bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Medical Doctors Global Health and Tropical Medicine on decision-making in caesarean section: a pre- and post-implementation study in a rural hospital in Malawi
Authors: Bakker Wouter , Bakker Emma , Huigens Christiaan , Kaunda Emily , Phiri Timothy , Beltman Jogchum , van Roosmalen Jos , van den Akker Thomas 
Published: November 2020

Abstract

Background
Medical doctors with postgraduate training in Global Health and Tropical Medicine (MDGHTM) from the Netherlands, a high-income country with a relatively low caesarean section rate, assist associate clinicians in low-income countries regarding decision-making during labour. Objective of this study was to assess impact of the presence of MDGHTMs in a rural Malawian hospital on caesarean section rate and indications.

Methods
This retrospective pre- and post-implementation study was conducted in a rural hospital in Malawi, where MDGHTMs were employed from April 2015. Indications for caesarean section were audited against national protocols and defined as supported or unsupported by these protocols. Caesarean section rates and numbers of unsupported indications for the years 2015 and 2016 per quarter for different staff cadres were assessed by linear regression.

Results
Six hundred forty-five women gave birth by caesarean section in the study period. The caesarean rate dropped from 20.1 to 12.8% (p < 0.05, R2 = 0.53, y = − 0.0086x + 0.2295). Overall 132 of 501 (26.3%) auditable indications were not supported by documentation in medical records. The proportion of unsupported indications dropped significantly over time from 47.0 to 4.4% (p < 0.01, R2 = 0.71, y = − 0.0481x + 0.4759). Stratified analysis for associate clinicians only (excluding caesarean sections performed by medical doctors) showed a similar decrease from 48.3 to 6.5% (p < 0.05, R2 = 0.55, y = − 0.0442x + 0.4805).

Conclusions
Our results indicate that presence of MDGHTMs was accompanied by considerable decreases in caesarean section rate and proportion of unsupported indications for caesarean section in this facility. Their presence is likely to have influenced decision-making by associate clinicians.
Position statement and best practice recommendations on the imaging use of ultrasound from the European Society of Radiology ultrasound subcommittee
Authors:   European Society of Radiology (ESR)
Published: November 2020

Abstract
This document summarises best practice recommendations for medical imaging use of ultrasound in Europe, representing the agreed consensus of experts from the Ultrasound Subcommittee of the European Society of Radiology (ESR), the European Union of Medical Specialists (UEMS) Section of Radiology, and the European Federation of Societies for Ultrasound in Medicine and Biology. Recommendations are given for education and training, equipment and its maintenance, documentation, hygiene and infection prevention, and medico-legal issues.
Identification of infrasonic and seismic components of tremors in single-station records: application to the 2013 and 2018 events at Ioto Island, Japan
Authors: Kurokawa Aika K. , Ichihara Mie 
Published: November 2020

AbstractInfrasonic stations are sparse at many volcanoes, especially those on remote islands and those with less frequent eruptions. When only a single infrasound station is available, the seismic–infrasonic cross-correlation method has been used to extract infrasound from wind noise. However, it does not work with intense seismicity and sometimes mistakes ground-to-atmosphere signals as infrasound. This paper proposes a complementary method to identify the seismic component and the infrasonic component using a single microphone and a seismometer. We applied the method to estimate the surface activity on Ioto Island. We focused on volcanic tremors during the phreatic eruption on April 11, 2013, and during an unconfirmed event on September 12, 2018. We used the spectral amplitude ratios of the vertical ground motion to the pressure oscillation and compared those for the tremors with those for known signals generated by volcano-tectonic earthquakes and airplanes flying over the station. We were able to identify the infrasound component in the part of the seismic tremor with the 2013 eruption. On the other hand, the tremor with the unconfirmed 2018 event was accompanied by no apparent infrasound. We interpreted the results that the infrasound with the 2013 event was excited by the vent opening or the ejection of ballistic rocks, and the 2018 event was not an explosive eruption either on the ground or in the shallow water. If there was any gas (and ash) emission, it might have occurred gently undersea. As the method uses the relative values of on-site records instead of the absolute values, it is available even if the instrument sensitivity and the station site effects are poorly calibrated.
Media guidelines for the responsible reporting and depicting of non-suicidal self-injury
Authors: Westers Nicholas J. , Lewis Stephen P. , Whitlock Janis , Schatten Heather T. , Ammerman Brooke , Andover Margaret S. , Lloyd-Richardson Elizabeth E. 
Published: November 2020

SummaryMedia coverage of non-suicidal self-injury (NSSI) ranges from providing helpful education to displaying graphic images. We offer the first research-informed, consensus-based guidelines for the responsible reporting and depicting of NSSI in the media, while also advising on ideas for dissemination and collaboration between media professionals and healthcare experts.
Effects of Photoperiod on Growth, Digestive Enzyme Activity, Stress, and Oxidative Status of Juvenile Chinese Soft-Shelled Turtles (Pelodiscus sinensis) in a Greenhouse
Authors: Li Haijun , Zhao Jian , Ji Baimin , Zhang Yadong , Ye Zhangying , Zhu Songming 
Published: November 2020

HIGHLIGHTSArtificial sunlight with the main components of UVB, UVA, and visible light was used to investigate the influence of photoperiod on large-scale farming of juvenile Chinese soft-shelled turtles in a greenhouse.The effects of photoperiod on digestive enzyme activity, stress, and oxidative status of juvenile Chinese soft-shelled turtles were revealed.The optimal photoperiod for juvenile Chinese soft-shelled turtles reared in a greenhouse was 0 h light:24 h dark.Abstract. To improve light conditions for soft-shelled turtles in a greenhouse, the effects of photoperiod on growth, digestive enzyme activity, stress, and oxidative status of juvenile Chinese soft-shelled turtles were investigated. In this study, juvenile Chinese soft-shelled turtles were reared under three photoperiods (hours light:hours dark), i.e., 0L:24D, 6L:18D, and 12L:12D) for four months. Results demonstrated that differences in growth were insignificant during the experiment, but the growth parameters of final weight, weight gain rate (WGR), and feed conversation ratio (FCR) were better at 0L:24D, and the survival rate was significantly higher at 0L:24D than at 12L:12D. Regarding digestive function, serum trypsin activity was significantly higher at 0L:24D than at 6L:18D, while lipase activity was significantly higher at 0L:24D than at 12L:12D. For the stress response parameters, serum cortisol level was significantly lower in turtles exposed to 0L:24D compared to the other treatments. With regard to antioxidant enzyme activities, the total antioxidant capacity (T-AOC) was significantly lower at 0L:24D compared to the other treatments, while superoxide dismutase (SOD) activity was significantly higher in turtles exposed to 0L:24D. The activity of glutathione peroxidase (GSH-PX) was significantly lower at 0L:24D than at 12L:12D. The malonaldehyde (MDA) activity was a little lower at 0L:24D than at 6L:18D; however, it significantly decreased in turtles exposed to 12L:12D. On the whole, the results indicated that the photoperiod treatments had no significant effects on the growth of juvenile Chinese soft-shelled turtles, while extended light exposure may cause physiological stress in turtles. Considering the survival rate, digestive function, cortisol level, and oxidative status, it is suggested that juvenile soft-shelled turtles should be reared under a 0L:24D photoperiod. Keywords: Chinese soft-shelled turtle, Digestive enzyme activity, Growth, Oxidative status, Photoperiod, Stress.
PCSK9 loss of function is protective against extra-coronary atherosclerotic cardiovascular disease in a large multi-ethnic cohort
Authors: Small Aeron M. , Huffman Jennifer E. , Klarin Derek , Lynch Julie A. , Assimes Themistocles , DuVall Scott , Sun Yan V. , Shere Labiba , Natarajan Pradeep , Gaziano Michael , Rader Daniel J. , Wilson Peter W. F. , Tsao Philip S. , Chang Kyong-Mi , Cho Kelly , O’Donnell Christopher J. , Casas Juan P. , Damrauer Scott M. ,   on behalf of the VA Million Veteran Program
Published: November 2020

BackgroundTherapeutic inhibition of PCSK9 protects against coronary artery disease (CAD) and ischemic stroke (IS). The impact on other diseases remains less well characterized.MethodsWe created a genetic risk score (GRS) forPCSK9using four single nucleotide polymorphisms (SNPs) at or near thePCSK9locus known to impact lower LDL-Cholesterol (LDL-C): rs11583680, rs11591147, rs2479409, and rs11206510. We then used our GRS to calculate weighted odds ratios reflecting the impact of a genetically determined 10 mg/dL decrease in LDL-C on several pre-specified phenotypes including CAD, IS, peripheral artery disease (PAD), abdominal aortic aneurysm (AAA), type 2 diabetes, dementia, chronic obstructive pulmonary disease, and cancer. Finally, we used our weighted GRS to perform a phenome-wide association study.ResultsGenetic and electronic health record data that passed quality control was available in 312,097 individuals, (227,490 White participants, 58,907 Black participants, and 25,700 Hispanic participants).PCSK9mediated reduction in LDL-C was associated with a reduced risk of CAD and AAA in trans-ethnic meta-analysis (CAD OR 0.83 [95% CI 0.80–0.87], p = 6.0 x 10−21; AAA OR 0.76 [95% CI 0.68–0.86], p = 2.9 x 10−06). Significant protective effects were noted for PAD in White individuals (OR 0.83 [95% CI 0.71–0.97], p = 2.3 x 10−04) but not in other genetic ancestries. Genetically reduced PCSK9 function associated with a reduced risk of dementia in trans-ethnic meta-analysis (OR 0.86 [95% CI 0.78–0.93], p = 5.0 x 10−04).ConclusionsGenetically reduced PCSK9 function results in a reduction in risk of several important extra-coronary atherosclerotic phenotypes in addition to known effects on CAD and IS, including PAD and AAA. We also highlight a novel reduction in risk of dementia, supporting a well-recognized vascular component to cognitive impairment and an opportunity for therapeutic repositioning.
Utility of the monocyte to lymphocyte ratio in diagnosing latent tuberculosis among HIV-infected individuals with a negative tuberculosis symptom screen
Authors: Mayito Jonathan , Meya David B. , Rhein Joshua , Sekaggya-Wiltshire Christine 
Published: November 2020

Background
Latent Tuberculosis Infection (LTBI) remains a major driver of the TB epidemic, and individuals with Human Immuno-deficiency Virus (HIV) are particularly at a heightened risk of developing LTBI. However, LTBI screening among HIV-infected individuals in resource limited setting is largely based on a negative symptom screen, which has low specificity.

Methods
In a cross sectional diagnostic study, 115 HIV infected participants with a negative symptom screen will be consented and enrolled. They will be requested to donate 5 ml of blood for complete blood count (CBC) and interferon gamma release assay (IGRA) testing. In a nested prospective study, the 115 participants will be initiated on Tuberculosis Preventive Therapy and the CBC testing repeated after 3 months. In the analysis of study finding, the monocyte to lymphocyte ratio (MLR) will be derived from the dividend of the absolute monocyte and lymphocyte counts. The optimal MLR positivity cut-off for elevated or normal MLR will be the highest value of Youden’s index, J (sensitivity + specificity-1). The MLR will be cross tabulated with the IGRA status to determine the sensitivity, specificity, negative and positive predictive values of the MLR. The area under the receiver operating characteristic (ROC) curve will be determined to give the overall diagnostic accuracy of MLR. The baseline and 3 month CBC will be used to determine the change in MLR, and a random effect logistic regression will be used to determine factors associated with the change in the MLR.

Discussion
If positive results are realized from this study, the MLR could become an inexpensive alternative biomarker with potential to improve the specificity of the negative symptom screen in identifying individuals that should be targeted for TB preventive therapy.
Geographic analysis of latent tuberculosis screening: A health system approach
Authors: Bonnewell John P. , Farrow Laura , Dicks Kristen V. , Cox Gary M. , Stout Jason E. 
Published: November 2020

Background
Novel approaches are required to better focus latent tuberculosis infection (LTBI) efforts in low-prevalence regions. Geographic information systems, used within large health systems, may provide one such approach.

Methods
A retrospective, cross-sectional design was used to integrate US Census and Duke Health System data between January 1, 2010 and October 31, 2017 and examine the relationships between LTBI screening and population tuberculosis risk (assessed using the surrogate measure of proportion of persons born in tuberculosis-endemic regions) by census tract.

Results
The median proportion of Duke patients screened per census tract was 0.01 (range 0–0.1, interquartile range 0.01–0.03). The proportion of Duke patients screened within a census tract significantly but weakly correlated with the population risk. Furthermore, patients residing in census tracts with higher population tuberculosis risk were more likely to be screened with TST than with an IGRA (p<0.001).

Conclusion
The weak correlation between patient proportion screened for LTBI and our surrogate marker of population tuberculosis risk suggests that LTBI screening efforts should be better targeted. This type of geography-based analysis may serve as an easily obtainable benchmark for LTBI screening in health systems with low tuberculosis prevalence.
Do electronic medication monitors improve tuberculosis treatment outcomes? Programmatic experience from China
Authors: Wang Ni , Shewade Hemant Deepak , Thekkur Pruthu , Zhang Hui , Yuan Yanli , Wang Xiaomeng , Wang Xiaolin , Sun Miaomiao , Huang Fei 
Published: November 2020

Background
In China, an indigenously developed electronic medication monitor (EMM) was used. EMM recorded each time the device was opened (no real time data), offering an indirect measure of tuberculosis treatment adherence. Previous study in China showed that the EMM uptake was satisfactory, missing adherence data were common in the information management system (25%) and shift to directly observed therapy (DOT) based on poor adherence documented by EMMs were seldom.

Objectives
Among people with tuberculosis notified in 30 counties (July-December 2018) where EMM supported self-administered therapy (SAT) was suggested to all eligible (no communication impairment, ambulatory), we assessed the relative differences in unfavourable outcomes and deaths among those started on EMM at baseline (within first month of diagnosis) when compared to SAT alone.

Methods
This was a cohort study using secondary data. We employed an intention to treat analysis, and used modified Poisson regression with robust variance estimates to assess the association.

Results
Of 1810 eligible people, 1047 used EMM at baseline and of them, 216 (20.1%) stopped using EMM midway. Of 763 people who did not use EMM at baseline, 267 (35.0%) started using EMM later during the treatment. Among those who started using EMM at baseline, 6.3% [95% CI: 4.9, 8.0] had unfavourable outcomes compared to 6.7% [95% CI: 5.1, 8.8] among those who did not (p = 0.746). Lesser deaths were observed in people who started EMM at baseline when compared to those who did not: 2.5% [95% CI: 1.7, 3.7] versus 3.5% [95% CI: 2.4, 5.2], p = 0.191. The lack of association remained after adjusting for potential confounders (occupation, TB classification and TB category).

Conclusion
Under programmatic settings, we did not find significant differences in the outcomes. Optimization of EMMs by shifting to DOT when indicated, addressing the issue of missing data and ensuring continuous use is required.
A Unique Case of Severe Hematochezia: Ruptured Pseudoaneurysm of the Superior Rectal Artery
Authors: Marusca Georgiana , Yeddi Ahmed , Kiwan Wissam , Al Masalmeh Nada , Newberger Shane , Kakos Roger , Ehrinpreis Murray 
Published: November 2020

ABSTRACT
Visceral artery aneurysms are rare, with an incidence of 0.01%–2% based on autopsy results. Among the visceral arteries, inferior mesenteric artery aneurysms are the rarest. To our knowledge, we report the first case of acute lower gastrointestinal bleeding in a 45-year-old man, arising from a nontraumatic pseudoaneurysm of the superior rectal artery, a branch of the inferior mesenteric artery. Urgent angiography provided the diagnosis and allowed successful hemostatic intervention via endovascular coil embolization. A subsequent routine colonoscopy revealed an ulcer with central yellow-bluish bulge in the distal rectum correlating with the site of the treated pseudoaneurysm.
Трудовая мобильность населения моногородов Свердловской области
Authors: Аникиева Анна Владимировна 
Published: November 2020

Постоянное снижение численности и отток трудоспособного населения — тенденции, которые часто ассоциируются с российскими моногородами. Вместе с тем социально-экономическая ситуация в таких поселениях совсем не одинакова. В статье выделяются типы моногородов в зависимости от направлений трудовой мобильности населения (отток местного населения, приток трудовых ресурсов из других населенных пунктов). Для исследования выбрана Свердловская область — регион, где высокая доля населения проживает в моногородах.
На основе анализа данных Всероссийской переписи населения 2010 г. и Сплошного статистического наблюдения малого и среднего бизнеса 2011 г. предлагается разделить все моногорода Свердловской области на четыре группы в зависимости от особенностей трудовой мобильности их населения. Первую группу составляют моногорода, для которых характерен отток трудовых ресурсов. Вторую группу — города, притягивающие трудовые ресурсы. В третью группу входят моногорода, в которых наблюдается трудовая мобильность в двух направлениях: часть собственного населения работает за пределами города, при этом жители других территорий приезжают в город для работы. Также выявлены моногорода, в которых трудовая мобильность населения не столь интенсивна. Автор приходит к выводу, что сложившееся представление об оттоке трудоспособного населения из моногородов не отражает ситуацию на их рынках труда. Проблема не только в нехватке трудовых ресурсов, но и в их несоответствии требованиям конкретного рынка труда, не принимаются во внимание барьеры для трудовой мобильности населения. Автор рассматривает мобильность в контексте как экономического производства, так и социальной инфраструктуры городов.
Благодарность. Статья подготовлена в рамках проекта «Траектории мобильности трудоспособного населения малых и средних моногородов различного профиля». Проект реализуется при финансовой поддержке Российского фонда фундаментальных исследований (РФФИ), проект № 18-011-00457, 2018—2020 гг.
Космос глазами социологов: астросоциология как новая социологическая дисциплина
Authors: Ходыкин Александр Владимирович 
Published: November 2020

Проблемы освоения космоса исследуются не только техническими и естественными, но и социогуманитарными науками. Комплекс социогуманитарных исследований деятельности по освоению космоса формирует дисциплинарное поле астросоциологии. Автор выделил и проанализировал две концепции астросоциологии: социологическую и междисциплинарную.
Социологическая концепция предполагает интеграцию астросоциологии в корпус социологических дисциплин и описание астросоциальных феноменов на языке социологической теории. Поскольку физические особенности космического пространства задают специфику деятельности по его освоению, в качестве теоретической базы для социологической концептуализации астросоциологии выбрана социология пространства. Автор определяет астросоциологию как относящуюся к социологии пространства отраслевую социологическую дисциплину, которая изучает возникающие в ходе освоения и присвоения космического пространства социальные связи, действия и коллективные представления людей.
Однако в настоящее время наиболее распространена междисциплинарная концепция астросоциологии, подразумевающая, что социогуманитарные проблемы освоения космоса исследуются в комплексе дисциплин: культурологии, философии, социальной антропологии, экономики, права и т.д.
В статье систематизирована дисциплинарная структура астросоциологии. На основании проведенной теоретической работы автор сформулировал проблему, объект, предмет, цель и задачи астросоциологии. Структуру астросоциологии, очерчивающую ее предметное поле, составляет комплекс направлений исследований: организационное или подготовительное, наземно-исследовательское, полетное, колонизационное, конструктивистское и трансформационное. Существующие исследования, а также перспективные темы для будущих исследований систематизированы автором в контексте данных направлений.
Благодарность. Автор выражает благодарность своему научному руководителю, доктору социологических наук профессору В.Б. Звоновскому (СГЭУ, Самара) за всестороннюю поддержку, оказанную в ходе написания данной работы, мудрые советы и конструктивную критику.
Glucose-Sparing Action of Ketones Boosts Functions Exclusive to Glucose in the Brain
Authors: Zilberter Yuri , Zilberter Tanya 
Published: November 2020

AbstractThe ketogenic diet (KD) has been successfully used for a century for treating refractory epilepsy and is currently seen as one of the few viable approaches to the treatment of a plethora of metabolic and neurodegenerative diseases. Empirical evidence notwithstanding, there is still no universal understanding of KD mechanism(s). An important fact is that the brain is capable of using ketone bodies for fuel. Another critical point is that glucose’s functions span beyond its role as an energy substrate, and in most of these functions, glucose is irreplaceable. By acting as a supplementary fuel, ketone bodies may free up glucose for its other crucial and exclusive function. We propose that this glucose-sparing effect of ketone bodies may underlie the effectiveness of KD in epilepsy and major neurodegenerative diseases, which are all characterized by brain glucose hypometabolism.