fixed effects estimations, the study identifies how men’s and women’s contributions via paid and unpaid work influences their satisfaction with the financial situation (SWFS) within households. Employment status is used to proxy each partner’s contribution to household resources. The results reveal that paid contributions through full-time employment have a strong role in determining SWFS. This is a source of gender difference because Australian men are much more likely to be engaged in full-time employment than women. Most often, for both men and women, unpaid contributions to household resources (proxied by less than full-time employment) has a detrimental effect on their own SWFS, but smaller effects on their partner’s SWFS. These results imply that gender asymmetry in paid and unpaid contributions to household resources contributes to the reproduction of gender inequalities within Australian households. The results add external validity to the relevance of De Henau and Himmelweit’s (2013) analysis of these issues.
Social attention in anorexia nervosa and autism spectrum disorder: Role of social motivation
Authors: Kerr-Gaffney Jess , Jones Emily , Mason Luke , Hayward Hannah , Murphy Declan , Loth Eva , Tchanturia Kate
Published: November 2021

Research suggests a relationship between anorexia nervosa and autism spectrum disorder. The aim of the current study was to examine social attention in anorexia nervosa and autism spectrum disorder compared with age- and sex-matched typically developing groups, and to examine whether lowered social motivation could explain reductions in social attention across the two disorders. Participants’ eye movements were tracked while watching a dynamic social scene. The proportion of fixation duration to faces, bodies and non-social areas of interest were compared across groups. Participants with autism spectrum disorder looked at faces significantly less often than controls, however, there were no differences between anorexia nervosa and controls in attention to faces. Typically developing -normed z-scores indicated that attention to faces showed the greatest deviation from normative data compared with body or non-social areas of interest in both autism spectrum disorder and anorexia nervosa, however, differences were larger in autism spectrum disorder than in anorexia nervosa. Social motivation scores did not predict attention to faces in either autism spectrum disorder or anorexia nervosa. Our results do not support the hypothesis that differences in social motivation underlie reduced social attention in both anorexia nervosa and autism spectrum disorder.

Lay abstract

Research suggests a relationship between autism and anorexia nervosa. For example, rigid and inflexible behaviour, a preference for routine and social difficulties are seen in both conditions. In this study, we examined whether people with anorexia and people with autism show similarities in social attention (where they look while engaging in social interactions or watching a scene with people interacting). This could help us understand why people with anorexia and autism experience difficulties in social situations. Participants with either anorexia or autism, as well as participants with no mental health problems watched a video of a social scene while we recorded which parts of the scene they looked at with an eye-tracker. Participants also completed questionnaires to assess characteristics of autism. We found that autistic participants looked at faces less than typically developing participants. However, participants with anorexia did not show a similar reduction in attention to faces, contrary to our predictions. Autistic features were not related to attention in either group. The results suggest that autistic people may miss important social cues (like facial expressions), potentially contributing to social difficulties. However, this mechanism does not appear explain social difficulties in people with anorexia.
Nonneutralizing FVIII-specific antibody signatures in patients with hemophilia A and in healthy donors
Authors: Schweiger Helmut , Rejtő Judit , Hofbauer Christoph J. , Berg Verena , Allacher Peter , Zwiauer Karl , Feistritzer Clemens , Schuster Gerhard , Ay Cihan , Reipert Birgit M. , Pabinger Ingrid
Published: November 2021

Previous studies identified nonneutralizing FVIII-specific antibodies in the circulation of severe and nonsevere hemophilia A (sHA and nsHA) patients without FVIII inhibitors and also in some healthy individuals. To gain a better understanding of the nature of these nonneutralizing antibody responses, we analyzed and compared anti-FVIII antibody signatures in 3 study cohorts: previously treated sHA as well as nsHA patients without FVIII inhibitors, and healthy donors. FVIII-binding IgM, IgG1-4, and IgA antibodies were differentiated, FVIII-specificity was assessed, and associated apparent affinity constants were determined. Our results indicate that the nonneutralizing FVIII-specific antibody response in all study cohorts is dominated by IgG1 and IgA. Prevalences, titers, and affinities of these nonneutralizing antibodies were higher in the hemophilia A cohorts than in healthy donors. Stratification for the anti-hepatitis C virus (HCV) antibody status demonstrated the presence of FVIII-specific IgA with elevated titers in sHA patients with an active or past HCV infection when compared with HCV antibody-positive nsHA patients or HCV antibody-negative patients and healthy donors. Increased titers and affinities of FVIII-specific IgG1 antibodies were observed in a considerable number of hemophilia A patients as opposed to healthy subjects independently of the patients’ anti-HCV antibody status. Overall, our findings support the hypothesis that the generation of nonneutralizing anti-FVIII antibodies in healthy individuals and in noninhibitor hemophilia A patients might be based on similar immune mechanisms. However, differences in prevalences, titers, and affinities of these antibodies indicate distinct differences in the antibody evolution between healthy individuals and patients.
Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study
Authors: Caballero-Milán Marta , Colomina Maria J. , Marin-Carcey Leo A. , Viguera-Fernandez Laura , Bayona-Domenge Roser , Garcia-Ballester Sara , López-Farre Albert , Ruiz-Buera Leticia , Sanz-Iturbe Maite , Álvarez-Villegas David , Jenssen-Paz Ely C. , Puig-Sanz Guillermo , Arcos-Terrones Aaron , Belmonte-Cuenca Carmen , Perelada-Alonso Elia , Blasco-Blasco Francho , Sabaté Antoni
Published: November 2021

Background

During the COVID-19 crisis it was necessary to generate a specific care network and reconvert operating rooms to attend emergency and high-acuity patients undergoing complex surgery. The aim of this study is to classify postoperative complications and mortality and to assess the impact that the COVID-19 pandemic may have had on the results.

Methods

this is a non-inferiority retrospective observational study. Two different groups of surgical patients were created: Pre-pandemic COVID and Pandemic COVID. Severity of illness was rated according to the Diagnosis-related Groups (DRG) score. Comparisons were made between groups and between DRG severity score-matched samples. Non-inferiority was set at up to 10 % difference for grade III to V complications according to the Clavien-Dindo classification, and up to 2 % difference in mortality.

Results

A total of 1649 patients in the PreCOVID group and 763 patients in the COVID group were analysed; 371 patients were matched for DRG severity score 3-4 (236 preCOVID and 135 COVID). No differences were found in relation to re-operation (22.5 % vs. 21.5 %) or late admission to critical care unit (5.1 % vs. 4.5 %). Clavien grade III to V complications occurred in 107 patients (45.3 %) in the PreCOVID group and in 56 patients (41.5 %) in the COVID group, and mortality was 12.7 % and 12.6 %, respectively. During the pandemic, 3 % of patients tested positive for Covid-19 on PCR: 12 patients undergoing elective surgery and 11 emergency surgery; there were 5 deaths, 3 of which were due to respiratory failure following Covid-19-induced pneumonia.

Conclusions

Although this study has some limitations, it has shown the non-inferiority of surgical outcomes during the COVID pandemic, and indicates that resuming elective surgery is safe.

Trial registration

Clinicaltrials.gov identifier: NCT04780594.
Inhibition of matrix stiffness relating integrin β1 signaling pathway inhibits tumor growth in vitro and in hepatocellular cancer xenografts
Authors: Wang Changsong , Jiang Xiaozhong , Huang Bin , Zhou Wenhao , Cui Xiao , Zheng Chenghong , Liu Fenghao , Bi Jieling , Zhang Yi , Luo Hong , Yuan Lin , Yang Jianyong , Yu Yu
Published: November 2021

Background

Cancer development is strictly correlated to composition and physical properties of the extracellular matrix. Particularly, a higher matrix stiffness has been demonstrated to promote tumor sustained growth. Our purpose was to explore the role of matrix stiffness in liver cancer development.

Methods

The matrix stiffness of tumor tissues was determined by atomic force microscopy (AFM) analysis. In vitro, we used a tunable Polyacrylamide (PA) hydrogels culture system for liver cancer cells culture. The expression level of integrin β1, phosphorylated FAK, ERK1/2, and NF-κB in SMMC-7721 cells was measured by western blotting analysis. We performed MTT, colony formation and transwell assay to examine the tumorigenic and metastatic potential of SMMC-7721 cells cultured on the tunable PA hydrogels. SMMC-7721 cancer xenografts were established to explore the anticancer effects of integrin inhibitors.

Results

Our study provided evidence that liver tumor tissues from metastatic patients possessed a higher matrix stiffness, when compared to the non-metastatic group. Liver cancer cells cultured on high stiffness PA hydrogels displayed enhanced tumorigenic potential and migrative properties. Mechanistically, activation of integrin β1/FAK/ ERK1/2/NF-κB signaling pathway was observed in SMMC-7721 cells cultured on high stiffness PA hydrogels. Inhibition of ERK1/2, FAK, and NF-κB signaling suppressed the pro-tumor effects induced by matrix stiffness. Combination of chemotherapy and integrin β1 inhibitor suppressed the tumor growth and prolonged survival time in hepatocellular cancer xenografts.

Conclusion

A higher matrix stiffness equipped tumor cells with enhanced stemness and proliferative characteristics, which was dependent on the activation of integrin β1/FAK/ERK1/2/NF-κB signaling pathway. Blockade of integrin signals efficiently improved the outcome of chemotherapy, which described an innovative approach for liver cancer treatment.
Outcomes of management of intestinal obstruction at an urban tertiary hospital in sub Saharan Africa: a cross-sectional study
Authors: Nakanwagi Arlene Muzira , Kijjambu Stephen C. , Ongom Peter , Luggya Tonny Stone
Published: November 2021

Background

Intestinal obstruction (IO) is a common cause of acute abdomen globally, it remains challenging as it increases surgical financial expenditure while also causing major morbidity. Clinically it presents with nausea, vomiting, colicky abdominal pain and cessation of bowel movements or passage flatus and stool. Diagnosis, especially in resource limited settings, can be clinical but is usually confirmed radiologically. We studied the current diagnosis, management and outcomes of IO in Mulago Hospital.

Materials and methods

This was a prospective study done at all the surgical units of Mulago from January to May 2014 to assess general diagnosis and management of IO. Ethical approval was got in line with Helsinki declaration, we used pretested and validated questionnaires to collect data. Informed consent was got with eligible and consenting/assenting patients that fitted the inclusion criteria of age and presenting with suspected intestinal obstruction. Uni-variate and bi-variate variables analysis was done plus measures of association.

Results

We enrolled 135 patients, excluded 25 and recruited 110 patient. We had more males than females i.e. 71.8% males and 28.2% females. Colicky abdominal pain, abdominal distension, and vomiting were commonest symptoms, then abdominal distension, increased bowel sounds and abdominal tenderness were the commonest signs. Most patients’ (51%) were diagnosed radiologically with a lesser number clinically diagnosed. “Dilated bowel loops” was the commonest radiological sign. Surgery was the main stay of management at 72.7% while 27.3% were conservatively managed. Postoperatively the bowels opened averagely on the 3rd post-operative day (POD) with return of bowel sounds occurring on 5th POD. Most discharges (73%) occurred by the 7th POD. Unfavourable outcomes were prolonged hospital stay followed by wound sepsis (surgical site infection) and then Mortality.

Conclusion

This study noted that In Mulago we mostly diagnosed patients radiologically with most surgically managed and which is similar to regional practices. Postoperatively bowel opening happening on third POD with return of bowel sounds on fifth POD. Prolonged hospital stay followed by wound sepsis and then mortality were commonest unfavorable management outcomes.
Women's knowledge about the genitourinary syndrome of menopause: adherence to its treatments in the COVID-19 era in a sample of them: COMEM-GSM study
Authors: Baquedano Mainar Laura , Sánchez Méndez Sonia , Dieste Pérez Peña , Hernández Aragón Mónica , Mendoza Ladrón de Guevara Nicolás ,   the COMEM Study Spanish investigators, Baquedano L. , Espiau A. , Ortega S. , Ruiz L. , Lamarca M. , José Y. , Rubio P. , Villalobos F. , Borque A. , Dieste P. , Gabasa L. , Roy V. , Puente M. J. , Chóliz M. , Cotaina L. , Negredo I. , del Tiempo P. , Yagüe H. , Hernández M. , Tajada P. , Fasero M. , Ramirez I. , Gutiérrez L. , Colmenarejo F. , Coronado P. , Aznar T. , Presa J. , Llaneza P. , Borrego R. Sánchez , Palacios S. , Jurado Ana R.
Published: November 2021

Objective

To study knowledge regarding genitourinary syndrome of menopause (GSM) and the treatments for it and to analyze treatment adherence during the COVID-19 confinement.

Methods

Multi-center observational study including women between 35 and 75 years. An extension study of treatment adherence was conducted during the coronavirus pandemic between March and April 2020.

Results

A sample of 2355 women were included. Vaginal dryness was the most frequently identified symptom (74.3%). Lubricants were the best-known treatments (69.6%), followed by local estrogens (25.7%); 66% of the women did not speak to their gynecologist about sexuality. Comparative analyses were conducted according to age, menopausal status, type of menopause, place of residence, type of health care received and level of education. During the coronavirus confinement period, adherence to treatments for vulvovaginal atrophy was poor in 72.5% asked (n = 204). Reduced sexual activity (p > 0.001) and coronavirus diagnosis (p = 0.003) were significantly associated with poorer treatment compliance.

Conclusions

There is great lack of knowledge of the treatments used for GSM. Most women do not talk to their gynecologist about sexuality. Adherence to treatments during the coronavirus confinement has been worryingly low.
Client satisfaction on community based health insurance scheme and associated factors at Boru Meda Hospital, Northeast, Ethiopia: institutional based cross-sectional study
Authors: Hailie Mulugeta Tasew , Hassen Seid Legesse , Temesgen Minwuyelet Maru
Published: November 2021

Background

Community-based health insurance systems are usually voluntary and characterized by community members pooling funds and protecting themselves against the high costs of seeking medical care and treatment for illness. Client satisfaction with health service provision during the implementation of health insurance schemes has often been neglected. This study aimed to determine client satisfaction with the community-based health insurance scheme and associated factors.

Methods

An institutional-based cross-sectional study design was applied from February 22–March 11 /2019. A total of 420 study participants were included in the study using a systematic random sampling technique. Data were collected using a pretested semi-structured interviewer-administered questionnaire with a patient exit interview. Bivariate and multivariate logistic regression analyses were used to identify factors associated with Community-based Health Insurance of client satisfaction. Statistical significance was decided at a p-value less than 0.05.

Result

A total of 420 community-based health insurance clients of health service users participated in the study with a 100% response rate. The overall client satisfaction was 80% at 95% Cl (76.1, 83.9), respondents who have perceived that partially or none availability of prescribing drugs were 0.09 times less likely satisfied as compared to full availability of prescribing drugs (AOR =0.09; 95% Cl: (0.04, 0.19)). Besides, study participants waiting time to consult service providers within 30 min were more satisfied than those who were delayed 60 min and above (AOR =3.16; 95% Cl: (1.19, 8.41)).

Conclusion

Community-based health insurance client satisfaction provided in the present study was 80% indicating low proportion. Full availability of prescribing drugs, clients renewed their community-based health insurance membership, and preference of clients to use the hospital for future health care need were positively associated with client satisfaction while the perception of waiting time before physician consultation negatively affected client’s satisfaction. Therefore, the hospital management members and service providers need to give attention to reduce waiting time preceding consultation, improve drug availability, and sustain the hospital preference by the client.
Adapting to change: Clalit's response to the COVID-19 pandemic
Authors: Lavie Gil , Weinstein Orly , Segal Yoram , Davidson Ehud
Published: November 2021

The COVID-19 pandemic is the most significant global health event of the past century. The profound and unexpected changes that it brought about have forced healthcare organizations to make far-reaching adjustments to accommodate the new reality. With the outbreak of the pandemic in Israel and the understanding of its consequences, Clalit Health Services (Clalit), the largest healthcare organization in Israel, rapidly mobilized in order to provide the best response possible from the perspective of both its patients and its employees. In the short term, four designated workgroups were established just days into the pandemic. Their task was to prepare operational work plans to achieve the following goals: providing the best possible treatment for COVID patients; maintaining the level of care for non-COVID patients; protecting healthcare personnel without compromising their competence and level of functioning; and beginning the process of post-crisis planning. In the context of the long term, and with the understanding that the changes in healthcare brought about by the COVID-19 pandemic would be long-lasting and irreversible, and would act as a catalyst in Clalit’s preparations for the future, Clalit has carried out the called-for modifications in its organizational strategy. This was based on the need to shift service and treatment foci from the hospitals to the community and the patient’s home and his cellular device, by means of strengthening Clalit’s strategic abilities to become more proactive, more digital and more home-based. In this article, we present a survey of Clalit’s preparations for the new reality in the short and medium terms, as well as the leveraging of insights gained during the first wave of the pandemic, with goal of revising Clalit’s long-term strategic plan. We conclude and point out the organizational abilities required for optimal response to future large-scale emergencies: The ability to quickly identify the need for change, respond quickly while harnessing the various parts of the organization in order to provide an agile and adaptive response, and facilitate long-term planning activity in parallel to providing an operational response in the short and medium terms.
Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: a collaborative-practice model
Authors: Hussain Kashif , Ikram Rahila , Ambreen Gul , Salat Muhammad Sohail
Published: November 2021

Background

Therapeutic drug monitoring (TDM) of Vancomycin (VCM) is required to prevent inappropriate dosage-associated bacterial resistance, therapeutic failure, and toxicities in pediatrics. Anecdotal experience and studies show that many healthcare institutions confront barriers while implementing TDM services, this study aimed to assess a pharmacist-directed VCM–TDM service for optimizing patient care in our institution.

Materials and methods

Patients aged 1 month–18 years who received intravenous VCM were included in this quasi-experimental study. The pre-implementation phase (March–June 2018) consisted of retrospective assessment of pediatric patients, the interventional phase (July 2018 to February 2020) included educational programs and the post-implementation phase (March–June 2020) evaluated the participants based on pharmacist-directed VCM–TDM services as a collaborative-practice model including clinical and inpatient pharmacists to provide 24/7 TDM services. Outcomes of the study included the mean difference in the number of optimal (i) prescribed initial VCM doses (primary) (ii) dosage adjustments and (iii) VCM-sampling time (secondary). After ethical approval, data were collected retrospectively.

Results

A hundred patients were there in each phase. The number of cases who were correctly prescribed initial VCM doses was significantly higher in the post-implementation phase, mean difference of 0.22, [95% CI (0.142–0.0.358), p < 0.0001]. Patients who had correct dosage adjustments in the post-implementation phase also had higher statistical significance, mean difference of 0.29, [95% CI (0.152–0.423), p < 0.05]. More correct practices of VCM-levels timing were observed in the post-implementation phase, mean difference of 0.15, [95% CI (− 0.053–0.264), p = 0.079].

Conclusion

This study showed the significant role of pharmacist-directed TDM services to optimize the correct prescribing of initial VCM doses and dose adjustments.
Culture learning in a daily space of kitchen: the case of Korean digital kitchen
Authors: Park Jaeuk
Published: November 2021

The rapid advancement of technology has allowed computer-assisted language learning (CALL) to have made inroads in the area of pedagogy for language and culture learning. While the majority of studies have used online and virtual environments for culture learning, very little attention has been paid to a real world environment. This study is based on a digital kitchen where students can learn foreign language, culture and cuisine at the same time through cooking tasks. Learning cultural aspects can be properly realised via cooking because the daily activity provides a window into culture, and the digital kitchen provides users with opportunities to directly encounter the target culture themselves via cooking and tasting. 48 international participants conducted two cooking sessions, one in a digital kitchen using real objects and the other in a classroom by looking at typical pictures/photos in a textbook. A range of data sources were employed, such as questionnaires, semi-structured interviews and video-observations to answer the research question. It was found that students learned foreign cultural aspects better when in direct engagement in a digital kitchen by handling actual items than when in a classroom by simply using photos. This study contributes to the development of the real world learning environment for culture learning via innovative technology.
Determinants of asthma in Ethiopia: age and sex matched case control study with special reference to household fuel exposure and housing characteristics
Authors: Abebe Yonas , Ali Ahmed , Kumie Abera , Haile Tewodros , Tamire Mulugeta , Addissie Adamu
Published: November 2021

Background

Asthma is a chronic inflammatory disorder characterized by airway obstruction and hyper-responsiveness. Studies suggest that household fuel exposure and housing characteristics are associated with air way related allergy. But there remains to be a considerable uncertainty about whether that reflects an association with asthma. This study endeavored to bridge the gap by identifying factors associated with asthma, with special reference to household fuel exposure and housing characteristics in selected public hospitals in Addis Ababa, Ethiopia.

Methods

We conducted a hospital-based matched case-control study. A total of 483 study participants were selected from two Ethiopian referral hospitals using a sequential sampling technique, with 161 cases and 322 controls. Standard questionnaire from the European Community Respiratory Health Survey II (ECRHS II) and the American Thoracic Society Division of Lung Disease (ATS-DLD-78) were used to collect household related data. Conditional logistic regression model was applied to identify the determinants of asthma. Both crude and adjusted odds ratios with 95% confidence interval (CI) were used to identify predictors of asthma.

Results

The response rate for both cases and controls was 99.17%. The odds of developing asthma was about four times higher among those who used agricultural residues for cooking (AOR: 3.81, 95% CI: 1.05, 13.79)., about five times higher among those who used wood for cooking (AOR: 4.95, 95% CI: 2.1, 11.69), nearly five times higher among those who had family history of asthma (AOR: 4.72, 95% CI: 1.54, 14.45), just over six times higher among those who smoke tobacco (AOR: 6.16, 95% CI: 1.31, 29.09) and over ten times higher among those who do not practice door opening, while cooking (AOR: 10.25, 95% CI: 3.97, 26.49).

Conclusion

Family history of asthma, tobacco smoking, use of solid fuels including, woods and agricultural residues were associated with development of asthma. To reduce the risk of asthma, people should practice door opening, while cooking, and must avoid using wood and agricultural residues for cooking and should also refrain from tobacco smoking.
Lhermitte duclos disease: what to expect during surgery?
Authors: Kumar Sanjeev , Sahana Debabrata , Jain Amit , Rathore Lavlesh , Tawari Manish , Mittal Jatinder , Sahu Rajiv
Published: November 2021

Lhermitte and Duclos first described the dysplastic gangliocytoma of the cerebellum in 1920. In the last 100 years, its clinical presentation, radiological features, pathological characteristics, and association with Cowden syndrome have been well described. However, documentation of surgical experiences is lagging. We here describe intraoperative experience during the removal of the tumor, which could help the operating surgeon plan and mental makeup.
Asymmetric effect of financial development and remittance on economic growth in MINT economies: an application of panel NARDL
Authors: Odugbesan Jamiu Adetola , Sunday Tomiwa Adebayo , Olowu Gbolahan
Published: November 2021

The empirical analysis examines the asymmetric effect of financial development and remittance on economic growth in MINT nations (Mexico, Indonesia, Nigeria, and Turkey). The present study utilized panel data covering the period from 1980 to 2019. The research objectives are to address the questions: (a) Is there a long-run association between economic growth and the regressors? (b) Do financial development and remittance trigger MINT nations' economic growth? Moreover, the present study applied both linear panel ARDL and the novel panel nonlinear ARDL to capture the asymmetric impact of development and remittance on economic growth. The outcomes of the linear ARDL disclosed that both financial development and remittance triggers economic growth positively. Furthermore, the outcomes of the NARDL disclosed that both positive and negative shocks in financial development increase economic growth. In addition, a positive and negative shock in remittance increases economic growth in the long-run.
Assessment and treatment of hypersexuality: a review
Authors: Elrafei Heba , Jamali Qutub
Published: November 2021

Hypersexuality is defined under various terms in the DSM and ICD diagnostic classifications. However, it can be challenging to differentiate between hypersexuality as one of the symptoms of a mental disorder and hypersexual disorder as a primary diagnosis. In this article, we explore the physiology, assessment and treatment of hypersexual disorder, and consider its aetiology and epidemiology. In addition, we highlight the paucity of evidence in the literature about licensed or specific pharmacological recommendations for its treatment and the poor awareness of hypersexuality in clinical and research practice. Further research is recommended to identify more precise guidance for the pharmacological management of hypersexuality.
Centralization vs. Decentralization in COVID-19 Responses: Lessons from China
Authors: Lv Aofei , Luo Ting , Duckett Jane
Published: November 2021

Researchers have begun to examine whether centralized or decentralized (or federal) political systems have better responded to the COVID-19 pandemic. In this article, we probe beneath the surface of China's political system to examine the balance between centralized and decentralized authority in China's handling of the pandemic. We focus not on the much-studied later response phase but on the detection and early response phases. We show that after the SARS epidemic of 2003, China sought to improve its systems by both centralizing early infectious disease reporting and decentralizing authority to respond to local health emergencies. But these adjustments in the central–local balance of authority after SARS did not change “normal times” authority relations and incentive structures in the political system—indeed they strengthened local authority. As a result, local leaders had both the enhanced authority and the incentives to prioritize tasks that determine their political advancement at the cost of containing the spread of COVID-19. China's efforts to balance central and local authority show just how difficult it is to get that balance right, especially in the early phases of a pandemic.
Prep School for Poor Kids: The Long-Run Impacts of Head Start on Human Capital and Economic Self-Sufficiency
Authors: Bailey Martha J. , Sun Shuqiao , Timpe Brenden
Published: November 2021

This paper evaluates the long-run effects of Head Start using large-scale, restricted administrative data. Using the county roll-out of Head Start between 1965 and 1980 and age-eligibility cutoffs for school entry, we find that Head Start generated large increases in adult human capital and economic self-sufficiency, including a 0. 65-year increase in schooling, a 2.7 percent increase in high school completion, an 8.5 percent increase in college enrollment, and a 39 percent increase in college completion. These estimates imply sizable, long-term returns to investments in means-tested, public preschool programs. (JEL I21, I26, I28, I38, J24)
Delegation in Veto Bargaining
Authors: Kartik Navin , Kleiner Andreas , Van Weelden Richard
Published: November 2021

A proposer requires a veto player’s approval to change a status quo. Proposer is uncertain about Vetoer’s preferences. We show that Vetoer is typically given a non-singleton menu, or delegation set, of options to pick from. The optimal set balances the extent of compromise with the risk of a veto. We identify conditions for certain delegation sets to emerge, including “full delegation”: Vetoer can choose any action between the status quo and Proposer’s ideal action. By contrast to expertise-based delegation, Proposer gives less discretion to Vetoer when their preferences are more (likely to be) aligned. (JEL D72, D82)