Strategies That Promote Equity in COVID-19 Vaccine Uptake for Black Communities: a Review

Black communities have had a high burden of COVID-19 cases, hospitalizations, and death, yet rates of COVID-19 vaccine uptake among Blacks lag behind other demographic groups. This has been due in part to vaccine hesitancy and multi-level issues around access to COVID-19 vaccines. Effective strategies to promote vaccine uptake among Black communities are needed. To perform a rapid review covering December 2020–August 2021, our search strategy used PubMed, Google, and print media with a prescribed set of definitions and search terms for two reasons: there were limited peer-reviewed studies during the early period of vaccine roll-out and real-time perspectives were crucially needed. Analyses included expert opinion, descriptions of implemented projects, and project outcomes. The strategies described in these reports largely converged into three categories: (a) addressing mistrust, (b) combatting misinformation, and (c) improving access to COVID-19 vaccines. When working to reduce hesitancy, it is important to consider messaging content, messengers, and location. To address mistrust, reports detailed the importance of communicating through trusted channels, validating the real, history- and experience-based reasons why people may be hesitant to establish common ground, and addressing racism embedded within the healthcare system. To combat misinformation, strategies included dispelling myths and answering questions through town halls and culturally intelligent outreach. Black physicians and clinicians are considered trusted messengers and partnering with community leaders such as pastors can help to reach more people. The settings of vaccination sites should be convenient and trusted such as churches, barbershops, and community sites. While a number of individual and combination efforts have been developed and implemented, data that disentangle components that are the most effective are sparse. This rapid review provides a basis for developing strategic implementation to increase COVID-19 vaccine uptake in this ongoing pandemic and planning to promote health equity for future bio-events and health crises.

Tissue engineered vascular grafts transform into autologous neovessels capable of native function and growth

Background Tissue-engineered vascular grafts (TEVGs) have the potential to advance the surgical management of infants and children requiring congenital heart surgery by creating functional vascular conduits with growth capacity. Methods Herein, we used an integrative computational-experimental approach to elucidate the natural history of neovessel formation in a large animal preclinical model; combining an in vitro accelerated degradation study with mechanical testing, large animal implantation studies with in vivo imaging and histology, and data-informed computational growth and remodeling models. Results Our findings demonstrate that the structural integrity of the polymeric scaffold is lost over the first 26 weeks in vivo, while polymeric fragments persist for up to 52 weeks. Our models predict that early neotissue accumulation is driven primarily by inflammatory processes in response to the implanted polymeric scaffold, but that turnover becomes progressively mechano-mediated as the scaffold degrades. Using a lamb model, we confirm that early neotissue formation results primarily from the foreign body reaction induced by the scaffold, resulting in an early period of dynamic remodeling characterized by transient TEVG narrowing. As the scaffold degrades, mechano-mediated neotissue remodeling becomes dominant around 26 weeks. After the scaffold degrades completely, the resulting neovessel undergoes growth and remodeling that mimicks native vessel behavior, including biological growth capacity, further supported by fluid–structure interaction simulations providing detailed hemodynamic and wall stress information. Conclusions These findings provide insights into TEVG remodeling, and have important implications for clinical use and future development of TEVGs for children with congenital heart disease.

Repenser la subjectivité incarnée. Levinas lecteur de Husserl

This paper intends to analyze the question of the embodied subjectivity in Emmanuel Levinas’s work, starting from a specific point of view: the controversial reception of Husserl’s phenomenology. In the early period of his confrontation with Husserl, Levinas criticizes the excess of theoreticism in transcendental idealism. However, he then seems to discover right inside of it the conditions to bring the philosophical debate out of the limits of knowledge theory. This is when he recognizes the important role played by the body in the husserlian description of the act of sense-giving (Sinngebung). Though, while praising Husserl for his conception of sensibility – as the “Commentaires nouveaux” clearly show – Levinas actually proceeds to an original rethinking of the meaning of incarnation, beyond the purity of the ego, and the supposed “property” of the flesh.

Defoliation Significantly Suppressed Plant Growth Under Low Light Conditions in Two Leguminosae Species

Seedlings in regenerating layer are frequently attacked by herbivorous insects, while the combined effects of defoliation and shading are not fully understood. In the present study, two Leguminosae species (Robinia pseudoacacia and Amorpha fruticosa) were selected to study their responses to combined light and defoliation treatments. In a greenhouse experiment, light treatments (L+, 88% vs L−, 8% full sunlight) and defoliation treatments (CK, without defoliation vs DE, defoliation 50% of the upper crown) were applied at the same time. The seedlings’ physiological and growth traits were determined at 1, 10, 30, and 70 days after the combined treatment. Our results showed that the effects of defoliation on growth and carbon allocation under high light treatments in both species were mainly concentrated in the early stage (days 1–10). R. pseudoacacia can achieve growth recovery within 10 days after defoliation, while A. fruticosa needs 30 days. Seedlings increased SLA and total chlorophyll concentration to improve light capture efficiency under low light treatments in both species, at the expense of reduced leaf thickness and leaf lignin concentration. The negative effects of defoliation treatment on plant growth and non-structural carbohydrates (NSCs) concentration in low light treatment were significantly higher than that in high light treatment after recovery for 70 days in R. pseudoacacia, suggesting sufficient production of carbohydrate would be crucial for seedling growth after defoliation. Plant growth was more sensitive to defoliation and low light stress than photosynthesis, resulting in NSCs accumulating during the early period of treatment. These results illustrated that although seedlings could adjust their resource allocation strategy and carbon dynamics in response to combined defoliation and light treatments, individuals grown in low light conditions will be more suppressed by defoliation. Our results indicate that we should pay more attention to understory seedlings’ regeneration under the pressure of herbivorous insects.

Reconsidering Ventriculoperitoneal Shunt Surgery and Postoperative Shunt Valve Pressure Adjustment: Our Approaches Learned From Past Challenges and Failures

Treatment for idiopathic normal pressure hydrocephalus (iNPH) continues to develop. Although ventriculoperitoneal shunt surgery has a long history and is one of the most established neurosurgeries, in the 1970s, the improvement rate of iNPH triad symptoms was poor and the risks related to shunt implantation were high. This led experts to question the surgical indication for iNPH and, over the next 20 years, cerebrospinal fluid (CSF) shunt surgery for iNPH fell out of favor and was rarely performed. However, the development of programmable-pressure shunt valve devices has reduced the major complications associated with the CSF drainage volume and appears to have increased shunt effectiveness. In addition, the development of support devices for the placement of ventricular catheters including preoperative virtual simulation and navigation systems has increased the certainty of ventriculoperitoneal shunt surgery. Secure shunt implantation is the most important prognostic indicator, but ensuring optimal initial valve pressure is also important. Since over-drainage is most likely to occur in the month after shunting, it is generally believed that a high initial setting of shunt valve pressure is the safest option. However, this does not always result in sufficient improvement of the symptoms in the early period after shunting. In fact, evidence suggests that setting the optimal valve pressure early after shunting may cause symptoms to improve earlier. This leads to improved quality of life and better long-term independent living expectations. However, in iNPH patients, the remaining symptoms may worsen again after several years, even when there is initial improvement due to setting the optimal valve pressure early after shunting. Because of the possibility of insufficient CSF drainage, the valve pressure should be reduced by one step (2–4 cmH2O) after 6 months to a year after shunting to maximize symptom improvement. After the valve pressure is reduced, a head CT scan is advised a month later.

Identification of Survival-Associated Hub Genes in Pancreatic Adenocarcinoma Based on WGCNA

Pancreatic adenocarcinoma is one of the leading causes of cancer-related death worldwide. Since little clinical symptoms were shown in the early period of pancreatic adenocarcinoma, most patients were found to carry metastases when diagnosis. The lack of effective diagnosis biomarkers and therapeutic targets makes pancreatic adenocarcinoma difficult to screen and cure. The fundamental problem is we know very little about the regulatory mechanisms during carcinogenesis. Here, we employed weighted gene co-expression network analysis (WGCNA) to build gene interaction network using expression profile of pancreatic adenocarcinoma from The Cancer Genome Atlas (TCGA). STRING was used for the construction and visualization of biological networks. A total of 22 modules were detected in the network, among which yellow and pink modules showed the most significant associations with pancreatic adenocarcinoma. Dozens of new genes including PKMYT1, WDHD1, ASF1B, and RAD18 were identified. Further survival analysis yielded their valuable effects on the diagnosis and treatment of pancreatic adenocarcinoma. Our study pioneered network-based algorithm in the application of tumor etiology and discovered several promising regulators for pancreatic adenocarcinoma detection and therapy.

Comparative Evaluation of Vibratory Physiotherapy Methods in the Early Period after Cardiac Surgery

Postoperative respiratory complications in patients undergoing cardiac surgery occur in 20‒30% cases, and the most of them can be associated with ineffective cough and bronchial mucus evacuation.The objective. Comparative assessment of effectiveness and safety of methods for stimulating the evacuation of bronchial secretions using oscillatory PEP-therapy (Acapella Duet), oscillatory chest compression insufflator-aspirator “Comfort Cough Plus”, and the traditional method of manual chest percussion in the early period after cardiac surgery.Subjects and Methods. The prospective study included 120 cardiac surgery patients. They were divided into 3 groups (40 in each), depending on the type of the applied respiratory procedure. Distribution into groups was carried out by random selection. All procedures were performed 10‒12 hours after tracheal extubation. Before the procedure and 20 minutes after it, the efficiency of sputum discharge was assessed, gas exchange indices on room air breathing and maximum inspiratory lung capacity (MILC) were measured.Results. Ineffective bronchial mucus evacuating in the early period after tracheal extubation was observed in 86.7% of the patients. A single procedure of both PEP-therapy (Group 1) and mechanical cough stimulation (Group 2) led to improved sputum passage, as evidenced by an increase in the number of patients with productive cough by 4.25 times (p < 0.0009) and 5.3 times (p < 0.0007), respectively. In patients of Groups 1 and 2, an increase in MILC was observed (by 42.2% and 60.0%, respectively, p = 0.000001), the difference between the groups was statistically significant. In Control Group 3, with manual physiotherapy, the average increase in MILC was only 11.6%. Mechanical respiratory therapy procedures led to significant improvement in gas exchange variables, as evidenced by an increase in SpO2 in Groups 1 and 2 (p = 0.000009 and 0.000001, respectively) and a decrease in the proportion of patients with impaired oxygenating lung function (SpO2 below 92%) by 11 and 12 times, respectively (p < 0.01). The most significant changes were revealed in case of mechanical stimulation with aspirator-insufflator due to combination of two methods (oscillatory chest compression and lung inflation). In Control Group, no significant changes of gas exchange variables were observed.Conclusion: Mechanical vibratory methods for stimulating the bronchial secretion evacuation have significant advantages over classical manual chest massage in patients after cardiac surgery. Their positive effect on sputum passage, ventilatory parameters and gas exchange was noted, and the most pronounced effect was observed after oscillatory chest compression with insufflator-aspirator. The procedures were well tolerated and there were no complications associated with them.

Communicating to Tourists During and Post-Covid-19: What Do They Want (Need) to Hear?

Swiss tourism relies heavily on international clientele to book rooms and purchase goods and services. However, from March to June 2020, due to the COVID-19 pandemic, travel and subsequent bookings slowed and, in some cases, stopped altogether. Based predominantly on Situational Crisis Communication Theory (SCCT), this paper investigates Swiss hotels’ messages on their official Facebook pages and the SCCT strategies they employed during this crisis. The findings from 48 independent four- and five-star hotels show that the Victimage strategy was the most often employed when communicating about the COVID-19 pandemic in general. Further, most hotels published positive messages during this period (68%) and strongly emphasized their roles as victims at this time. Only 5% of the messages posted were negative messages. Hotels ‘blamed’ the government and the sanitary measures for their closing or reduced services. The findings presented here contribute to the literature by offering a pattern of crisis responses from Swiss hotels in the early period of the pandemic. These results are currently being updated with the messages communicated in the 12 months since the beginning of this study. The findings of this crisis communication during an early stage of the pandemic will be used to make concrete recommendations for the strategies that should be implemented in the future if the COVID-19 crisis continues or when faced with other crises.

Literature review: Effects of Katuk Leaf (Sauropus androgynus L. Merr) on Breast Milk Increase

Breast milk is considered the best form of nutrition for neonates and infants. The properties of breast milk facilitate the transition of life from in utero to ex utero. Breast milk provides a variety of bioactive substances for the developing baby during the early period of brain, immune and gut development. Katuk leaves (Sauropus androgni) are found very abundantly in Indonesia. People use S. androgyny as a traditional herbal medicine and are believed to have it to increase breast milk production. There are many publications that show the effect of lactagogum (an agent to increase milk production) of this plant. In several studies conducted there is evidence that the role of phytosterols and papaverine are two components that can increase the hormones prolactin and oxytocin. Scientific sources were obtained from Google Scholar and Pubmed in the form of textbooks and scientific journals totaling 24 units. Giving the extract resulted in a smoother circulation of the oxytocin hormone. The purpose of this literature review is to discuss the effect of S. androgynus which is believed to have a beneficial effect on breast milk production in and can be an agent of breast milk production in future research subjects.