bluuebunny/crossref_metadata_2025 huggingface dataset:
The “Unruly” Space: Tanjong Piandang, a Pirates’ Haven to a Fishing Village
Authors: Tan Miau Ing
Published: October 2022

Tanjong Piandang is a Chinese fishing village in Krian, Perak, Malaysia. It first appeared in Anderson’s work in 1824 as a favorite resort for pirates. The people in Tanjong Piandang had the reputation of being a lawless and turbulent lot, and the British colonial government tried to demolish the settlement twice by burning it down after riots. Each time, villagers gathered together and rebuilt their houses. This paper investigates how the colonial government tried to maintain law and order in this space, and the local resistance that attempted, though ultimately failed, to keep the colonial power out their village. Most of the studies on the grassroots resistance against British rule in Malaya are concentrated on the local Malay communities, not on the Chinese who are considered as a migrant community. Therefore, Tanjong Piandang is a good case study of Chinese resistance against the British.
Disintegration in the Age of COVID-19: Biological Contamination, Social Danger, and the Search for Solidarity
Authors: Abrutyn Seth
Published: October 2022

Like any disaster, COVID-19 laid waste to infrastructure and the ability for a community to do community. But, unlike a tornado or nuclear meltdown, COVID-19 laid waste to social infrastructure in unique ways that only a disease can do. On the one hand, a pandemic brings biological dangers that, in turn, make all individuals—loved ones, too—into potential threats of biological contamination. On the other hand, the efforts to contain disease present social dangers, as isolation and distancing threatens mundane and spectacular ritualized encounters and mask-wearing heighten our awareness of the biological risk. By exploring the link between disasters and disease, this paper leverages the lens of contamination, beginning first with the barriers it presents to making and remaking the self in everyday life. Constraints on ritualized encounters, both in terms of delimiting face-to-face interaction and in determining that some spaces have contaminative risks, reduces collective life to imagined communities or shifts to digitally mediated spaces. The former intensifies the sense of anomie people feel as their social world appears as though it were disintegrating while the latter presents severe neurobiological challenges to reproducing what face-to-face interaction habitually generates. Finally, these micro/meso-level processes are contextualized by considering how institutions, particularly polity but also science, manage collective risk and how their efficacy may either contribute to the erosion of solidarity or provide a sense of support in the face of anomic terror. Using the US to illustrate these processes, we are able to show how an inefficacious state response weakens the already tenuous connective tissue that holds a diffuse and diverse population together, while also exposing and intensifying existing political, economic, and cultural fissures, thereby further eroding existing solidarity and the capacity to rebuild post-pandemic cohesion.
Motor Competence Among Irish Adolescents: An Investigation of Sex Differences and Relatedness Between Fundamental Movement Skills and Functional Movement
Authors: Philpott Conor , Donovan Brian , Belton Sarahjane , Lester Diarmuid , Chambers Fiona , O’Brien Wesley
Published: October 2022

In prior research, Irish youth displayed poor motor competence across fundamental movement skills (FMS) and functional movements (FM). Our purpose in this study was to compare FMS and FM across male and female Irish adolescents and to determine whether there are associations between these movement domains. We collected data on 373 adolescents (178 females; M age = 14.38, SD = 0.87 years) from six Irish secondary schools, including motor competence testing of 10 FMS, and 7 FM. Overall levels of motor competence of both FMS and FM were low, and certain levels of dysfunctional movement were high. We observed significant sex-based differences in both FMS and FM, and there was a moderate association between FMS and FM that warrants further investigation. There is a need for societal intervention and policy changes to address low levels of motor competence among adolescent youth.
Communication in interfaith and multiethnic-racial families: Navigating identity and difference in family relationships
Authors: Warner Colaner Colleen , Atkin Annabelle L. , Elkhalid Amnee , Minniear Mackensie , Soliz Jordan
Published: October 2022

The current manuscript provides a critical review of family communication in multiethnic-racial and interfaith families. The review specifically focuses on differences related to religious and ethnic-racial identity, given that both are salient aspects of self-concept tied to psychosocial well-being, exist in a sociocultural environment characterized by racialized structures and systems of privilege, have been problematized through a deficit approach, and have implications for how to constructively address religious and ethnic-racial differences outside of the family. We begin by defining the three core concepts: (a) interfaith, (b) multiethnic-racial, and (c) family. We then discuss our methodology for selecting and reviewing empirical research and provide a synthesis of findings for each family type. We specifically address how interfaith then multiethnic-racial families communicate to address socialization and identity development, integrate differences, and combat bias. We conclude with a critical summary, arguing that interfaith and multiethnic-racial families are more accurately characterized through their strengths rather than difficulties. We point to limitations of current work, namely that research is largely based on Western perspectives on race/ethnicity and Ibrahimic religious traditions, that children and adolescent perspectives are relatively absent, and that the research tends to primarily focus on communication between couples or in parent-child relationships rather than extended family networks. Trajectories for future research include a focus on the manner in which communication surrounding identity and difference impacts self-concept and psychosocial well-being as well as contextualizing experiences of multiethnic-racial and interfaith families within the sociocultural environment. Our articulated conceptual landscape and synthesis of the research shed light on these complex relationships and encourage ongoing scholarship on these relatively understudied family forms.
Impact of Driver Behavior and Vehicle Type on Safety of Vehicle Platoon Under Lane Change Situation
Authors: Shin Yong Woo , Kim Dong-Kyu , Kim Eui-Jin
Published: October 2022

Lane changes are critical contributors to road traffic safety on highways. Among the safety indexes aimed at evaluating the risk associated with lane changes, the lane-change risk index (LCRI) is used to determine the collision probability of a platoon of vehicles during lane-change maneuvers. This study estimated the impact of driver behavior and vehicle type on the LCRI using individual vehicle trajectory data from the Next Generation Simulation (NGSIM) program. We define the subject vehicle (i.e., a vehicle changing lane) and its surrounding vehicles (i.e., front, rear, lead, and lag vehicles) as a platoon. Each vehicle type (i.e., truck, bus, car, and motorcycle) and driver behavior (i.e., aggressive, ordinary, and timid) were categorized for regression analysis. Driver behavior was classified through time–space deviations between each vehicle’s trajectories and expected trajectories using Newell’s car-following model. In addition, to take into account the heterogeneity among the lanes, this study used a linear mixed model, which reflected fixed and random effects. Two unique findings were that (i) we were able to quantify and analyze the complex interaction between vehicle type and driver behavior within the platoon during lane changes, and (ii) using the random parameter model, the influence of vehicle type and driver behavior in the platoon was heterogeneous, depending on the lane. The findings of this study are expected to provide detailed lane-change strategies for autonomous vehicles as well as to evaluate the causative factors of lane-change risk.
Work-Related Musculoskeletal Symptoms and Associated Factors Among Academic Staff in Ethiopian Universities
Authors: Zenbaba Demisu , Sahiledengle Biniyam , Dibaba Diriba , Tufa Tilahun , Mamo Ayele , Atlaw Daniel
Published: October 2022

Background:

Work-related musculoskeletal symptoms (WMSs) are common injuries or pains that primarily affect various body structures. It is difficult to estimate the burden of WMSs in developing countries such as Ethiopia due to a lack of evidence, particularly among university academic staff. There is a universal and rapidly growing need for information about WMSs, as this is the main challenge to public health and economic burden. The purpose of this study was to determine the magnitude of work-related musculoskeletal symptoms and their associated factors among academic staff in Ethiopian universities.

Methods:

From February 2 to March 24, 2021, a web-based cross-sectional study was conducted among 422 academic staff members working in Ethiopian universities. A structured and self-administered Google Form questionnaire was sent and shared with the academic staff via their email addresses, Facebook, and Telegram accounts. Using a p-value of <0.05 and a 95% confidence interval, multivariable logistic regression was used to identify factors associated with the outcome variable.

Results:

Around 321 (77.2%) of the 416 participants were reported to have work-related musculoskeletal symptoms at least in one part of the body (95% CI: 73.1, 81.5%), with 28.1% reporting lower back pain. Respondents working in second-stage universities (AOR = 7.35, 95% CI 3.21, 16.79), being 44 years old or older (AOR = 7.89, 95% CI 2.10, 21.57), having a Ph.D. (AOR = 7.09, 95% CI 1.50, 17.93), engaging in physical activity (AOR = 3.32, 95% CI 1.43, 7.74), and working on a computer (AOR = 6.89, 95% CI 2. 0.72, 19.15) were the factors associated with work-related musculoskeletal symptoms.

Conclusion:

Almost three-quarters of academic staff reported work-related musculoskeletal symptoms in this survey. Factors such as university establishment stage, age, educational status, physical activity, and frequent computer use were found to be significantly associated with work-related musculoskeletal symptoms.
Technologies of justice: forensics and the evolution of transitional justice
Authors: Kovras Iosif
Published: October 2022

Despite growing scholarly attention to normative and institutional influences promoting international accountability, limited attention has been paid to the transformative role of forensic technologies in reshaping how societies deal with their violent past. The paper contributes to transitional justice debates by revealing the revolutionary, yet undertheorized, role of forensic technologies of justice in advancing victims’ struggle for truth, accountability, and human rights. On one hand, the application of forensic tools has enabled the identification of human remains for humanitarian purposes, while, on the other hand, incriminatory evidence from exhumations is deemed critical to secure the conviction of perpetrators of gross human rights violations. Drawing on interviews with judges, prosecutors, forensic experts, and policymakers, the paper traces the specific pathways through which these tools affect accountability in post-conflict settings. It sheds light on the relationship between the availability of forensic tools to investigate human rights violations and the evolution of transitional justice.
Human Reproduction and Infertility in the Hebrew Bible
Authors: Vivian Eleanor
Published: October 2022

Given the biblical imperative to humanity to “be fruitful and multiply” (Gen. 1.28; see also 9.1, 7; 35.11) and the fact that several biblical narratives hinge on a woman’s reproductive incapability (Gen. 16–18; 21; 25.21–34; 30.1–24; Judg. 13; 1 Sam. 1), it is not surprising that there are extensive studies of human reproduction and infertility. The emergence of feminist criticism in the 1970s–1990s led to a particular focus on the way in which the biblical texts present the contribution of women to the procreative process, and many studies analyze the barren woman motif. Yet the various methodological and hermeneutical approaches applied to the study of human fertility and reproduction leads—somewhat inevitably—to a range of conflicting opinions on the role of the respective parties (the male, the deity, and the female) in reproduction and inducing fertility.
Machine learning for Internet of things anomaly detection under low-quality data
Authors: Han Shangbin , Wu Qianhong , Yang Yang
Published: October 2022

With the popularization of Internet of things, its network security has aroused widespread concern. Anomaly detection is one of the important technologies to protect network security. To meet the needs of automatic and intelligent detection, supervised machine learning is widely used in anomaly detection. However, the existing schemes ignore the problem of data quality, which leads to the unsatisfactory detection effect in practice. Therefore, practitioners may not know which algorithm to choose due to the lack of review and evaluation of anomaly detection methods under low-quality data. To address this problem, we give a detailed review and evaluation of six supervised anomaly detection methods, as well as release the core code of feature extractor for pcap format traffic traces and anomaly detection methods for reuse. We evaluate the methods on two public datasets (one is a simulated network dataset and the other is a real Internet of things dataset). We believe that our work and insights will help practitioners quickly understand and develop anomaly detection schemes for Internet of things and can provide reference for future research.
Methotrexate Induces an Antioxidant Hormetic Response in Primary Rat Astrocytes
Authors: Luna-López Armando , Flores-González Giovanna Adonahi , Rivera-Ruz Itzel Alejandra , Librado-Osorio Raúl , Erosa-De Haro Luis Alberto , Königsberg Mina , Alarcón-Aguilar Adriana
Published: October 2022

Neurodegenerative diseases have increased worldwide in recent years. Their relationship with oxidative stress has motivated the research to find therapies and medications capable of suppressing oxidative damage and therefore slowing the progression of these diseases. Glutathione (GSH) is the most important cellular antioxidant in living beings and is responsible for regulating the cellular redox state. However, GSH cannot be administered by any route of administration, so molecules that increase its levels by activating Nrf2-ARE signaling pathway are explored; since Nrf2 regulates the main genes involved in GSH de novo synthesis and recycling. Astrocytes are the most important cell-type in the antioxidant cell response and are responsible for providing GSH and other substrates for neurons to have an efficient antioxidant response. Methotrexate (MTX) is an anti-inflammatory agent that has different cellular effects when administered at low or high concentrations. So in this study, we used MTX different concentrations and exposure times to induce a hormetic antioxidant response in rat primary astrocytes. Our results showed that 20 nM MTX pre-conditioning for 12 h augmented the GSH/GSSG ratio and protected cellular viability against a toxic MTX and H2O2 insult, which was abrogated when Nrf2 was inhibited by brusatol. Hence, MTX subsequent studies as a drug to counteract the progression of some stress-associated neurodegenerative diseases are suggested.
Cross-Cultural Adaptation, Reliability, and Content Validity of Thai Version of Workplace Violence in the Health Sector Country Case Study Questionnaire
Authors: Khiaw-im Nareewan , Aimyong Natnaree , Wongrathanandha Chathaya , Tangsangwornthamma Chaturon
Published: October 2022

Introduction/Objectives:

Workplace violence against healthcare workers has been a global problem including Thailand. However, the study has been limited partly due to lack of the standardized tool in Thai context. Therefore, this study aims to translate “Workplace Violence in the Health Sector Country Case Studies Research instruments,” conducted by WHO, and to validate Thai version questionnaire.

Methods:

The study was conducted to translate Workplace Violence in the Health Sector Questionnaire by WHO from English to Thai. A sample of 92 participants was accidentally selected among physicians, nurses, and health-supporting workers who took part on examined the validity and reliability of the questionnaire. The internal consistency was calculated using Cronbach’s Alpha Coefficient.

Results:

The study demonstrated that the index of item-objective congruence (IOC) of Thai version questionnaire is 0.75 to 1. Cronbach’s Alpha Coefficient in Physical violence is .879, Verbal abuse is .934, Bullying/mobbing is .510, and health sector employer is .842.

Conclusion:

The Thai Version of Workplace Violence in the Health Sector Questionnaire apparently shows good validity and reliability. The questionnaire could be applied to be a useful tool for studying workplace violence in the health sector.
Volatile Organic Compounds, Evaluation Methods and Processing Properties for Cooked Rice Flavor
Authors: Zheng Zichen , Zhang Chao , Liu Kewei , Liu Qiaoquan
Published: October 2022

Rice (Oryza sativa L.), as the main refined grain in China, has attracted much attention in terms of quality. Rice is usually consumed after cooking, and it is a commonly staple food. Nowdays, people's requirements for cooked rice focus more on the taste characteristics and quality. Furthermore, aroma is one of the primary sensory reference points, which is the most intuitive way for people to judge cooked rice. By integrating and analyzing the researches of cooked rice aroma identification in recent five years, this paper expounds the extraction and identification methods (sensory evaluation method, GC-MS, SPME, MOS sensors, electronic nose, etc.) of the flavor substances in cooked rice, as the processing methods and properties of cooked rice, and the volatile organic compounds of cooked rice under different conditions are summarized as well.

Graphical abstract
The maximum entropy principle for compositional data
Authors: Weistuch Corey , Zhu Jiening , Deasy Joseph O. , Tannenbaum Allen R.
Published: October 2022

Background

Compositional systems, represented as parts of some whole, are ubiquitous. They encompass the abundances of proteins in a cell, the distribution of organisms in nature, and the stoichiometry of the most basic chemical reactions. Thus, a central goal is to understand how such processes emerge from the behaviors of their components and their pairwise interactions. Such a study, however, is challenging for two key reasons. Firstly, such systems are complex and depend, often stochastically, on their constituent parts. Secondly, the data lie on a simplex which influences their correlations.

Results

To resolve both of these issues, we provide a general and data-driven modeling tool for compositional systems called Compositional Maximum Entropy (CME). By integrating the prior geometric structure of compositions with sample-specific information, CME infers the underlying multivariate relationships between the constituent components. We provide two proofs of principle. First, we measure the relative abundances of different bacteria and infer how they interact. Second, we show that our method outperforms a common alternative for the extraction of gene-gene interactions in triple-negative breast cancer.

Conclusions

CME provides novel and biologically-intuitive insights and is promising as a comprehensive quantitative framework for compositional data.
Rapid and simultaneous detection of multiple pathogens in the lower reproductive tract during pregnancy based on loop-mediated isothermal amplification-microfluidic chip
Authors: Xu Xiaofang , Jia Yiguo , Li Ruolin , Wen Yuting , Liang Yuchen , Lao Guangjie , Liu Xiaojuan , Zhou Wei , Liu Huawei , Xie Jiang , Wang Xiaoxia , Xu Wenming , Sun Qun
Published: October 2022

Background

Female reproductive tract infection (RTI) is the common source of varied diseases, especially as an important risk factor for pregnancy outcomes, therefore the rapid, accurate and simultaneous detection of multiple pathogens is in urgent need for assisting the diagnosis and treatment of RTI in pregnant women. Streptococcus agalactiae (S. agalactiae), Enterococcus faecalis (E. faecalis), Gardnerella vaginalis (G. vaginalis), Candida albicans (C. albicans) and Chlamydia trachomatis (C. trachomatis) are five main pathogens in lower genital tract with high risk, serious consequences and clinical demands. The combination of loop-mediated isothermal amplification (LAMP) and microfluidic technology was used to develop the LAMP-microfluidic chip for rapid, simple, sensitive and simultaneous detection of the five target pathogens above.

Results

Standard strains and clinical isolates were used for the establishment of the novel LAMP method in tube and LAMP-microfluidic chip, followed by the chip detection on 103 clinical samples and PCR verification partially. The sensitivities of LAMP of S. agalactiae, E. faecalis, G. vaginalis, and C. albicans in tube were 22.0, 76.0, 13.2, 1.11 CFU/μL, respectively, and C. trachomatis was 41.3 copies/μL; on LAMP-microfluidic chip they were 260, 154, 3.9 and 7.53 CFU/μL, respectively, and C. trachomatis was 120 copies/μL. The positive coincidence rates of clinical stains in tube and on chip experiments were 100%. Compared with the classic culture method performed in hospitals, the positive coincidence rate of the 103 clinical samples detected by LAMP-microfluidic chip were 100%. For the six inconsistent ones, including four G. vaginalis and two C. albicans positive samples tested by LAMP-microfluidic chip and verified by PCR were negative by culturing method in hospitals, indicating the lack of efficient detection by the classic culturing method.

Conclusion

Our study suggested that the LAMP-microfluidic chips could simultaneously, efficiently, and accurately detect multiple main pathogens, including S. agalactiae, E. faecalis, G. vaginalis, C. albicans and C. trachomatis, in clinical samples of female RTI to give a great clinical value. Accordingly, this novel method has the potential to provide a valuable reference for female RTI screening and early diagnosis during pregnancy.
Hepatic vein Doppler in critically ill patients: a reflection of central venous pressure or right ventricular systolic function?
Authors: Zhang Hongmin , Liu Ye , Zhang Qing , Wang Xiaoting , Liu Dawei ,   Critical Care Ultrasound Study Group (CCUSG)
Published: October 2022

Background

To explore whether hepatic vein systolic filling fraction (SFF) is associated with central venous pressure (CVP) and right ventricular (RV) systolic function in critically ill patients.

Methods

Adult patients admitted to ICU with echocardiographic examination were retrospectively enrolled. Echocardiographic parameters including hepatic vein systolic velocity (S) and diastolic phase velocity (D) and haemodynamic information at the time of echo examination were collected. RV systolic dysfunction was defined as tricuspid annular plane systolic excursion (TAPSE) < 16 mm. SFF was calculated as S/(S + D).

Results

Two hundred four patients were enrolled in this study among whom 40 patients had a CVP ≤5 mmHg, 110 patients had a CVP 6–9 mmHg and 54 patients had a CVP ≥10 mmHg. The three groups had similar S velocity, D velocity and SFF. No correlation between SFF and CVP was found (r = − 0.046, p = 0.500), but correlation between SFF and TAPSE was noticed (r = 0.468, p < 0.001). The ROC analysis showed that the area under curve (AUC) of SFF for determining CVP ≥10 mmHg was 0.513 (95% CI: 0.420–0.606, p = 0.775), but the AUC of SFF for determining RV systolic dysfunction was 0.759 (95% CI: 0.686–0.833, p < 0.001).

Conclusion

Hepatic vein systolic filling fraction is associated with RV systolic function in critically ill patients and is not associated with CVP.
Coronary artery calcification in patients with advanced chronic kidney disease
Authors: Xiang Xiadan , He Ji , Zhang Wei , He Qiang , Liu Yueming
Published: October 2022

Introduction

Cardiovascular disease (CVD) is associated with higher morbidity and mortality rates in patients with chronic kidney disease (CKD). Studies have shown that vascular calcification is a major predictor of CVD. Vascular calcification in the CKD population is associated with various risk factors, and changes in bone and mineral metabolism have been linked to an increased risk of atherosclerosis. Therefore, we aimed to investigate the correlation between vascular calcification and bone metabolism, which is necessary to improve the survival and prognosis of patients with CKD.

Methods

We included 146 patients with CKD who received coronary artery calcification (CAC) scores at our hospital from May 2017 to November 2018. Spearman rank correlation analysis, Mann–Whitney U test, and Kaplan–Meier method were used to analyze laboratory data and all-cause mortality.

Results

In the 146 patients, chronic glomerulonephritis accounted for the most common cause of CKD, at approximately 39.0%. Spearman rank correlation analysis on the factors influencing vascular calcification in patients with CKD showed that CAC score was significantly and positively correlated with C-reactive protein, N-terminal/midregion osteocalcin (N-MID), N-terminal peptide of type 1 procollagen (P1NP), β-cross-linked C-telopeptide of type 1 collagen (β-CTx), and parathyroid hormone (P = 0.0423, P = 0.0432, P = 0.0235, P = 0.0061, P < 0.0001, respectively). Serum calcium levels were positively correlated with N-MID, P1NP, β-CTx, and iPTH (r = 0.19, r = 0.24, r = 0.21, r = 0.21, respectively), and serum phosphorus levels were positively correlated with N-MID, P1NP, β-CTx, and iPTH (r = 0.50, r = 0.37, r = 0.50, r = 0.55, respectively). However, no difference was found in CVC scores among patients with CKD in different stages and receiving different treatments. In the Kaplan–Meier analysis of all-cause hospitalization and mortality rates, patients with CAC > 400 had a higher risk.

Conclusion

We found that the primary cause of CKD is glomerulonephritis, and the CAC score is positively correlated with inflammatory and bone metabolism markers, with a higher risk of all-cause mortality and cardiovascular hospitalization when the CAC score is greater than 400.
Establishment and evaluation of a CT-based radiomic model for AIDS-associated pulmonary cryptococcosis
Authors: Zhang Zi-xin , Mu Xing-yu , Yu Jing , Guan Chun-shuang , Chen Bu-dong , Xie Ru-Ming
Published: October 2022

Background

Establish a CT-based diagnostic radiomic model for AIDS complicated with pulmonary cryptococcosis and evaluate the diagnostic efficacy of this model.

Methods

This retrospective study enrolled 98 AIDS patients with pulmonary cryptococcosis and 103 AIDS patients with other infections or neoplastic lesions, comprising a total of 699 lesions. Patients were randomly divided into a training group and test group at a ratio of 2.75:1. Features from all lesions, cavity lesions and solid nodule lesions were extracted, and two kinds of radiomic models (6 types) were established. ROC curves were drawn, and the sensitivity and specificity were calculated to compare the SVM model and LR model, radiologists’ empirical diagnoses and the combination of these empirical diagnoses with the radiomic model.

Results

The AUCs of senior radiologist for all lesions and cavity lesions were lower than those of the SVM and LR models. The diagnostic efficacy of primary radiologist was lower than that of both of the other model types. The diagnostic efficacy of the LR model was relatively stable, with the highest diagnostic efficiency of the 3 model/radiologist groups. The AUCs of intermediate radiologist in combination with the LR radiomic model for all lesions, nodular lesions and cavity lesions were 0.88, 0.84, and 0.9, respectively, which were the highest among all models and radiologists.

Conclusions

The CT-based radiomic LR model of AIDS-associated pulmonary cryptococcosis exhibits good diagnostic performance, which was similar to that of senior radiologists and higher than that of the primary radiologist. With the help of a radiomic model, radiologists can achieve improved diagnostic accuracy compared to that when only an empirical diagnosis is used.
An interpretative phenomenological analysis of the experience of couples’ recovery from the psychological symptoms of trauma following traumatic childbirth
Authors: Attard Rosie , Iles Jane , Bristow Florence , Satherley Rose-Marie
Published: October 2022

Globally, a large proportion of birthing mothers, and a to a lesser extent their partners, experience birth trauma each year, and yet access to adequate post-natal trauma support is rarely available. Untreated birth trauma has been shown to negatively impact the family in terms of the parents’ relationship with one another, and long-term negative consequences for the child. Despite a drive towards integrating mental health support into maternity services and a call to provide mental health support for couples rather than solely the birthing mother, there is little research exploring what birthing couples find helpful in recovery from birth trauma. The current research interviewed six couples using an Interpretative Phenomenological Approach in order to explore their understanding of what supported their recovery from birth trauma. Four themes were identified: ‘We need validation’, ‘Feeling paper thin’, ‘This is a system failure’ and ‘Birth trauma is always going to be a part of you’. The data describes an understanding of parents’ feelings of vulnerability and loss of trust in services to provide support following birth trauma. Further, parents’ need for validation and repositioning of control away from healthcare professionals when considering the availability and knowledge of the support options available is discussed. Clinical implications for supporting parents following birth trauma are explored, including an identified need for trauma informed care communication training for all healthcare professionals involved in maternity care, and the requirement for sources of therapeutic support external from the parent dyad in order to maintain the couples’ interpersonal relationship.
Magnitude and its associated factors of teenage pregnancy among antenatal care attendees in Bahir Dar city administration health institutions, northwest, Ethiopia
Authors: Beyene Fentahun Yenealem , Tesfu Azimeraw Arega , Wudineh Kihinetu Gelaye , Wassie Toyiba Hiyaru
Published: October 2022

Background

Worldwide teenage pregnancies develop many devastating complications, both the mother and the neonate like developing anemia, nutritional deficiency, pregnancy induced hypertension, preterm baby, inadequate weight gains and obstructed labor, fistula and sepsis. Reproductive health concerns of adolescents the main emphasis area which increasing international attention in recent years. Therefore, we intended to assess the magnitude and its associated factors of teenage pregnancy in Bahir Dar city administration health institutions, northwest, Ethiopia, 2017.

Methods

A health institution based a cross-sectional study was conducted among pregnant mothers from February 20-March 27, 2017 in Bahir Dar city administration. Five hundred forty-nine participants were selected by face to face interview and medical card review by using systematic random sampling technique every four intervals for each health institution. Bivariate and multivariate data analysis was performed using Statistical Package for the Social Sciences (SPSS) Windows version 21 and level of significance of association was determined at P- value < 0.05.

Result

The study identified 12.2%with (95%CI (9.5, 14.9)) of pregnant women were teenagers. Multivariable logistic regression analysis showed that: [(AOR (95% CI)) rural residency 3.21(1.234, 9.345), age at first marriage < 18 years 9(7.823, 17.571) and not using contraception prior to this pregnancy 5.22(3.243, 11.675)] were significantly associated with teenage pregnancy.

Conclusion

The magnitude of teenage pregnancy was comparable to the 2016 Ethiopian demographic health survey finding. Rural residency, age at first marriage and not using of contraception prior to the current pregnant were significantly associated with teenage pregnancy. As per the findings, awareness creation to the rural population, advocating utilization of contraception, avoid early marriage and put the mindset the effect of teenage pregnancy for those are needed.
Effectiveness of adjunct telephone-based postnatal care on maternal and infant illness in the Greater Accra Region, Ghana: a randomized controlled trial
Authors: Ameme Donne Kofi , Akweongo Patricia , Afari Edwin Andrew , Noora Charles Lwanga , Anthony Richard , Kenu Ernest
Published: October 2022

Introduction

Globally, postnatal care (PNC) is fraught with challenges. Despite high PNC coverages in Ghana’s Greater Accra Region (GAR), maternal and newborn health outcomes are of great concern. In 2017, neonatal and post-neonatal mortality rates in GAR were 19 and 13 per 1000 live births respectively despite PNC coverages of 93% for at least one PNC and 87.5% for PNC within 48 hours post-delivery. Telephone follow-up has been used to improve health outcomes in some settings, however, its usefulness in improving maternal and infant health during the postnatal period is not well known in Ghana. We assessed effectiveness of telephone-based PNC on infant and maternal illness in selected hospitals in GAR.

Methods

An open-label, assessor-blinded, parallel-group, two-arm superiority randomized controlled trial with 1:1 allocation ratio was conducted from September 2020 to March 2021. Mother-baby pairs in intervention arm, in addition to usual PNC, received midwife-led telephone counselling within 48 hours post-discharge plus telephone access to midwife during postnatal period. In control arm, only usual PNC was provided. Descriptive and inferential data analyses were conducted to generate frequencies, relative frequencies, risk ratios and 95% confidence intervals. Primary analysis was by intention-to-treat (ITT), complemented by per-protocol (PP) analysis.

Results

Of 608 mother-baby pairs assessed for eligibility, 400 (65.8%) were enrolled. During 3 months follow-up, proportion of infants who fell ill was 62.5% in intervention arm and 77.5% in control arm (p = 0.001). Maternal illness occurred in 27.5% of intervention and 38.5% of control participants (p = 0.02). Risk of infant illness was 20% less in intervention than control arm in both ITT analysis [RR = 0.8 (95%CI = 0.71–0.92] and PP analysis [RR = 0.8 (95%CI = 0.67–0.89)]. Compared to controls, risk of maternal illness in intervention arm was 30% lower in both ITT [RR = 0.7 (95%CI = 0.54–95.00)] and PP analysis [RR = 0.7 (95%CI = 0.51–0.94)].

Conclusion

Telephone-based PNC significantly reduced risk of maternal and infant illness within first 3 months after delivery. This intervention merits consideration as a tool for adoption and scale up to improve infant and maternal health.

Trial registration

This trial was retrospectively registered with the International Standard Randomized Controlled Trial Number (ISRCTN) Registry with number ISRCTN46905855 on 09/04/2021.
Mechanical strength of antibiotic-loaded PMMA spacers in two-stage revision surgery
Authors: Lunz Andre , Knappe Kevin , Omlor Georg W. , Schonhoff Mareike , Renkawitz Tobias , Jaeger Sebastian
Published: October 2022

Background

Antibiotic-loaded polymethylmethacrylate (PMMA) bone cement spacers provide high local antibiotic concentrations and patient mobility during the interim period of two-stage revision for periprosthetic joint infection (PJI). This study compares mechanical characteristics of six dual antibiotic-loaded bone cement (dALBC) preparations made from three different PMMA bone cements. The study`s main objective was to determine the effect of time and antibiotic concentration on mechanical strength of dALBCs frequently used for spacer fabrication in the setting of two-stage revision for PJI.

Methods

A total of 84 dual antibiotic-loaded bone cement specimens made of either Copal spacem, Copal G + V or Palacos R + G were fabricated. Each specimen contained 0.5 g of gentamicin and either 2 g (low concentration) or 4 g (high concentration) of vancomycin powder per 40 g bone cement. The bending strength was determined at two different timepoints, 24 h and six weeks after spacer fabrication, using the four-point bending test.

Results

Preparations made from Copal G + V showed the highest bending strength after incubation for 24 h with a mean of 57.6 ± 1.2 MPa (low concentration) and 50.4 ± 4.4 MPa (high concentration). After incubation for six weeks the bending strength had decreased in all six preparations and Palacos R + G showed the highest bending strength in the high concentration group (39.4 ± 1.6 MPa). All low concentration preparations showed superior mechanical strength compared to their high concentration (4 g of vancomycin) counterpart. This difference was statistically significant for Copal spacem and Copal G + V (both p < 0.001), but not for Palacos R + G (p = 0.09).

Conclusions

This study suggests that mechanical strength of antibiotic-loaded PMMA bone cement critically decreases even over the short time period of six weeks, which is the recommended interim period in the setting of two-stage revision. This potentially results in an increased risk for PMMA spacer fracture at the end of the interim period and especially in patients with prolonged interim periods. Finally, we conclude that intraoperative addition of 4 g of vancomycin powder per 40 g of gentamicin-premixed Palacos R + G (Group D) is mechanically the preparation of choice if a dual antibiotic-loaded bone cement spacer with high antibiotic concentrations and good stability is warranted. In any case the written and signed informed consent including the off-label use of custom-made antibiotic-loaded PMMA bone cement spacers must be obtained before surgery.
Application of pedicled greater omentum flap tamponade combined with laparoscopic fenestration in diaphragmatic hepatic cyst
Authors: Wu Zujian , Chen Yun , Jin Ye , Liu Changfeng , Liu Yusu , Zhang Bing
Published: October 2022

Objective

To investigate the efficacy and clinical application advantage of omental tamponade with vascular pedicle combined with Laparoscopic fenestration for the treatment of diaphragmatic hepatic cyst.

Methods

A total of 56 patients with diaphragmatic hepatic cysts underwent laparoscopic surgery in a single tertiary academic medical center from January 2010 to October 2020, including 21 patients (non-omental group) underwent laparoscopic fenestration of liver cysts, and 36 patients underwent laparoscopic liver cyst fenestration combined with vascular pedicle omentum tamponade (omental group). The general conditions and follow-up results of the two groups were compared and annalyzed.

Results

The operation time of the omental group was longer than that of the non-omental group (P = 1.358E-4). There was no significant difference in postoperative complications, postoperative laboratory values and hospital costs (P>0.05). The length of hospital stay in omental group was shorter than that in non-omental group (P = 0.034). In the omental group, recurrence occurred in 1 of 35 patients (4.65%) who were followeded up 12 months after surgery. In the non-omental group, of the 21 patients followed, 3 patients (14.28%) recurred 6 months after surgery, and 8 patients (38.10%) recurred 12 months after surgery.

Conclusion

It is an effective method to prevent the recurrence of diaphragmatic hepatic cyst after laparoscopic fenestration by packing the cyst with vascularized omentum.
A fluoroscopic view for midshaft clavicular fracture reduction and internal fixation: posteroanterior 25° skyline projection
Authors: Chen Wentao , Wang Baojun , Liu Zhenyu
Published: October 2022

Background

Open reduction and internal fixation have been frequently applied for displaced midshaft clavicular fracture. Plate and screw fixation of clavicular fractures could provide rigid fixation and rotational control. Proper implant positioning in surgical fixation is critical to prevent iatrogenic complications. Fluoroscopy plays an important role in the intraoperative evaluation of implants. This study aimed to introduce a new fluoroscopic projection to evaluate the positioning of plates and screws.

Methods

Adult patients with a diagnosis of acute displaced midshaft clavicular fracture were included in this study. The slope angle of the midshaft clavicle was measured on sagittal reconstructions of preoperative computed tomography (CT) scans. The incidence of screw revision based on intraoperative standard posteroanterior (PA) and PA 25° cephalic skyline projections was compared. The interobserver agreement for the two projections was calculated.

Results

Twenty-nine patients with midshaft clavicular fractures were enrolled from January 2020 to June 2021. The PA 25° skyline projection could clearly display the tangential line of the plate and inferior border of the clavicle. The slope angle on the superior surface of the midshaft clavicle was 26.0 ± 5.8° (range: 18.5–38.3°). The incidence of screw revision using the PA projection (72.4%) was significantly different from that using the PA 25° skyline projection (34.5%) (P < 0.05). The concordance of the screw revision rate based on the standard PA and PA 25° skyline projections was strong, with kappa coefficients of 0.680 (95% CI: 0.394–0.968) and 0.776 (95% CI: 0.537–0.998).

Conclusion

The PA 25° skyline projection corresponds to the slope angle of the midshaft clavicle. It can provide more accurate information regarding the proper screw length and be applied as a routine method for intraoperative evaluation.
Needs and preferences of women with prior severe preeclampsia regarding app-based cardiovascular health promotion
Authors: Kókai Lili L. , van der Bijl Marte F. , Hagger Martin S. , Ó Ceallaigh Diarmaid T. , Rohde Kirsten I.M. , van Kippersluis Hans , Burdorf Alex , Duvekot Johannes J. , van Lennep Jeanine E. Roeters , Wijtzes Anne I.
Published: October 2022

Background

Women with prior severe preeclampsia are at an increased risk for cardiovascular diseases later in life compared to women who had a normotensive pregnancy. The objective of this study was to assess their needs and preferences regarding app-based cardiovascular health promotion.

Methods

Patients (n = 35) of the Follow-Up PreEClampsia Outpatient Clinic (FUPEC), Erasmus MC, the Netherlands, participated in an anonymous online survey. The main outcomes under study were women’s needs for health behavior promotion, and their preferences with respect to intervention delivery. Descriptive statistics were used to evaluate needs, and thematic analysis was used to analyze preferences.

Results

Women’s primary need for health behavior promotion pertained to their fat and sugar intake and physical activity; for some, to their mental health (practices), fruit and vegetable intake, salt intake, and water intake; and for a few, to their alcohol and tobacco use. Most women preferred an app-based intervention to include, in descending order: the tracking of health-related metrics, an interactive platform, the use of behavior change strategies, the provision of information, and personalization.

Conclusion

Cardiovascular health promotion targeting women with prior severe preeclampsia should feel relevant to its audience. App-based interventions are likely to be well received if they target fat and sugar intake and physical activity. These interventions should preferably track health-related metrics, be interactive, contain behavior change strategies, provide information, and be personalized. Adopting these findings during intervention design could potentially increase uptake, behavior change, and behavior change maintenance in this population.
An exploratory assessment of the impact of a novel risk assessment test on breast cancer clinic waiting times and workflow: a discrete event simulation model
Authors: Smith Alison F. , Frempong Samuel N. , Sharma Nisha , Neal Richard D. , Hick Louise , Shinkins Bethany
Published: October 2022

Background

Breast cancer clinics across the UK have long been struggling to cope with high demand. Novel risk prediction tools – such as the PinPoint test – could help to reduce unnecessary clinic referrals. Using early data on the expected accuracy of the test, we explore the potential impact of PinPoint on: (a) the percentage of patients meeting the two-week referral target, and (b) the number of clinic ‘overspill’ appointments generated (i.e. patients having to return to the clinic to complete their required investigations).

Methods

A simulation model was built to reflect the annual flow of patients through a single UK clinic. Due to current uncertainty around the exact impact of PinPoint testing on standard care, two primary scenarios were assessed. Scenario 1 assumed complete GP adherence to testing, with only non-referred cancerous cases returning for delayed referral. Scenario 2 assumed GPs would overrule 20% of low-risk results, and that 10% of non-referred non-cancerous cases would also return for delayed referral. A range of sensitivity analyses were conducted to explore the impact of key uncertainties on the model results. Service reconfiguration scenarios, removing individual weekly clinics from the clinic schedule, were also explored.

Results

Under standard care, 66.3% (95% CI: 66.0 to 66.5) of patients met the referral target, with 1,685 (1,648 to 1,722) overspill appointments. Under both PinPoint scenarios, > 98% of patients met the referral target, with overspill appointments reduced to between 727 (707 to 746) [Scenario 1] and 886 (861 to 911) [Scenario 2]. The reduced clinic demand was sufficient to allow removal of one weekly low-capacity clinic [N = 10], and the results were robust to sensitivity analyses.

Conclusion

The findings from this early analysis indicate that risk prediction tools could have the potential to alleviate pressure on cancer clinics, and are expected to have increased utility in the wake of heightened pressures resulting from the COVID-19 pandemic. Further research is required to validate these findings with real world evidence; evaluate the broader clinical and economic impact of the test; and to determine outcomes and risks for patients deemed to be low-risk on the PinPoint test and therefore not initially referred.